First Things to Be Done in Emergencies – Providing First Aid for Health Professionals First Things to Be Done This publication has been published by the following project: in Emergencies – Providing First Aid TÁMOP-4.1.2-08/1/A-2009-0061 for Health Professionals © József Betlehem PhD, 2012 by József Betlehem Authors: József Betlehem Ph.D. Krisztina Deutsch M.Ed. Nikolett Gál M.Sc in PT. Tamás Köcse M.Ed. József Marton-Simora M.NS. András Oláh Ph.D. Gábor Nagy M.D. Proofread by Zsigmond Göndöcs M.D James Garvey Ph.D. Medicina Responsible for Edition: Director of Medicina Publishing House Co. Published by: Commissioning Editor: Katalin Benjámin Medicina Könyvkiadó Zrt. ● Budapest, 2012 Technical Editor: Imre Dóczi Number of figures: 119 db © József Betlehem, 2012 illustrations: Zoltán Bodor © Authors, 2012 Identification number: 3587 ’Anyone can have an accident Contents anywhere any time.’ Dr. Bán S. István Foreword / 7 1. The Significance of Administering First Aid in Today’s Society / 9 (by Krisztina Deutsch) 2. Recognition of Status in Case of Emergencies / 20 (by József Betlehem and Krisztina Deutsch) 3. Patients’ Examinations and Making Decisions / 30 (by Gábor Nagy) 4. Asking for Help, Calling an Ambulance / 63 (by József Betlehem and József Marton-Simora) 5. Basic Life Functions / 73 (by András Oláh and Nikolett Gál) 6. Immediate Interventions Supporting Life Functions with or without Appliances / 80 (by József Betlehem and József Marton-Simora) 7. Automated External Defibrillator / 102 (by Gábor Nagy) 8. Primary Care of Unconscious Patients / 107 (by József Marton-Simora and Gábor Nagy) 9. Care of Patients with Foreign-body Airway Obstruction / 119 (by József Marton-Simora and Gábor Nagy) 10. Further Care of Conscious Patients / 126 (by József Marton-Simora) 11. Accident Occurences / 136 (by József Betlehem, Tamás Köcse, József Marton-Simora and Gábor Nagy) 12. Sicknesses of Internistic Nature by Nature / 181 (by József Betlehem, Tamás Köcse and József Marton-Simora) 13. Assisting Childbirth / 210 (by Gábor Nagy) 14. Relatively Common Paediatric Occurrences Requiring First Aid / 221 (by József Betlehem) Tests / 227 Answers to the tests / 263 — 5 — Foreword — 7 — First Things to Be Done in Emergencies – Providing First Aid for Health Professionals 1. The Significance of Administering First Aid in Today’s Society Krisztina Deutsch The content of chapter The social i.e. legal and moral requirements for rendering assistance The relationship between the health care system and first aid The psychological effects, motivation or apathy towards first aid assistance Bibliography — 8 — — 9 — First Things to Be Done in Emergencies – Providing First Aid for Health Professionals 1. The Significance of Administering First Aid in Today’s Society The social i.e. legal and moral requirements for rendering assistance Administering first aid and being prepared to do so and consequently its quality is an organic part of every nation’s health culture. The international epidemiological data show that the most common situations that require first aid, namely accidents, in the world appear as the third most common Household School Sport reason for death after vascular and tumorous diseases. That is why the fast recognition of the given actualities and performing the first basic life saving primary activities get a special emphasis since they fundementally define the further life of the person in trouble by decreasing the chances for premature death on one hand and improving the quality of life after survival on the other hand. Teaching the basic phases of first aid is not only important for professionals in the developed countries of west Europe but it acquires a significant role in the education of non-professionals and it is attached to the shaping of a helpful attitude from a very young age on. This bears a special signifi- cance because the first witnesses of accidents or sudden health impairments are usually members of the family, friends, acquaintances or co-workers. Consequently the responsibility is theirs to try to ticlopidine help the one in trouble as best as they can. The knowledge of the basic principles of first aid is indis- pensable for administering proper help and it ought to be continuously updated. Consequently during the education of the health care professional staff the practical knowledge Work Vehicular trac of basic life support interventions require special attention irrespective of their specialist areas or Illustration 1/1 The most common accident locations disciplines. The legal and moral obligation to be able to perform life saving interventions in case of emergencies can be expected from professionals graduating at degree level in health science edu- cation in disciplines such as education in the area of nursing, medical attendance, health care, pre- themselves in and the objective environment in question and to prevent the development vention, management, medical laboratory and visual diagnostical analyst and also on some other of further damages. majors resulting in a Bachelor’s degree. Out of these the most important point of view has to be to save the human life and to stop During the last decades the techniques that can be applied in such situations have been simpli- or delay the damage to health. fied a great deal on the basis of the newer scientific achievements on one hand and for the sake of In a narrower sense first aid can be defined as the application and treatment of the in- easier acquirement and implementation on the other. Besides the technical simplification there has jured person within the context of first aid knowledge. been another very important point of view, namely taking into consideration the degree of scien- tific data that underpins the interventions that we perform in case of emergencies. With the flare of The basic book noted by the St. John (the Johannitas) Ambulance Service and the British Red Cross professional medical knowledge more and more scientifically based practical knowledge evolves, a says ’ first aid means the first help or medical attendance given to the injured or people who became sud- substantial amount of which can be used in non-professional education as well. A good example to denly ill’. the latter is the application of the automatic external defibrillator (AED). According to Aurél Gábor ’We call first aid the health attendance that is performed either by a (Illustration 1: Most common accident locations) medical professional or a non-professional before starting the final medical attendance in order to delay Before the exposition of the chain of survival and the factors influencing the first aid process it is the direct consequencies of an accident or of some sudden health damage and also to keep off further subservient to define what first aid application is. decline of health and eliminate newer or secondary damage. Róbert Almási says that ’administering first aid is not only a skill or ability but it is also the unity and In a complex interpretation first aid application expresses all the primary activities around harmony of intention, knowledge and action.’ the person in trouble that are aimed at the elimination of the dangers that people might find — 10 — — 11 — First Things to Be Done in Emergencies – Providing First Aid for Health Professionals 1. The Significance of Administering First Aid in Today’s Society Two new concepts have been introduced in the last decades which interpret first aid in a less The relationship between the health care system and first aid wide sense. They characterize those situations from the point of view of health care when immediate help really might be necessary. The injured or health damaged patient gets medical assistance within the frames of the chain of Urgent need is ’a change in the state of health as a result of which the patient’s life would either be survival from the first level of non-professional first aid to the highest level of hospital treatment directly threatened or badly or permanently damaged in lack of immediate medical attendance.’ while each medical level is built on each other, being connected as chain links. Consequently the Endangering state is ’the state when the lack of immediate arrangements would either result in efficiency of each medical assistance level fully depends on the efficiency of the previous medical a situation that would endanger the patient’s or another person’s life, body integrity or health or would assistance level, thus determining the further outcome of the patient. (Illustration 4: The units of the mean direct danger to the surroundings. ’ saving chain in Hungary In Hungary helping a person in trouble is a citizen’s obligation even at a non-professional level and it is specified in Act CLIV of 1997 on Health. ’It is everyone’s obligation to help in a way which The chain of survival includes the following medical assistance levels and activities: can be expected from him/her and notify the authorized health care server in case an urgent need or an 1. non-professional first aid endangering state is noticed or heard about. 2. notification of professional aid providers The above statement is even better understandable if we put ourselves into the position of 3. ambulance assistance someone who is in trouble, who expects help, since according to the previously mentioned law 4. hospital treatment ’Every patient is entitled to get life saving medical attendance or attendance that ensures the preven- tion of bad or permanent health damage and also his pain to be soothed and his suffering to be lessened.’ The non-professional first aid provider usually does not possess professional health care knowledge People working in the health care system are especially obliged in this respect to administer and reliable practical experience consequently a difficult job awaits him at the location of the ac- help in an urgent need.