First aid is emergency care given to an ill or injured person usually in a prehospital setting before professional medical treatment is available. This section provides information about some of the major objectives of first aid care.
Patient Care/Decision-Making Models
A decision-making model is a tool or technique that can be used to help rescuers make a decision in a first aid emergency. Essentially, a decision-making model is principle or set of principles that, when applied, lead the rescuer to make the appropriate decision. Such principles include:
- Do no harm - When a rescuer intervenes to help a patient, he or she must not cause any additional pain or injury.
- Act in good faith - The rescuer’s motive to help the patient must be a sincere one, and he or she must act ethically and honorably at all times and in all ways.
- Act in the patient’s best interest - The rescuer’s actions must be competent and caring, and they must clearly contribute to the well-being of the patient and be respectful of the patient’s wishes.
- Act within the appropriate scope of practice – When deciding how to care for a patient, the rescuer must follow the appropriate established scope of practice, which include best practices, standards of care, and treatment limitations.
Rescuers have an ethical obligation to carry out their duties in a professional manner using these and similar decision-making models.
General First Aid Approach
The page on Assessment of the scene and patient provides a technical guideline for checking and caring for the patient. The mnemonic word PELVIS can be used to apply a set of objectives to any first aid situation. PELVIS means:
- Personal protective equipment (PPE) – Always apply appropriate PPE before beginning assessment and care.
- EMS call – Determine as early as possible if EMS personnel should be called.
- Life-threatening conditions – Take care of any life-threatening conditions first (i.e., level of consciousness, airway, breathing, and circulation issues, including several bleeding, severe shock, poisoning, etc.).
- Vital signs – Monitor vital signs to determine if a life-threatening condition develops.
- Injury/illness – Care for any specific injuries or illnesses you find during assessment.
- Shock – Always care for shock by:
- Maintaining an open airway and administering oxygen, if available
- Keeping the patient still and comfortable
- Caring for illness or injury (e.g., stopping any pain or bleeding, etc.)
- Maintaining normal body temperature
- Reassuring the patient
The following situations may present themselves at the emergency scene.
- Medical identification
- Obvious signs of death - Although a physician must ultimately declare a patient dead, there are conditions in which death is obvious and resuscitation should not be attempted. These include:
- Rigor mortis
- Dependent lividity (discoloration due to the pooling of blood)
- Incineration of the entire body
- Removal/destruction of vital organs
- Evidence preservation - If the emergency is connected to a crime, the scene must be preserved (see Sample Protocol) as much as possible so evidence at the scene is not destroyed. To do this:
- Remember that emergency care is the highest priority.
- Make sure the EMS caller indicates a crime may have been committed.
- Do not disturb any item at the scene unless emergency care requires it. Keep bystanders away from the area.
- Observe and document anything unusual at the scene.
- Do not cut through bullet holes or knife piercings in clothing.
- Work closely with law enforcement authorities.
- Special reporting requirements- Mandated reporting refers to the practice of reporting injuries that may have been caused by battery, abuse, rape, or other forms of violence. The requirements for mandated reporting vary from state to state and should be defined for professional rescuers by local protocols.