First-Aid is the assistance given to a person suffering from sudden illness or injury, with care to preserved life, prevent the condition from worsening and promote recovery. It includes initial interventions in a serious condition prior to professional medical help being available. Interventions include performing CPR(Cardiopulmonary resuscitation) while awaiting an ambulance and complete treatments for minor conditions such as applying a plaster to a cut.

First-Aid is generally performed by the lay person with many people trained in providing basic levels of First-Aid and others willing to do so from acquired knowledge.

Mental Health is an extension of the concept of first aid to cover mental health.

Aims of first aid.

The key aims of first aid are;

  1. Preserve life: The aim of all medical care which include first aid it to save life and minimize deaths.
  2. Prevent further harm. This is also called prevent condition from worsening or danger from further injury. This covers external factors such as moving away from the cause of harm and applying pressure to stop bleeding from becoming dangerous.
  3. Promote recovery. First-Aid also require trying to start the recovery process from the illness or injury and in some cases it might invoke completing a treatment such as applying plaster to a small wound.

Certain skills are considered essential to provision of First-Aid. Particularly the ABC (Airway, Breathing, Circulation.) which focuses on critical lifesaving.

Specific disciplines.

There are several types of first Aid and First-Aider which may require specific additional training. These are usually undertaken to fulfill the demands of the work or activity undertaken.

  1. Aquatic/marine first aid. This is usually practiced by professional such as lifeguards. Professional marine, or in a diver rescue and covers a specific problems which may be faced after water based rescue.
  2. Battlefield first aid. It takes into account the specific need of treating wounded combatants and non-combatants (person or nation engaged in fighting war.) during armed conflict.
  3. Oxygen first aid. This is the provision of First-Aid under conditions where the arrival of emergency responders or the evacuation of the injured person may be delayed due to constraints of terrain, weather, and available persons or equipment. It may be necessarily to care for a person for several hours.
  4. Mental health first aid. It is taught independently of physical first aid on how to support someone experiencing mental health problems or in a crisis situation. It also involves how to identify the first signs of someone developing mental ill health and guides a person to appropriate help.


The internationally accepted symbol for first aid is the white cross on a green background.

Conditions that require first Aid.

  1. Altitude sickness. It may begin in a susceptible people at altitude as low as 5000 can cause potentially fatal.
  2. Anaphylaxis. This is a life threatening condition in which the airway can become constricted and the patient may go into shock. This reaction may be caused by allergic reactions to allergens such as insect bites. It is treated with injections of epinephrine.
  3. Battlefield. It refers to treating gunshots, burns, bone fracture.
  4. Cardiac Arrest. This may lead to death unless a CPR is started within minutes. There is no time to wait for the emergency services to arrive as 92% of people die before reaching the hospital.
  5. Chocking. This is blockage of airway which can result to death due to lack of oxygen if the patients trachea is not cleared. For example by Heimlich maneuver.
  6. Childbirth.
  • This occurs due to accumulation of lactic acid in muscles caused by either inadequate oxygenation of muscles or lack of water or salt.

Road accidents, drowning or asphyxiation.

Heat stroke(hypothermia)

Heavy bleeding

Hyperglycemia and hypoglycemia.

  • Insects and animal bites.
  • Joint dislocation
  • Poisoning


  • Temporary loss of blood in the brain.


First-Aid kit.

Many accidents can happen at home, office, school, laboratories, which require immediate attention before the patient is attend to by a doctor.

Contents of first aid.

First-Aid manual, adhesive tape, adhesive bandage, elastic bandages, a splint, antiseptic wipes, soap, antibiotic ointment, antiseptic solution (hydrogen peroxide), acetaminophen and ibuprofen, extra prescribed medication, tweezers, sharp scissors, safety pins, disposable instant cold PP, calming lotion, alcohol wipes, thermometer, tooth preservation kit, plastic and nonlatex gloves, flashlight and extra batteries, thermal shock blanket, First-Aid card (contains emergency personal information, phone number, medication, manual)

First aid is the initial assistance or treatment given to a person who is injured or suddenly becomes ill. The person who provides this help may be a first aider, a first responder, a policeman or fireman, or a paramedic or EMT. This chapter prepares you for being a first aider, psychologically and emotionally, as well as giving practical advice on what you should and should not do in an emergency situation.

The information given throughout this book will help you give effective first aid to any casualty in any situation. However, to become a fully competent first aider, you should complete a recognized first aid course and receive certification. This will also strengthen your skills and increase your confidence. The American Red Cross and the American Heart Association teach a variety of first aid courses, at different educational levels.

Aims and objectives

  • To understand your own abilities and limitations.
  • To stay safe and calm at all times.
  • To assess a situation quickly and calmly and summon the appropriate help if necessary.
  • To assist the casualty and provide the necessary treatment, with the help of others if possible.
  • To pass on relevant information to the emergency services, or to the person who takes responsibility for the casualty.
  • To be aware of your own needs.


First aid refers to the actions taken in response to someone who is injured or has suddenly become ill. A first aider is a person who takes action while taking care to keep everyone involved safe (p.28) and to cause no further harm while doing so. Follow the actions that most benefit the casualty, taking into account your own skills, knowledge, and experience, using the guidelines set out in this book.

This chapter prepares you for the role of first aider by providing guidance on responding to a first aid situation and assessing the priorities for the casualty. There is advice on the psychological aspect of giving first aid and practical guidance on how to protect yourself and the casualty.

One of the primary rules of first aid is to ensure that an area is safe for you before you approach a casualty (p.28). Do not attempt heroic rescues in hazardous circumstances.

If you put yourself at risk, you are unlikely to be able to help casualties and could become one yourself and cause harm to others. If it is not safe, do not approach the casualty, but call 911 for emergency help.


Assessing an incident

When you come across an incident stay calm and support the casualty. Ask him what has happened. Try not to move the casualty; if possible, treat him in the position you find him.

  • Assess a situation quickly and calmly.
  • Protect yourself and any casualties from danger—never put yourself at risk (p.28).
  • Prevent cross-contamination between yourself and the casualty as best as possible (p.16).
  • Comfort and reassure casualties.
  • Assess the casualty: identify, as best as you can, the injury or nature of illness affecting a casualty (pp.38–53).
  • Give early treatment, and treat the casualties with the most serious (life-threatening) conditions first.
  • Arrange for appropriate help: call 911 for emergency help if you suspect seriousinjury or illness; take or send the casualty tothe hospital; transfer him into the care of ahealthcare professional, or to a higher levelof medical care. Stay with a casualty untilcare is available.


When responding to an emergency you should recognize the emotional and physical needs of all involved, including your own. You should look after your own psychological health and be able to recognize stress if it develops (pp.24–25).

A calm, considerate response from you that engenders trust and respect from those around you is fundamental to your being able to give or receive information from a casualty or witnesses effectively. This includes being aware of, and managing, your reactions, so that you can focus on the casualty and make an assessment. By talking to a casualty in a kind, considerate, gentle but firm manner, you will inspire confidence in your actions and this will generate trust between you and the casualty.

Without this confidence he may not tell you about an important event, injury, or symptom, and may remain in a highly distressed state.

The actions described in this chapter aim to help you facilitate this trust, minimize distress, and provide support to promote the casualty’s ability to cope and recover. The key steps to being an effective first aider are:

  • Be calm in your approach
  • Be aware of risks (to yourself and others)
  • Build and maintain trust (from the casualty and the bystanders)
  • Give early treatment, treating the most serious (life-threatening) conditions first
  • Call appropriate help
  • Remember your own needs

Be calm

It is important to be calm in your approach to providing first aid. Consider what situations might challenge you, and how you would deal with them. In order to convey confidence to others and encourage them to trust you, you need to control your own emotions and reactions.

People often fear the unknown. Becoming more familiar with first aid priorities and the key techniques in this book can help you feel more comfortable. By identifying your fears in advance, you can take steps to overcome them. Learn as much as you can, for example, by enrolling in a first aid course, asking others. how they dealt with similar situations, or talking your fears through with a person you trust.

Stay in control

In an emergency situation, the body responds by releasing hormones that may cause a “fight, flight, or freeze” response. When this happens, your heart beats faster, your breathing quickens, and you may sweat more. You may also feel more alert, want to run away or feel frozen to the spot.

If you feel overwhelmed and slightly panicky, you may feel pressured to do something before you are clear about what is needed. Pause and take a few slow breaths. Consider who else might help you feel calmer, and remind yourself of the first aid priorities (opposite). If you still feel overwhelmed, take another breath and tell yourself to be calmer. When you are calm, you will be better able to think more clearly and plan your response.

The thoughts you have are linked to the way you behave and the way you feel. If you think that you cannot cope, you will have more trouble determining what to do and will feel more anxious: more ready to fight, flee, or freeze. If you know how to calm yourself, you will be better able to deal with anxiety and help the casualty.

When you give first aid, it is important to protect yourself (and the casualty) from infection as well as injury. Take steps to avoid cross-contamination—transmitting germs or infection to a casualty or contracting infection from a casualty. Remember, infection is a risk even with relatively minor injuries. It is a particular concern if you are treating a wound, because blood-borne viruses, such as hepatitis B or C and Human Immunodeficiency Virus (HIV), may be transmitted by contact with blood. In practice, the risk is low and should not deter you from carrying out first aid. The risk increases if an infected person’s blood makes contact with yours through a cut or scrape.

Usually, taking measures such as washing your hands and wearing disposable gloves will provide sufficient protection for you and the casualty. There is no known evidence of these blood-borne viruses being transmitted during resuscitation. If a face shield or pocket mask is available, it should be used when you give rescue breaths (pp.68–69 and pp.78–79).

Take care not to prick yourself with any needle found on or near a casualty, or cut yourself on glass. If you accidentally prick or cut your skin, or splash your eye, wash the area thoroughly and seek medical help immediately. If you are providing first aid on a regular basis, it is advisable to seek guidance on additional personal protection, such as immunization. If you think you have been exposed to an infection while giving first aid, seek medical advice as soon as possible.


Minimizing the risk of cross

  • Do wash your hands and wear latex-free disposable gloves (in case you or the casualty are allergic to latex). If gloves are not available, ask the casualty to dress his or her own wound, or enclose your hands in clean plastic bags.
  • Do cover cuts and scrapes on your hands with waterproof dressings.
  • Do wear a plastic apron if dealing with large quantities of body fluids, and wear glasses or goggles to protect your eyes.
  • Do dispose of all waste safely (p.18).
  • Do not touch a wound or any part of a dressing that will come into contact with a wound with your bare hands.
  • Do not breathe, cough, or sneeze over a wound while you are treating a casualty.


Take care not to prick yourself with any needle found on or near a casualty, or cut yourself on glass. If you accidentally prick or cut your skin, or splash your eye, wash the area thoroughly and seek medical help immediately. If you are providing first aid on a regular basis, it is advisable to seek guidance on additional personal protection, such as immunization. If you think you have been exposed to an infection while giving first aid, seek medical advice as soon as possible.


If you can, wash your hands before you touch a casualty, but if this is not possible, wash them as soon as possible afterward. For a thorough wash, pay attention to all parts of the hands— palms, wrists, fingers and thumbs, and fingernails. Use soap and water if available, or rub your hands with alcohol gel.


  1. Wet your hands under running water. Put some soap into the palm of a cupped hand. Rub the palms of your hands together.
  2. Rub the palm of your left hand against the back of your right hand, then rub the right palm on the back of your left hand.
  3. Interlock the fingers of both hands and work the soap between them.
  4. Rub the back of the fingers of your right hand against the palm of your left hand, then repeat with your left hand in your right palm.
  5. Rub your right thumb in the palm of your left hand, then your left thumb in the right palm.
  6. Rub the fingertips of your left hand in the palm of your right hand and vice versa. Rinse thoroughly, then pat dry with a disposable paper towel.


In addition to hand washing, gloves give added protection against infection in a first aid situation.

If possible, carry protective, disposable, latex-free gloves with you at all times. Wear them whenever there is a likelihood of contact with blood or other body fluids. If in doubt, wear them anyway.

Disposable gloves should be used to treat only one casualty. Put them on just before you approach a casualty and remove them as soon as the treatment is completed and before you do anything else.

When taking off the gloves, hold the top edge of one glove with your other gloved hand and peel it off so that it is inside out. Repeat with the other hand without touching the outside of the gloves.

Dispose of them in a biohazard bag (below).

Ideally, wash your hands before putting on the gloves.

Hold one glove by the top and pull it on. Do not touch the main part of the glove with your fingers.

Pick up the second glove with the gloved hand. With your fingers under the top edge, pull it onto your hand. Your gloved fingers should not touch your skin.

Always use latex-free gloves. Some people have a serious allergy to latex, and this may cause anaphylactic shock (p.223). Nitrile gloves (often blue or purple) are recommended.



Once you have treated a casualty, all soiled material must be disposed of carefully to prevent the spread of infection.

Place items such as dressings or gloves in a plastic bag—ideally a biohazard bag—and give it to the emergency services. Seal the bag tightly and label it to show that it contains clinical waste. Put sharp objects, including needles, in a plastic container known as a sharps container, which is usually red. If no sharps container is available, put used needles in a jar with a screw top and give it to the EMT for disposal.


Casualties are often frightened because of what is happening to them, and what may happen next. Your role is to stay calm and take charge of the situation—but be ready to stand back if there is someone better qualified. If there is more than one casualty, use the primary survey (pp.44–45) to identify the most seriously injured casualties and treat in the order of priority.


Consider the age and appearance of your casualty when you talk to him, since different people need different responses. Respect people’s wishes; accept that someone might want to be treated in a particular way.

Communication can be difficult if a person speaks a different language or cannot hear you. Use simple language or signs or write questions down. Ask if anyone speaks the same language as the casualty or knows the person or saw the incident and can describe what happened.


Establish trust with your casualty by introducing yourself. Find out what the person likes to be called, and use his name when you talk to him. Crouch or kneel down so that you are at the same height as the casualty. Explain what is happening and why. You will inspire trust if you say what you are doing before you do it. Treat the casualty with dignity and respect at all times. If possible, give him choices, for example, whether he would prefer to sit or lie down and/or who he would like to have with him. Also, if possible, gain his consent before you treat him by asking if he agrees with whatever you are going to do.

Reassure the casualty

When treating a casualty, remain calm and do not do anything without explanation. Try to answer any questions he may have honestly.


You will need to use simpler, shorter words when talking to children. If possible, make sure a child’s parents or caregivers are with him, and keep them involved at all times.

It is important to establish the caregiver’s trust as well as the child’s.

Talk first to the parent/caregiver and get his or her permission to continue to treat the child. Once the parent/ caregiver trusts you, the child will also feel more confident.


Use your eyes and ears to be aware of how a casualty responds. Listen by showing verbal and nonverbal listening skills.

  • Make eye contact, but look away now and then so as not to stare.
  • Use a calm, confident voice that is loud enough to be heard but do not shout.
  • Do not speak too quickly.
  • Keep instructions simple: use short sentences and simple words.
  • Use affirming nods and “mmms” to show you are listening when the casualty speaks.
  • Check that the casualty understands what you mean—ask to make sure.
  • Use simple hand gestures and movements.
  • Do not interrupt the casualty, but always acknowledge what you are told; for example, summarize what a casualty has told you to show that you understand.


If someone is ill or injured he may be upset, confused, tearful, angry, and/or anxious to get away. Be sensitive to a casualty’s feelings; let him know that his reactions are understandable.

Also accept that you may not be able to help,or might even be seen as a threat. Stay at a safe distance until you have gained the person’s consent to move closer, so that he does not feel crowded. Do not argue or disagree. A casualty may refuse help, for example because he is suffering from a head injury or hypothermia. If you think a person needs something other than what he asks for, explain why. For example, you could say, “I think someone should look at where you’re hurt before you move, in case moving makes it worse.” If someone still refuses your help and you think he needs urgent medical attention, call 911 for emergency help.

A casualty has the right to refuse help, even if it causes further harm. Tell the dispatcher that you have offered first aid and have been refused. If you are worried that a person’s condition is deteriorating, observe from a distance until help arrives.

When treating a casualty

When treating a casualty, always relate to him calmly and thoughtfully to maintain trust. Think about how he might be feeling. Check that you have understood what the casualty said and consider the impact of your actions, for example, is the casualty becoming more (or less) upset, angry, and tense? A change in emotional state can indicate that a condition is worsening.

Be prepared to change your manner, depending on what a person feels comfortable with; for example, ask fewer questions or talk about something else. Keep a casualty updated and give him options rather than telling him what to do. Ask the casualty about his next-of kin or friends who can help, and help him make contact with them. Ask if you can help make arrangements so that any responsibilities the casualty may have can be taken care of.

Stay with the casualty. Do not leave someone who may be dying, seriously ill, or badly injured alone except to go to call for emergency help.

Talk to the casualty while touching his shoulderor arm, or holding a hand. Never allow a casualty to feel alone.


In an emergency situation you may be faced with several tasks at once: to maintain safety, to call for help, and to start giving first aid. Some of the people at the scene may be able to help. you do the following:

  • Make the area safe; for example, control traffic and keep onlookers away.
  • Call 911 for emergency help (p.23).
  • Obtain first aid equipment, for example an AED (automated external defibrillator).
  • Control bleeding with direct pressure, or support an injured limb.
  • Help maintain the casualty’s privacy by holding a blanket around the scene and encouraging onlookers to move away.
  • Transport the casualty to a safe place if his life is in immediate danger, only if it is safer to move him than to leave him where he is, and you have the necessary help and equipment (p.234).

The reactions of bystanders may cause you concern or anger. They may have had no first aid training and feel helpless or frightened themselves. If they have seen or been involved in the incident, they too may be injured and distressed. Bear this in mind if you need to ask a bystander to help you. Talk to people in a firm but gentle manner. By staying calm yourself, you will gain their trust and help them remain calm too.


Make sure the casualty’s belongings are with him at all times. If you have to search belongings for identification or clues to a person’s condition (medication, for example), do so in front of a reliable witness. If possible, ask the casualty’s permission before you do this. Afterward, ensure that all of the clothing and personal belongings and medication accompany the casualty to the hospital or are handed over to the police.


As you gather information about a casualty, write it down so that you can refer to it later.

A written record of the timing of events is particularly valuable to medical personnel.

Note, for example, the length of a period of unconsciousness, the duration of a seizure, the time of any changes in the casualty’s condition, and the time of any intervention or treatment. Hand your notes to the emergency services when they arrive, or give them to the casualty. Useful information to provide includes:

  • Casualty’s details, including his name, age and contact details
  • History of the incident or illness
  • Brief description of any injuries
  • Unusual behavior, or a change in behavior
  • Treatment—where given and when
  • Vital signs—level of response, breathing rate, and pulse (pp.52–53), if the first aider is trained
  • Medical history
  • Medication the casualty has taken, with details of the amounts taken and when
  • Next-of-kin contact details
  • Your contact details as well as the date, time, and place of your involvement

Remember that any information you gather is confidential. Never share it with anyone not involved in the casualty’s care without his agreement. Let the casualty know why you are recording information and who you will give it to. When you are asking for such information, be sensitive to who is around and of the casualty’s privacy and dignity.


Further help is available from a range of sources. If help is needed, you must decide both on the type of help and how to access it. First, carry out a primary survey (pp.44–45) to ascertain the severity of the casualty’s condition. If it is not serious, explain the options and allow him to choose where to go. If a casualty’s condition is serious, seek emergency help. Throughout the book there are guidelines for choosing the appropriate level of help.

Call 911 for emergency help if the casualty needs urgent medical attention and should be transported to the hospital in an ambulance, for example, when you suspect a heart attack.

Take or send the casualty to a hospital.

Choose this option when a casualty needs hospital treatment, but his condition is unlikely to worsen; for example, with a finger injury. You can take him yourself if you can arrange transportation—either in your own car or in a taxi.

Seek medical advice. Depending on what is available in his area, the casualty should be advised to call his own physician or nurse practitioner. He would do this, for example, when he has symptoms such as earache or diarrhea.


You can call for help from:

  • Emergency services, including police, fire and ambulance services, by calling 911
  • Utilities, including gas, electricity or water—the phone number will be in the telephone directory
  • Health services, including doctor, dentist, and hospital—this varies in different areas. The phone numbers will be in the telephone directory

Calls to the emergency services are free from any phone, including cell phones. On some roadways, emergency phones have been placed at regular intervals to enable people to call for help. To summon help using these telephones, pick up the receiver and your call will be answered. However, the density of these phones can vary widely by state and area. You may do better with a cell phone than these highway phones.

Keep time away from the casualty to a minimum. Ideally, tell someone else to make the call for you while you stay with the casualty.

Ask the person to confirm that the call has been made and that help is on the way. If you have to leave a casualty to call for help, first take any necessary vital action (primary survey pp.44–45).


When you dial 911, you will be asked which service you require. If there are casualties, ask for the ambulance service (EMS); the dispatcher will alert other services if they are required.

Always remain on the telephone and let the dispatcher hang up first, because you may be given important information about what to do for the casualty while you wait, and/or asked for further information as the situation develops. If someone else makes the call, make sure that he is aware of the importance of his call and that he reports back to you after making the call.


State your name clearly and say that you are acting in your capacity as a first aider. It is essential to provide the following:

  • Your telephone number and/or the number you are calling from.
  • The exact location of the incident; give a road name or number. It can also be helpful to mention any intersections or other landmarks in the area. In many cases your call can be traced if you are unsure of your exact location. If you are on a highway, say in which direction the vehicles were traveling.
  • The type and gravity of the emergency. For example, “Traffic accident, two cars, road blocked, three people trapped.”
  • Number, gender, and age of casualties. For example, “One man, early sixties, breathing difficulties, suspected heart attack.”
  • Details of any hazards, such as gas, toxic substances, power-line damage, or adverse weather conditions, such as fog or ice.


Once the emergency services arrive, they will take over the care of the casualty. Tell them what has happened and any treatment given. Hand over any notes you made while attending the casualty. You may be asked to continue helping, for example, by assisting relatives or friends of the casualty while the paramedics provide emergency care.

You should also follow instructions given to you by the medical team. Remain until you are told you can go, since they may need to ask you more questions or the police may want to speak to you. Help maintain a clear and clean environment and preserve the dignity and confidentiality of those involved.

You may be asked to contact a relative.

Explain as simply and honestly as you can what has happenened and where the casualty has been taken. Do not be vague or exaggerate because this may cause unnecessary alarm.

It is better to admit ignorance than to give someone misleading information

However, the information you give may cause distress; if so, remain calm and be clear about what to do next.


In first aid, administering medication is largely confined to relieving general aches and pains.

It usually involves helping a casualty take his own medicines.

A variety of medications can be bought without a doctor’s prescription. However, you must not buy or borrow medication to administer to a casualty, or give your own.

If you advise the casualty to take any medication other than that stipulated in this manual, he may be put at risk and you could face legal action as a consequence. Whenever a casualty takes medication, it is essential to make sure that:

  • It is for the condition
  • It is not out of date
  • It is taken as advised
  • Any precautions are strictly followed
  • The recommended dose is not exceeded
  • You keep a record of the name and dose of the medication as well as the time and method of administration


Most people who learn first aid gain significantly from doing so. In addition to learning new skills and meeting new people, by learning first aid you can make a real difference in peoples’ lives. Being able to help people who are ill or injured often results in a range of positive feelings. However, you may also feel stressed when you are called upon to administer first aid, and feel emotional once you have finished treating a casualty, whatever the outcome. Occasionally, that stress can interfere with your physical and mental well-being after an incident. Everyone responds to stressful situations in different ways, and some people are more susceptible to stress than others. It is important to learn how to deal with any stress in order to maintain your own health and effectiveness as a first aider. Gaining an understanding of your own needs can help you be better prepared for future situations.


An emergency is an emotional experience.

Many first aiders experience satisfaction, or even elation, and most cope well. However, after you have treated a casualty, depending on the type of incident and the outcome, you might experience a mixture of the following:

  • Satisfaction
  • Confusion, worry, doubt
  • Anger, sadness, fear

You may go through what has happened again and again in your mind, so it can be helpful to talk to someone you trust about how you feel and what you did. Consider talking to someone else who was there, or who you know has had a similar experience. Never reproach yourself or hide your feelings. This is especially important if the outcome was not as you had hoped. Even with appropriate treatment, and however hard you try, a casualty may not recover.


Delivering first aid can lead to positive feelings because you notice new things about yourself, such as your ability to deal with a crisis.

However, occasionally, the effect of an incident on you will depend on your first aid experience as well as on the nature of the actual incident.

The majority of the incidents you will deal with will be of a minor nature and they will probably involve people you know. If you have witnessed an incident that involved a threat to life or you have experienced a feeling of helplessness, you may find yourself suffering from feelings of stress after the incident. In most cases, these feelings will disappear over time


If, however, you experience persistent or distressing symptoms associated with a

Stressful incident, such as nightmares and flashbacks, seek further help from someone you trust and feel you can confide in.

See your doctor or a mental health professional if you feel overwhelmed by your symptoms. You can talk through them with the professionals and together decide what is best for you. Seeking help is nothing to be embarrassed about, and it is important to overcome these feelings. This will not only help you deal with your current reactions, but it will also help you learn how to respond to situations in the future.

Talking things over

Confiding in a friend or relative is often useful. Ideally, talk to someone who was also present at the incident she may have the same feelings about it as you. If you are unable to deal with the effects of the event you were part of or witnessed, seek help from your doctor


The scene of any incident can present many potential dangers, whether someone has become ill or has been injured, whether in the home or outside at the scene of an incident. Before any first aid is provided you must make sure that approaching the scene of the incident does not present unacceptable danger to the casualty, or to yo or anyone else who is helping.

This chapter provides advice for first aiders on how to ensure safety in an emergency situation. There are specific guidelines for emergencies that pose a particular risk. These include fires, traffic accidents, and incidents involving electricity and drowning.

The procedures that are used by the emergency services for major incidents, where particular precautions are necessary and where first aiders may be called on to help, are also described here.

  • To protect yourself from danger and make the area safe.
  • To assess the situation quickly and calmly and summon help if necessary.
  • To assist any casualties and provide necessary treatment with the help of bystanders.
  • To call 911 for emergency help if you suspect serious injury or illness.
  • To be aware of your own needs.


In any emergency it is important that you follow a clear plan of action. This will enable you to prioritize the demands that may be made upon you, and help you decide on your best response.

The principle steps are: to assess the situation, to make the area safe (if possible), and to give first aid. Use the primary survey (pp.44–45) to identify the most seriously injured casualties and treat them in the order of priority.


Evaluating the scene accurately is one of the most important factors in the management of an incident. You should stay calm. State that you have first aid training and, if there are no medical personnel in attendance, calmly take charge.

Identify any safety risks and assess the resources available. Action for key dangers you may face, such as fire, are dealt with in this chapter, but be aware, too, of tripping hazards, sharp objects, chemical spills, and falling debris.

All incidents should be managed in a similar manner. Consider the following:

Safety What are the dangers and do they still exist? Are you wearing protective equipment?

Is it safe for you to approach?

Scene What factors are involved at the incident? What are the mechanisms of the injuries (pp.42–43)? How many casualties are there? What are the potential injuries?

Situation What happened? How many people,are involved and what ages are they? Are any of them children or elderly?


The conditions that give rise to an incident may still present a danger and must be eliminated if possible. It may be that a simple measure, such as turning off the ignition of a car to reduce the risk of fire, is sufficient.

As a last resort, move the casualty to safety.

Usually specialist help and equipment is required for this.

When approaching a casualty, make sure you protect yourself: wear high-visibility clothing, gloves, and head protection if you have them. Remember, too, that a casualty faces the risk of injury from the same hazards that you face. If extrication from the scene is delayed, try to protect the casualty from any additional hazards.

If you cannot make an area safe, call 911 for emergency help before performing first aid.Stand clear until the emergency services havesecured the scene.


Once an area has been made safe, use the primary survey (pp.44–45) to quickly carry out an initial assessment of the casualty or casualties to establish treatment priorities. If there is more than one casualty, attend to those with life-threatening conditions first. If possible, treat casualties in the position in which you find them; move them only if they are in immediate danger or if it is necessary in order to provide life-saving treatment. Enlist help from others if possible. Ask bystanders to call for the emergency services (p.23). They can also help protect a casualty’s privacy, put out flares or warning triangles in the event of a vehicle accident (p.30), or retrieve equipment while you begin first aid.


Hand over any notes you have made to the emergency services when they arrive (p.21).

Answer any questions they may have and follow any instructions. As a first aider you may be asked to help, for example, to move a casualty using specialist equipment. If so, you should always follow their instructions.


Occasionally, helicopter rescue is required.

If a casualty is being rescued in this way, there are a number of safety rules to follow. If the emergency services are already present, you should stay clear unless they give you specific instructions.

If the emergency services are not present, keep bystanders clear. Make sure everyone is at least 50 yards (45 meters) away, and that no one is smoking. Kneel down as the helicopter approaches, keeping well away from the rotor blades. Once it has landed, do not approach it. Keep bystanders back and wait for a member of the crew to approach you.


The severity of traffic accidents can range from a fall from a bicycle to a major vehicle crash involving many casualties. Often, the accident site will present serious risks to safety, largely because of passing traffic.

It is essential to make the accident area safe before attending any casualties (p.28); this protects you, the casualties, and other road users. Once the area is safe, quickly assess the casualties and prioritize treatment. Give first aid to those with life-threatening injuries before treating anyone else. Call 911 for emergency help, giving as much detail as you can about the accident, indicating number and age of the casualties, and types of injury.

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