First Aid: Would you Know What to Do?

I've been a qualified First Aider since the mid-90s. For a few years there in the noughties, I was the head First Aider for an entire University campus.

There have been plenty of incidents, when my appearance was met with relief. People who had called me, because they didn't know what to do. The assumption was always that I would.

I might not be able to save all that I encountered. That wasn't my remit. But I knew enough to act with confidence. Peace of mind is infectious.

My job was to keep the person alive, or comfortable, for as long as it took for real help to arrive. Anyone can do that. On average, it takes less than five minutes from your call to a paramedic standing beside you. But those five minutes can be vital.

They can be the difference between life or death.

I'm going to present some scenarios that could actually happen. I know, because they did and I dealt with them. I'm going to ask you the consistent question - would you have known what to do?  If not, then you really need to learn.

It was time to go home! I strolled out of the office and along the street. This was one of the main arteries leading in and out of the city, so it was always bustling with people. It was also lined with bus-stops, which meant that many of those people were standing around.

Even so, it was obvious from the general demeanor of the crowd that something untoward was going on. The panic was palpable.

Like any decent rubber-necker, I peered over a shoulder as I approached. There was a woman sitting on the kerb and her face was grey.  "I'm a First Aider, can I...?" I began. I didn't get much further. The crowd parted like the red sea before me and the cry of 'First Aider!' went up.

I checked that traffic had been stopped in the vicinity. It had. I crouched beside the lady and introduced myself. Her forearm hung at a dreadful angle, but worse was the bone sticking right out through the skin. She'd been knocked down by a bus. 

What would you have done?

There was more that I could have done. I could have sent someone running to my office to grab my First Aid box. My priority would have been to stem the bleeding with compression, being careful not to push upon the protruding bone.

Then I would have used a couple of wrapped up bandages to pack either side of the bone. I'd have tied them in place with padded gauze at both ends, then covered it all with a loosely tented triangular bandage.

Finally, her arm would have been immobilized flat across her midriff with the application of a handy sling.

I didn't do any of this because I was in the middle of the city center. The ambulance had been called about three minutes before I got there. I basically made it my job to ensure that the situation wasn't going to get any worse during the next couple of minutes, and to reassure her that I was here.

Then I handed over to the paramedics, when they arrived about a minute later.

The cattle grid in the foreground of the picture is precisely where this incident occurred. The photographer is standing on a T-junction.

The lady was lying on that cattle grid in the middle of the road. Any vehicle turning that corner would not see her until it was too late.

There were plenty of people around. I asked a couple of them to stop traffic at the end of the lane. I asked a gentleman to hold the leads of both dogs (I had one too).

Her son was already crouching, deeply upset, alongside his mother. I let Mum calm her son. All of which took longer to write here, than it did to action there.

After checking that the only issue was the suspected fracture of her forearm, I helped the lady to stand up. We relocated to the pavement, where I could deal with the arm without risk of being run over.

Lacking a triangular bandage, we improvised. I pulled up the hem of her t-shirt at the front and back.  These were tied together over her shoulder to create a lovely makeshift sling.

She did need to go to hospital, but I didn't need to make those decisions for her. My First Aid part was done, as soon as her arm was immobilized. Ultimately I walked her home, so that I could hold the leashes of both dogs.

Her husband was able to take over with son, pet and getting his wife to hospital then. While Lily the Rottweiler puppy and I went on with our day.

There's panic, and there's hysteria. The couple at the side of the road were exhibiting the latter. I was driving along, paused at traffic lights, and even I could tell that!

I pulled over as soon as it was safe enough to do so and hurried over. Equally apparent was the source of such concern. The young boy was lying prostrate on the pavement. He had been in the road, where one of these people had accidentally run him over.

When I say that I dealt, there wasn't that much to do. The boy was actually fine! Bit shaken and bruised, but the emergency stop meant that he'd only been tapped.

Then around the corner ran his Dad. The big man's face was purple. He was nearly at the point of collapse. He'd received that phone-call about his son and immediately dashed from the house. Unfortunately Dad was an asthmatic. Such shocks and great spurts of energy had triggered an attack.

I dealt with the panicking couple, the run-down boy and the gasping father.  What would you have done?

To my mind, the mark of a good First Aider is the same as that of a triage nurse. You prioritize according to the severity, or potential danger, of each situation.

Panicking people fit into the latter category. But they had already calmed somewhat just by me turning up and taking control. I often joke that 90% of First Aid is crowd control, but it's all too often true.

The best way of doing that is to give people things to do. I sent the man to stand at the kerb and watch out for the ambulance. His job was to wave them towards the scene. He was perfectly calm once he was doing that. 

I asked the woman to ensure that the gathering group of neighbors and passers-by didn't crowd us. She was great.

I was sitting with the boy, ensuring that he remained stationary, when his father arrived. I didn't want the boy to move, just in case there were spinal injuries that I couldn't see. He'd said that he had banged his head when he fell, but I couldn't feel any bumps.

Once Dad was there, my priority immediately switched to his asthma attack. His son had taken one look at him and apprised me of that condition! I reassured Dad that his son was fine, and tried to direct him to a nearby low wall, where we could sit down.

I'd just ascertained that he didn't have his medication on him, when the paramedics pulled up. I relayed to them his situation. One paramedic took over there, while I explained the secondary situation to the second paramedic.

When she walked over to the boy, I returned to my car and left. Job done.

The entire city was in gridlock. Like most British conurbations, it wasn't built with cars in mind. It was all sheep tracks at first, before the Industrial Revolution brought railways and canals. Automobiles were a last century after-thought.

As a result, it's surprisingly easy for my city to be in gridlock. All it takes is for congestion to start in strategic places and off we go. Or don't, as the reality would be.

I was sitting in traffic in a back-street. My cunning plan to avoid the queues had failed miserably. I'd been there for about ten minutes, when a teenager walking by yelled to friends further along the lane. "There's been a big accident!"

I looked around. How on Earth would the emergency services get through here? Even if we saw the flashing lights, there was no way to move.  So who was helping up ahead?

For a few seconds, I hesitated. 'A big accident', with no hope of the paramedics coming through, sounded much bigger than my puny skills. But what if I was all they had?  I drove up onto the pavement and parked on a grass verge, then I ran.

A car had crashed into a wooden electrical post. It had landed on a woman walking by. The cable was bouncing, sparking in the street. The driver was in his seat. It took an hour for an ambulance to arrive. I was the only person with any medical experience there, even though that was only First Aid.

What would you have done?

A First Aider is not a paramedic. Nor are we police officers, fire crew, nurses, doctors or any of those other heroes of the hour.

It's important to remember these things, when faced with a huge situation. Our remit is solely as a stop-gap until the professionals get there.

What went so wrong here is that the professionals weren't going to arrive any time soon. That was scary and it did worry me. Nevertheless, there were things that I could do. I told myself that the only differing factor here, to any other situation, was the time scale. I did what I could.

First job is always to secure the area. You're helping nobody by becoming a casualty yourself. Unfortunately there was nothing I could do about the cable. I'm not an electrician either. I did what everyone else was doing, I kept clear of the thing.

I checked the driver first. He proclaimed himself shaken but otherwise fine. His seat-belt had saved him, though he had jerked forward in his seat. There was potential whiplash there. Nothing I could help him with.

He remained in the car with a gentleman from a nearby house waiting with him. They knew to call me, should the situation change.

The lady slumped on the pavement was a different matter. She had been unconscious and had only just come around. She'd been helped into a half-sitting position against a nearby garden wall. I wouldn't have done that, because I don't know about internal injuries. I would have left her lying there.

She was bleeding quite badly from a head wound. I always carry a First Aid box in my car. I had it with me now.

I gingerly touched around the area, feeling for a fractured skull. I should probably have dealt with the bleeding first, but I was nervous. Nor did I want to apply a compression bandage, while my imagination was filling in details about shattered skulls.

I found nothing, so I used a padded gauze to compress as lightly as I could. She was too disoriented to hold the bandage in place herself, which worried me even more. I asked a lady standing by to help me keep the padding there. Then I secured it with a final bandage wrapped down under her chin.

Most of the next hour was spent sitting beside her, fending off people wishing to feed her cups of tea. There's no way of knowing if she'd ultimately be in surgery, so I couldn't allow any food or drink to pass her lips. Even if she was British and there was a kettle on.

Let me tell you, I've never been more relieved to hear ambulance sirens in my life. It did take a long time for them to get down the street, but a paramedic had already run down ahead of it.

I very, very gratefully handed over to him, then made my way back to my car and waited for the traffic to clear.

Please remember that I wouldn't be there, if you found yourself in a similar position. It would be down to you.

You'll not get the hands on, easy to remember training from reading such stories. But gain a good understanding of First Aid, and you can trust yourself to deal with most medical emergencies.

It's not in the remit of a First Aider to be a medic. We're merely there to give the person a chance to survive. To keep them going until the paramedics, nurses, doctors, surgeons and other specialists can take over.

But we are the first on the scene. I can deal. Can you?