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First Aid for the Injured: Systematic Assessment, Life Support, and Stabilization

Effective first aid follows a structured, prioritized sequence: ensure safety, activate EMS, then address life threats in CAB order (Circulation, Airway, Breathing) per current AHA/ARC guidelines.

Phase 1: Scene Safety & Activation

  1. Assess Scene Safety: Traffic, fire, electrical, chemical, structural, violence. Do not enter if unsafe.
  2. Activate EMS: Call 911 (or local equivalent). Provide location, number of victims, mechanism, consciousness, breathing. Use speakerphone.
  3. Assess Responsiveness: Tap and shout "Are you okay?" No response = unresponsive.

Phase 2: Primary Survey (CAB)

Circulation – Severe Bleeding Control

  • Apply direct pressure with sterile gauze/clean cloth. Pack deep wounds (hemostatic gauze if trained).
  • Elevate extremity if no fracture suspected.
  • Tourniquet: proximal, 2–3 inches above wound, tighten until bleeding stops. Time-stamp. Only for life-threatening limb hemorrhage uncontrolled by pressure.

Airway & Breathing

  • Unresponsive: Head-tilt/chin-lift (jaw thrust if cervical spine injury suspected).
  • Check breathing ≤10 sec (look, listen, feel). Absent/agonal = start CPR.
  • Rescue Breaths: 2 breaths, 1 sec each, visible chest rise. If trained, 30:2 compressions:breaths. Untrained: hands-only CPR (100–120/min, 2–2.4" depth).
  • AED: Apply ASAP. Follow prompts. Minimize interruptions.

Phase 3: Secondary Survey & Stabilization

Musculoskeletal

  • Suspected fracture: Immobilize in position found. Splint above/below joint. Do not realign.
  • Assess CMS (circulation, motor, sensory) distal to injury.

Shock Management

  • Supine, legs elevated 6–12" (if no pelvic/leg fracture, respiratory distress).
  • Prevent heat loss (blanket).
  • Nothing by mouth.
  • Monitor LOC, pulse, skin signs.

Other

  • Burns: Cool 10–20 min with running water; cover loosely.
  • Eye injury: Shield (cup), no pressure.
  • Amputation: Wrap part in moist gauze, seal in plastic, place on ice (not direct).

Phase 4: Handoff & Documentation

Communicate mechanism, findings, interventions, times, and patient info to EMS. Complete incident report.

Key Principles

  • Do no harm. Act within training. Reassess continuously. Prioritize life over limb.

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