Introduction to First Aid

Medical Help on the Scene

The following sections discuss medical help, bystanders, and managing stressful situations while on the scene of an emergency.

Importance of Medical Help

In first aid, any type of medical care is referred to as medical help.

Unless an injury is very minor, you should always make sure the casualty receives medical help following first aid. Medical help may be given at the scene, on the way to a medical facility, or in a hospital.

Know the EMS telephone number for your community. This is usually 9-1-1 in most of Canada. Calling for medical help is important. Every second counts in life-threatening emergencies.

You can ask a bystander to call for medical help.

Provide them with the following details:

  • Emergency phone number(s)
  • A description of the casualty’s condition
  • Directions to follow to reach the scene
  • Instructions to report back to you after getting medical help

If you are alone, you must decide whether to stay with the casualty or leave to get help. The correct decision will depend on the specifics of the situation. If you have a mobile phone, call from the scene and perform first aid with the dispatcher’s assistance.

Medical care

As a first aider, you are not trained to diagnose the nature and extent of an injury or illness; a medical doctor has the training to do this. As a rule, make sure the casualty receives medical care following first aid. For minor injuries, this may not be necessary. Medical care is either given by a medical doctor or under the supervision of a medical doctor. Paramedics provide medical care because they work under the supervision of medical doctors.

Help at an Emergency Scene

Bystanders should be asked to leave unless asked to stay and assist.

Other first aiders may offer to help. Identify yourself and accept their assistance. If someone is more qualified to handle the situation, you may ask that person to take control. Off-duty doctors, nurses and other health professionals may identify themselves and offer to help.

First responders include ambulance personnel, police officers, and firefighters. They will take charge of the scene as soon as they arrive.

Other authorities may be called to the scene (e.g., an electrical utility crew may arrive if there are downed power lines). Identify yourself and continue giving first aid.

Ten ways a bystander can help

A bystander can provide help in the following ways:

  1. Make the area safe.
  2. Find all the casualties.
  3. Find a first aid kit.
  4. Control the crowd.
  5. Call for medical help.
  6. Help provide first aid, under your direction.
  7. Gather and protect the casualty’s belongings.
  8. Take notes.
  9. Reassure the casualty’s relatives.
  10. Lead the paramedics to the scene of the emergency.

Communication Best Practices

Communication is necessary in every emergency, regardless of the details. As the first aider, there are many people you may need to communicate with – the casualty, bystanders, family members, other first aiders, EMS providers, and other professionals (e.g., police, fire, utility workers). Effective communication skills will help you to assess the casualty’s condition and explain what you are doing and why.

The following are some rules for effective communication:

  • Be calm and direct.
  • Be respectful.
  • Do not use medical terms.
  • Call the casualty by name.
  • Do not diagnose the casualty’s condition.
  • Always be honest, reassuring, and choose your words carefully.

As a first aider, the first thing you do when you arrive at an emergency scene is to take charge of the situation. You stay in charge until you hand control of the scene over to more qualified people. While in charge, many other people may offer to help.

When handing the scene over to someone other than the casualty, describe the complete history of the incident and pass along any notes you have taken.

Be sure to include:

  • Your name
  • The time you arrived
  • The history of the illness or injury, including signs and symptoms observed
  • What first aid has been provided
  • Any changes in the casualty’s condition since you took charge

Communication principles

Though each situation is different, the following general guidelines help improve communication.

Focus

Maintain your attention on the casualty. Position yourself at eye level and maintain eye contact.

Terminology

Refrain from using medical terminology when communicating with the casualty or bystanders. Explanations and answers must be clear, concise, and easily understood.

Body Language

Refrain from using body language that could be perceived as threatening or aggressive.

Professionalism

Always maintain your professionalism. Explain everything you are doing and why. If what you are doing may be painful, let the casualty know.

Communication barriers

Despite following the principles of communication above, there are certain barriers that may arise, making communication difficult.

  • Language – The casualty or bystanders may not speak the same language as the first aid provider.
  • Physical – The casualty or bystanders may have a hearing, speech, or visual impairment.
  • Cognitive – The casualty or bystander may not understand the questions or requests.
  • Cultural – Different cultures approach interactions with others in a manner that is different from yours, which may impact communication.
  • Environment – Noisy situations can make communication very difficult.
  • Technical – Failure or limitations of communication devices (radios, phones) can hinder communication.

When faced with these barriers, the first aid provider may have to attempt several different ways to gather information or give directions.

First aid providers should also remember to keep things simple, clear, and to the point. Drawn out descriptions using large words can make it very difficult for the casualty or those around to understand. An example would be “Get me the AED” instead of “I need you to find an Automated External Defibrillator while I perform cardiopulmonary resuscitation.”

Stress Management in Emergency Situations

First aiders may experience a certain level of stress because of the assistance they provide. Stress is the body’s normal reaction to physical and psychological events. It can be seen in certain attitudes and behaviours in both casualties and first aiders.
It is a biological response and may be reflected in:

  • An increase in heart rate
  • An increase in blood pressure
  • An increase in blood sugar
  • Dilation of the bronchi and pupils

Possible reactions of casualties

Casualties may react to stressors in different ways and first aiders must observe and adjust to such reactions, which can include:

  • Denial – The casualty may deny the seriousness of the situation and refuse assistance.
  • Resignation –The casualty may be resigned to dying even if their life does not seem to be in danger, and does not want to make any effort to do what is needed.
  • Aggressiveness –The casualty may be hostile.
  • Assertiveness –The casualty is positive, cooperative, and may even want to take charge of their own care, including directing the first aiders.

Stress management

Managing stress in an emergency can make a significant difference in the quality of first aid provided. Appropriate mental preparation and regular first aid skills practice can help first aiders react effectively when faced with an emergency. The negative impact of stress can be reduced by understanding it and taking measures to try and overcome it. After serious incidents, it is important for first aiders to process their emotions.

When faced with a highly stressful situation, some first aiders may experience prolonged effects of stress and they should seek professional assistance.