Many people purchase first aid kits to have them on the road and outdoors trips. Having the kit provides some mental comfort as one may think that in a case of an accident or injury one would be prepared. Of course, there are some good and some better first aid kits, and the quality of the kit plays also a role in the successful treatment. But the kit alone is just the beginning.
Accident situations require number of skills sets that are important for the success of the operation. Basic knowledge of anatomy is of key importance. So are the treatment skills like for example bandaging or immobilizing various body parts or taking vitals. Another set of skills that may not be considered by many is the situation management – from monitoring the patient to managing the scene and potentially observers.
The fundamental question is if an average owner of a first aid kit will be able to effectively manage serious injury situation? Is there even a chance that somebody without a formal medical training can do that?
In order to find answers to our questions we will look at the Ski Patrol. The Ski Patrol members are the first responders that manage the injuries in the outdoors and stabilize the patient before the professional responders can manage transport to medical facilities. In essence they perform the backcountry first aid.
First let’s look at who the members of the Ski Patrol are. The Ski Patrol is very often based on volunteers that fulfill their passion for skiing and snowboarding along with the passion for helping others. As volunteers they can offer only so much time to the patrolling duty while having full time jobs or attending a school. What is the secret that people that are not professionally educated in the medical field and with limited time for relevant training can effectively manage injuries?
The answer to that question is …. system. The Ski Patrol has developed very efficient education system to quickly and effectively educate the patrollers in the human anatomy and physiology in the extend necessary for injury treatments. Additionally, the Ski Patrol has developed a training that teaches a well-defined step by step process for dealing with the injury scene, the victim and injury itself. Let’s look at that system.
The system consists of well identified steps which addresses all priorities in the sequence based on importance.
Survey the scene
The first step is to do the scene assessment. What is the situation? How many victims are present? What is the source of injury? Is there a danger present to the first aid responder or bystanders or further danger to the victim? Those are the questions that need answers while entering the injury scene. If there is a danger to the first aid provider that danger must be removed first before help can be provided to the victim. Otherwise, the first aid provider can become the next victim.
Perform Prioritized Treatment
Use prioritized approach to evaluate and treat the most important conditions of the victim:
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A – airways – are the airways clear? If not clear the airways.
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B – breathing – does the person breathe? If not start CPR
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C – circulation – is the circulation present? If not start CPR
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D – disabilities – are there any angulated fractures and bleeding? If present immobilize and control bleeding
Take Vitals Readings
At this point it is good time to take some notes. Taking notes is important for many reasons. First, it may be hard during a stressful situation to remember all the numbers for breathing and pulse. Additionally, most of the vitals should be taken periodically every few minutes to see if they change what may indicate some serious problems like internal bleeding or shock. On top of that if the patient is eventually delivered to the hands of the professional medical personnel, they will for sure appreciate the vital numbers and any observations about vitals changes over time.
Take the set of vitals:
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Breathing rate – where normal range for an adult is 12 – 20 breaths per minute and higher for children.
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Pulse rate – where normal rate for an adult is 60 – 100 beats per minute and higher for children.
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Skin color and condition – red, pale, sweaty, cold ….
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Eyes – are both pupils same, dilated, fixed, reacting to light?
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Level of consciousness – is the patient alert / aware of the situation? Responding to noise only or pain only? Not responding?
Assess the full body
After the priorities are attended and vitals taken the first aid responder usually does a full body assessment in order to find out other injuries that may not be obvious. Very often the one injury that the patient is complaining about is not the only one and sometimes even not the most serious one. The body assessment is performed with attention to signs and symptoms and progresses along the body with focus on head and neck, chest area, abdomen, back, upper limbs and lower limbs.
Signs to look and feel for include:
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D – deformities
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C – contusions – bruise or tissue injury
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A – abrasions
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P – penetrations
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B – burns
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L – lacerations
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S – swelling
While doing the assessment the first aid provider listens to any communication of symptoms from the victim. Indications of pain or overall condition are of great help in diagnosing the patient. The patient can lead the responder to the area of changed sensation like pain or numbness.
Conclusion
There is more to be effective at dealing with injury situations. Knowing the system and priorities and having a good first aid kit is just a start. Practical exercises and constant building of the knowledge is of key importance. One of the great ways to start with the practical skills is to get certified in the CPR. Training for this certification allows gaining some skills and habits that help being effective and in control while facing potentially tragic and stressful injury situation.
