D18 The ABC of First Aid

• After checking for danger, make sure that injured people are still breathing. If someone is badly injured, particularly if their neck or back may be damaged, move them as little as possible. In order of priority, check: AIRWAY BREATHING CIRCULATION
• 
  The Airway of an unconscious person may be narrowed or blocked. This makes breathing either difficult and noisy, or impossible if the tongue drops back and blocks the throat. Lift the chin by placing two fingers under the chin with the other hand on the forehead, tilting the head back.
• Check if a person is still Breathing by placing your ear near their nose and mouth, and listen. If they are still breathing, place in the recovery position. If they have stopped breathing, give mouth to mouth ventilation. Pinch the nostrils together, take a deep breath and blow into the mouth, firmly sealing your lips around the mouth so air is not lost. Do this twice and then check for breathing. Continue this, giving about ten breaths a minute until help arrives or breathing begins.
• Test Circulation of blood by checking if the heart is still beating. Place your finger tips to the side of the windpipe in the person’s throat. If no heartbeat can be felt, use chest compression to try and keep the heart beating. If the person is also not breathing, give 15 compressions and then two breaths.

The recovery position

Discussion 

• If no outside help can be obtained for First Aid training, could the community organise this?
• How important is it to practise the ABC of First Aid long before any accident or disaster? These techniques should ideally be taught by someone with good First Aid experience. Consider how to encourage many people in your community to attend First Aid training. How could this be done?
• Why is it important to check for danger to yourself before helping someone who is injured?
• What are the dangers of mouth to mouth ventilation if a person is severely injured and bleeding? How can you protect yourself from the possible risk of HIV infection?
• Practise how to check for circulation. First practise on finding the correct place in your own throat. Then practise on other people until you are confident that you could do this in an emergency.
• The recovery position is the best position for an unconscious person as it allows them to breathe easily and prevents them from choking. Kneel by the person. Straighten their legs. Bend the arm nearest to you so it rests by their head. Bring the other arm across their chest and hold both hands in one of yours. With your other hand pull the furthest leg up at the knee and roll the person towards you. Tilt their head back to keep the airway open, using their hand to support their head. Leave them in this position until help arrives.
• Chest compression must not be given unless no heartbeat can be felt. Place your hand flat just above the point where the ribs meet the breastbone. (Find this place on your own chest.) Bring the other hand on top of it and lock your fingers together. With your arms straight, press down firmly on the breastbone, pushing it down quickly and firmly by 4–5cm. Release the pressure and repeat the compression at a rate of about 80 per minute. Practise the timing with a watch. It may help to say ‘push down, push down’ as this will give about the right timing. Practise using a large sack of rice or maize flour, as it is dangerous to use chest compression on a healthy person. Practise the movements until you are sure you will remember what to do in an emergency. It is not recommended to continue either mouth to mouth ventilation or chest compression for more than 30 minutes.

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This page was last updated on 08 June 2005