First aid

First aid, treatment that can be given by minimally trained people for accident, injury, and sudden illness, until more skilled persons arrive or the patient is transferred to a hospital. Recognition of the injury or the nature of the illness and its gravity are crucial first measures, along with prevention of further injury to the patient or helpers. Clues such as medical bracelets or cards, evidence of food, drink, or drugs, and evidence of external injury should be sought and appropriate action taken. Cessation of breathing should be treated as a priority by clearing the airway of dentures, gum, vomit, and other foreign material and by the use of artificial respiration. Cardiac massage may be needed to restore blood circulation if major pulse cannot be felt. In traumatic injury, fractures must be recognized and splinted to reduce pain; the possibility of injury to the spine must be considered before moving the patient, to avoid unnecessary damage to the spinal cord. External hemorrhage should be arrested, usually by direct pressure on the bleeding point; tourniquets are rarely needed and may be dangerous. Internal hemorrhage may be suspected if shock (depression of vital signs) develops soon after collapse or trauma without obvious bleeding. Burns and scalds should be treated by immediately cooling the burned surface to reduce the continuing injury to skin due to retained heat. The use and, if necessary, improvisation of simple dressings, bandages, splints, and stretchers should be known; simple methods of moving the injured, should this be necessary, must also be understood. Accessory functions such as contacting ambulances or medical help, direction of traffic, and different aspects of resuscitation should be delegated by the most experienced person present. The inquisitive should be kept away and a calm atmosphere maintained. Prevention as a part of first aid includes due care in the home: avoiding highly polished floors and unfixed carpets, obstacles on or near stairs, loose cords, overhanging saucepan handles, and unlabeled bottles of poison; drug cupboards accessible to children also present significant dangers. Effective first aid depends on prevention, recognition, organization, and, in any positive action, adherence to the principle of “do no harm.”