We have discussed numerous ways in which we can assist people in medical distress, from simple cuts to Heart Attacks, Strokes and Cardiac Arrest. They all have one thing in common, the starting point: DRABC or DR ABC (an acronym used in the Medical world) D: is for DANGER. This applies to any casualty you may be approaching for the purpose of offering First Aid. Whilst the patients welfare and safety is important, it is also essential that you safeguard yourself and bystanders from becoming additional casualties. The danger can come in many forms, certainly if you have not witnessed the collapse or accident. i.e.: Has he been electrocuted and still holding a live cable. Has he been stabbed and there is a knife in the vicinity that you are about to kneel, or is the assailant still in the area. If he has been shot is the area now a safe area. Are there needles in the area or in the patient. In an RTC are you safe from other vehicles, is there is a risk of fire or explosion. If he has fallen or something has fallen on him, are you safe from other falling objects. If he is in water or quicksand are you safe to proceed. If he has been attacked by an animal, has the animal now left the area. R: is for RESPONSE. You look for a response from the patient in 2 ways. 1) Response to sound: Kneel down and ask the patient to open their eyes. 2) Response to touch: Tap their shoulders, with a baby stroke the sole of the foot. A: is for AIRWAY. Check that the airway is clear of obstruction, including an obstruction by the tongue. (look in the mouth but do not do a finger sweep) If they have suffered any form of trauma allow that whilst the airway still needs to be kept open, do not compound any potential injury more than absolutley necessary by being too forceful in your actions. Open the airway by placing one hand on the patienst forehead and 2 fingers under the point of his chin, then gently tilt the head back. B: is for BREATHING. Check for breathing by placing your ear close to his mouth and listen for 10 seconds to determine whether or not he is breathing. He should take 2 to 3 normal breaths in that period. Be aware that if he is showing signs of agonal breathing, an abnormal pattern of breathing characterized by gasping, laboured breaths and strange sounds, he should be deemed as non breathing. Whilst listening for breathing also be alert to the feel of his breath on your face, and be looking down his chest and stomach for signs of movement as he breathes. C: is for CIRCULATION. Check for a pulse or signs of a heartbeat. In realty, this is not crucial as you may not know how to check his pulse, or it may be very weak. If you have confirmed whether or not he is breathing during your 10 second BREATHING check, you would then proceed accordingly regardless of circulation. Proceeding from that point will normally only involve 1 of 3 options. 1) The patient is breathing normally, and following the Secondary Survey (see previous training posts) you are satisfied that he has suffered no other injuries requiring consideration, place him in the Recovery Position. 2) The patient is breathing but there are indications of other serious injuries, possibly even to the spine or neck. At this point, although still crucial to control his airway, if your training does not cover this aspect ring 999 again and follow the advice given. 3) The patient is not breathing, commence CPR immediately regardless of any potential secondary injuries.(see previous posts) Remember, we do not want to perform CPR on someone who has only fainted and we certainly do not want to put a deceased person in the recovery position. Any questions, please ask.
Posted on: Fri, 05 Sep 2014 07:18:40 +0000
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