Basic first aid knowledge a mustPOSTED BY Nigel Andretti ON 14 September 2015
By YS CHAN
RECENTLY, I joined 23 other participants to learn basic first aid at MATTA Academy conducted by a trainer from the Selangor branch of the Red Crescent Society of Malaysia.
At 9am sharp, the trainer handed out notes containing 31 pages. Although he had both Malay and English versions, he brought only the former.
He also had slide presentations and asked us to choose the language they preferred as he is equally adept in both languages.
I pointed out that since the notes are in Malay, he should also use the slides in the same language and could explain in English.
This is because the participants are from the tourism industry and many of them are tour guides and tourist drivers.
Apart from learning first aid, such classroom training would be a good opportunity for them to brush up on English, especially for those less proficient.
We learnt that while waiting for the ambulance to arrive, laymen can administer first aid to stop bleeding or lessen injury, but not to apply medication and avoid giving drinking water which could cause more harm to the victim.
The first aider should continue to offer words of encouragement to keep the victim awake and improve the chances for survival in critical cases.
When without a first aid box, one has to improvise. A bottle of water and cloth can be used to clean and cover the wound.
All participants were given a piece of triangular cloth which has multiple uses in an emergency.
It can be folded into a pad to protect a wound, used as a tight bandage to control severe bleeding, tie injured limbs to immobilise them or made into an arm sling.
Apart from the mandatory first aid kit and fire extinguisher for all commercial vehicles, tour van drivers could add one or two 1.5 litre bottles of water, some old but clean T-shirts, and clean plastic bags, as all these are useful for providing first aid.
For example, when severed fingers and limbs are placed in plastic bags with ice added at the first opportunity, the chances of reattaching them are considerably higher.
Tissue paper should never be used as they are easily embedded in bleeding human tissue and reattachment would not succeed without removing them, which is very difficult.
A good first aider must be knowledgeable, confident, observant, act fast but stay cool, be gentle yet committed, and must gain the trust of the public.
Participants were asked to differentiate between removing danger from the victim and removing victim from danger.
The first demonstration by the trainer was conducting a “Primary Survey” on someone found lying on the floor or ground.
If the victim is breathing normally, to check for bleeding, swelling, broken bones and other injuries by using both palms sliding simultaneously on both sides of the body from head to toe to detect variations.
The next topic was asphyxia which occurs when the body is deprived of oxygen, causing unconsciousness or death due to suffocation.
Heimlich manoeuvre using abdominal thrust could be applied on normal persons but the obese and pregnant would require a chest thrust to be effective in dislodging the choker.
After the morning break, the first topic was shock. In medicine, it is a critical condition that is brought on by a sudden drop in blood flow through the body.
It was the cause of death for victims in the nation’s worst road accident at Genting on August 27 2013 which claimed 37 lives, as many bled to death inside the overturned bus that plunged into a ravine, as rescue workers could only reach them hours later.
We learnt never to pull out a knife impaled into the flesh as doing so could cause the blood to spurt out if a major artery was pierced.
The first aid for wounds is to apply the 2C formula – cleaning by pouring water over it and then covering with cloth.
When bones are broken or suspected, it is essential that the victim should not be moved and an injured hand to be immobilised by tying to the body or the legs together.
I now understand what are first, second and third degree burns. Their seriousness depends on how deep it goes.
First degree burns affect the first layer of the skin or epidermis, the second the next layer or
dermis and third degree burns have reached deeper tissues.
It is necessary to cool the epidermis with water or ice if available to lessen the heat permeating into deeper layers.
Participants were next taught to switch off the electrical mains board if someone is suspected to have been electrocuted and use something that does not conduct electricity to detach the victim from the electric circuit.
Before lunch time, CPR was demonstrated using a dummy and I asked the same question which I did 23 years ago when I attended an intermediate level first aid course that included CPR.
I wanted to find out how would I know whether a body had been dead for hours or days before giving CPR.
The previous trainer replied that a doctor could tell by the pupil of the eye and today’s trainer
pointed out that only a doctor, and not others, could certify a person as dead.
Later, I found out the answer when we were told that death occurs within 4–6 minutes without oxygen. Therefore I would only administer CPR when a body is still warm.
The front cover of the notes given to the participants has the abbreviation DRCAB which strikes me as doctor in a taxi, something similar to tour van drivers prepared for first aid.
It is actually the formula for administering cardiopulmonary resuscitation (CPR).
Danger – we approach the victim only when it is safe to do so.
Response – if no response and victim is unconscious and without a heartbeat.
Compression – place the base of one hand on the victim’s chest between the nipples, interlock the fingers of two hands, elbow straight, press the chest down by two inches for 30 times at 100 compressions per minute.
Airway – next tilt the head by lifting up the chin, pull down the jaw to open the airway.
Blowing – cup the victim’s mouth with yours and blow once, pause and blow a second time.
Discontinue if victim starts to cough or respond, otherwise continue with compressions and blowing.
Before commencing compressions, get an onlooker to call 999 for ambulance and to confirm when it is done, so that an ambulance is on the way while administering CPR.
Towards the end of training, we learnt that paramedics use a special face mask to perform CPR to avoid HIV and other infections, and participants were advised to apply CPR only on family members.
After lunch, we covered poisons and poisoning. For corrosive acids and alkaline, it is important not to induce vomiting.
After wiping off the corrosive substance, wash the face with water, allow victim to drink some plain water but not too much so as not to cause vomiting, rush to hospital with some ice cubes and place them one by one in the mouth to alleviate pain.
For non-corrosive substance, prepare salt water for victim to drink which would induce vomiting and then proceed to hospital for treatment.
The next demonstration was putting out a fire using an office fire extinguisher. The trainer showed how to remove the safety pin, aim the nozzle at the base of fire and squeeze the trigger to puncture the cartridge allowing compressed gas to force dry powder out through the hose to put out the fire.
Some participants found the 10kg fire extinguisher for office use too heavy. Those kept in tour vans are only around 1kg.
While the pressure gauge may indicate the gas cartridge is intact, the dry powder may have caked up if the fire extinguisher is left un-serviced for too long, as powder can only be forced out by pressure if they remain fine and loose.
After the afternoon tea break, participants learnt how to tie a reef knot using the triangular cloth, tie a large arm sling, another sling for a broken collar bone and use it as a head