Emergency Medicine Caregivers / Homecare Public Health Become A First Aider And Make A Difference

Becoming a first aider is not a big deal, you give a small amount of time to learn knowledge and skill, but it could one day make a difference and save a life. This article gives one or two examples of where basic first aid knowledge, administered in a few crucial minutes has saved lives, dispels some common myths about first aid and how one charity is raising awareness through their "Be the Difference" campaign (including a neat iPhone app so you can carry first aid knowledge around with you). It finishes off with some advice on how to choose a first aid course and what to put in a basic first aid kit.

First Aid in Action

My earliest memory of first aid in action was as a child in the 1960s. It was a hot day, and I was in the shallow end of a busy outdoor pool when suddenly there was a piercing scream: I looked round, as did dozens of other children and adults, to see a very distressed mother clutching her little girl's still, blue body. To our horror it appeared she had drowned in our midst. We stared, stupefied, not knowing what to do.

Then, we noticed a man in the distance race towards us, leap the fence around the pool, and dash into the shallow water. Approaching the desperate mother, he gently took the lifeless child from her arms, lay her on the ground, and proceeded to do what for me was an extraordinary thing: he raised her arms, then pushed them down on her chest, several times, like he was trying to make her fly. After what seemed like a long time, but was probably only a minute or two, the little girl vomited some watery fluid, then started crying, and the colour came back to her body.

The rescuer asked for a towel, wrapped the child in it and returned her to her mother murmuring something about keeping her warm and getting her to a doctor straight away. He was a shy man who withdrew quietly without a fuss when he saw the mother had friends now helping her.

That hero was my father. I was so proud of him, not just because of what he did, but because he seemed to be the only person who knew what to do. As I got older, I began to realize that second part should actually be a cause for concern.

(The method my father used was the old chest-pressure and arm-lift technique he learned as a schoolboy in the 1930s; that approach has since been overtaken by the mouth to mouth breathing and chest compressions of cardiopulmonary resuscitation or CPR.)

Later, as a teenager, when I took my bronze life-saving course, I wondered if I would ever be called to save a life, like my dad. So far, I have not had to do so, and hope like he did, I would not panic and remember my training.

As the decades have slipped by, other opportunities to learn first aid came up and I took them. These included some half day courses in a large company I worked at, and in my 40s, I took the bronze life-saving course, including a CPR refresher, again. The most recent course was a session with St John Ambulance in the UK about three years ago, geared toward first aid for walkers and hikers.

Don't Assume You Know What to Do

Sadly, too many people have had no first aid training whatsoever. But perhaps just as alarming is that many people think they would know what to do, but when faced with the emergency would do the wrong thing. A UK survey commissioned by St John Ambulance in February last year found that although just over a quarter of respondents said they'd know what to do, when asked to describe what they would do in some specific scenarios, many would have done the wrong thing and even made things worse.

For example when faced with a man thrown off his motorbike and not breathing, 42% of respondents said they'd know what to do and then described the wrong thing. Of these, 43% said they would not move him for fear of spinal injury, yet if he's not breathing and does not receive CPR, he will die.

In a second example, respondents were asked what they would do to help someone choking. Only 53% said they would bang them hard on the back with their hand: and a worrying 9% said they would put their fingers down the person's throat to try and retrieve the obstacle, which is the wrong thing to do because this can push it further down the throat.

And in a third example, they were asked what they would do for a middle-aged man with chest pains. 9% said they would put him in the recovery position (lying horizontally on the side) while waiting for an ambulance. But if the chest pains signal problems with the heart, this position could increase the strain on the heart and worsen the condition. The correct thing to do is to sit him up in a comfortable position.

Be the Difference

To raise awareness of the importance of first aid, St John Ambulance launched a hard-hitting "Be the Difference" campaign depicting 5 common scenarios where first aid could make the difference between life and death.

The scenarios are: (1) Severe bleeding, (2) Choking, (3) Heart attack, (4) Unconscious, breathing casualty, and (5) Unconscious, not breathing casualty. They are summarized in the Five ways to be the difference section of the charity's website.

St John Ambulance also invite you to test your first aid knowledge in a section that takes you through the five scenarios.

The campaign is hard-hitting because in the summary page for each scenario it describes what might happen if the casualty does not receive first aid, and it also describes a real case of a life saved as a result of correctly administered first aid.

One example of a life saved is the real case of 24-year-old Katryn Burgess who had a heart attack just after completing a half-marathon in Cheshire, UK. Fortunately, St John Ambulance volunteers were on hand and sprang into action. They began administering CPR and using a portable electronic device (automated external defibrillator or AED) gave her a shock to bring her heart back into rhythm and then they took her to hospital.

The UK is not the only country with low awareness and training in first aid.

A Pfizer Health report from 2007 describes a similar lack of first aid skills in Australia, where more than 90% of people are unsure of their ability to help in an emergency, despite 73% saying learning first aid is as important as learning to swim and 17% saying it is more important.

The report says more than 10% of Australians have been faced with an emergency where someone required first aid but could do nothing to help, and only 6% claim to be completely confident they would be able to do the right thing.

Confidence Matters

Once you have your basic training it is important to keep it topped up. This boosts confidence, reduces your sense of panic, and also, because new knowledge is emerging all the time, you keep up to date with new procedures.

St John Ambulance Australia recommends that everybody do a refresher course in general first aid at least every three years. And they urge first aiders to do their CPR course every year.

The Red Cross is another organization that offers a range of first aid courses. Young Hannah Niesser, a schoolgirl from North Wales, saved a man's life at a bus stop thanks to the confidence and skill she learned on one of their courses.

Hannah, was waiting for a bus to take her to school to sit a GCSE exam (public exams youngsters in the UK take at around age 16), when the man standing next to her suddenly collapsed.

Bystanders lay him down on the ground, but they didn't know what to do next. Hannah said she remembered feeling a "bit of a shock" when she realized she was going to have to save someone's life.

She said at first she panicked, but then became calmer as she remembered what to do. The man had stopped breathing and was beginning to turn blue, so she gave him chest compressions and he began to respond. Someone had called an ambulance that arrived in ten minutes, by which time the man was breathing again.

When the bus arrived shortly after, Hannah got on it and went to sit her exam, happy in the knowledge she had put her first aid skills to good use. She was clearly recomposed by the time she got to school because she passed her exam with flying colours.

Janice Kinsella, event first aid coordinator with the British Red Cross, said Hannah was one of their very young volunteers and it was "great that her training stood her in such good stead when this man really needed it. Hannah's attended lots of first aid duties over the last few months and shown her steel at those too. She's a complete all-rounder and we're just so proud of her."

First Aid Help On Your Phone

As part of their "Be the Difference" campaign, St John Ambulance have also launched a first aid app for the iPhone that gives life saving advice designed to be easy to absorb quickly under pressure. This app is a very good example of a developing market of mobile phones applications that help both health professionals and patients with managing health and giving first aid.


screenshot of the St John Ambulance iPhone app.

Currently selling at a special price of $2.99, the first aid app covers the same five scenarios as the web-based "Be the Difference" campaign, such as how to deal with choking, severe bleeding, heart attacks, breathing and unbreathing unconscious casualties.

By April 2010, only two months after the launch, it had been downloaded 10,000 times across the globe, despite no marketing or promotion.

It is now at version 1.3, and has been updated to reflect recent revisions to the European Resuscitation Council protocol. It also shows you how to use an AED, and how to help a drowning person.

The app has a simple, clear, attractive and intuitive graphic interface. It is compatible with iPhone, iPod touch, and iPad (requires iOS 3.2 or later).

St John Ambulance point out that the app doesn't replace the benefits of learning first aid on one of their courses, nor is it as in depth as a full first aid manual:

"But when there is an emergency, it will help you to know what to do to in those few crucial moments when basic knowledge of first aid can make the difference."

The app covers other areas of first aid too, such as hyperventilating, cold, heat, diabetes, allergic reactions, and bites and stings.

Choosing a First Aid Course

Choosing the right first aid course can be rather daunting, just a few minutes browsing the internet soon shows the wealth of specialist courses available from various providers.

The British Red Cross site has a web page that takes you through a series of questions to help you decide which course is most appropriate for your needs. And it differentiates between work-based and general public courses and whether you are looking to train from scratch or refresh your skills.

Perhaps a good place to start is to have some basic training, a two-hour or half-day course, to learn the basics of first aid. As well as practical hands-on skills, you need to know simple principles such as how to make a quick assessment of the casualty, what resources you are going to need and have, and how to get help.

Also, consider where you are most likely to be needed as a first aider: what are your hobbies, where do you work, do you travel a lot by car, bus or train, do you do voluntary work with children or the elderly, and so on.

Then go in search of a course that builds on the basics, and after that, make sure you keep up to date.

You may also find that various charities, like St John Ambulance, are amenable to angling their training towards specific needs. I was lucky to have met David, who works for St John Ambulance in the UK, at our local gym. We got talking about first aid for walkers and hikers. David is a keen walker himself, and was happy to put together a special 2 hour refresher for our group that covered areas such as how to deal with minor and major emergencies, including adminstering CPR.

He also gave us a list of what to carry in addition to the usual first aid kit. As well as the usual plasters, sting relief, bandages, lint, wound cleaning fluid, he recommended a whistle, a roll of duct tape (eg for emergency strapping around a limb), a large pair of safety scissors (to cut quickly through clothes), a thermal bag (to keep casualties warm), some Kendal Mint Cake (or other high energy rations), a torch (with spare batteries), and water purification tablets.

The Ramblers charity also has a comprehensive webpage on Health and Safety for Walkers.

First Aid Kit

One of the first things you should do as a first aider, is put together first aid kits for your home and your car and familiarize yourself with the contents: read the manual and learn how to use them.

You can buy ready made first aid kits from a good chemist, or you can make them to your own personal specification, depending on the purpose. For example, if taking one on an outing, make sure it is big enough for the party of members and the type of activity, and perhaps take a second one that is carried by another member of the party.

Here is a suggested list for a basic kit: