It is a heart felt plea that as you read these recounts from people just like you or me, that perhaps you will take the steps to learn how to act in a positive confident manner. It is also my hope that we will be able to put together a better understanding of the realities of what a first aider is expected to do. This comes out of reading a couple of years back a statement a politician made about cabbies knowing first aid, although aimed at 1 profession the same can be said about any person required to deliver first aid. This politician made the observation that “they dont need it (first aid) all they need to do is ring 000 and wait for the ambulance, they are after all the ones with the training and skills”. I took offence and still do, every person out there that comes to another persons need at the time of an incident is calling on all their skills and resources to make a difference. as can be seen from the stories below.

The first recounting comes from Georgia Bolden-Strestik

* An outline of the incident

A gathering of good friends for Christmas get together. There were about 5 families in total with children ranging from 4yo to 10yo. Kids were in the pool, splashing around shrieking with glee and enthusiasm. Adults sat at the side of the pool around a table with nibbles and drinks. All were facing the pool either directly or side-on. Not all the kids were in the pool at the time, probably about 5 or 6 were in the pool at the time of the incident.

This occurred at about 4:30pm. Most of us had only been at the pool for less than half an hour.

* A step through account

As far as we can piece together this is what happened:

One little 7 year old boy (Master R) was by the side of the pool, we aren’t exactly sure if he jumped in or slipped but he hit his head on the way in. His father noticed that R was underwater very quickly. The first I noticed of the incident was t he father running and jumping into the pool out of the corner of my eye. Next I knew the father has surfaced with the boy in his arms yelling “Help! Someone help!”. Little R was blue and floppy, a sight I never want to see ever again. I can still recall the moment of panic, we thought he was dead.

I was by the pool in an instant and to be honest, my memory is sketchy of what happened next. I went into autopilot, checking airways first. His jaw was clenched shut, a small amount of blood was coming out of his mouth. I could not feel a pulse or feel any life in the boy at all. I flipped him onto his back and started CPR. I knew there was no chance of getting any air in by mouth-to-mouth so I just thought “get his blood moving, get his airways moving.”

The mother was absolutely beside herself with shock and grief. She thought, as did all of us, that this little boy had gone.

I went through about 5 or 6 compressions then flip ped the boy on his side to try and open his mouth again, clear anything I could, then repeated. I remember yelling at the stunned onlookers to call 000 (I think someone was already onto it). I was forceful with the compressions, I could really feel that I needed to squash his ribcage to get the blood moving and his airways compressed. I did this for about 3 cycles and just started on the fourth when he moaned and his eyes rolled open and back. I flipped him again into the recovery position and tried to clear his mouth again.

Little R’s lips turned pink and he was back. I will remember this sight for the rest of my life as one of the most joyful things I have ever seen.

Another friend who knew little R better started talking to him and trying to engage him to maintain consciousness. We could see he was on the brink of lapsing. By now I could feel his lungs working, I listened to his chest on his back and could feel and hear crackling. Little R started c oughing up small frothy bits of mucous. We encouraged him to keep breathing and coughing and told him it was fine if he felt the need to throw up. I explained to the mother that if he did, not to be alarmed, it was what his body needed to clear any water that was in his tummy or lungs.

I did a quick check of the rest of his body, could not see any obvious signs of trauma. We had dry towels underneath R’s head and body and had covered him up to keep him warm.

The mother was in shock, she was absolutely desperately worried about her little boy. At this stage I was concerned about both the mother and the father going into shock. As it happens the team of friends that were around were incredibly slick at organising and leaping into action. The ambulance was on it’s way, the father had his clothes changed. The mother was being comforted as best as we could. The other children were looked after and taken away from the pool. My husband ran to the top of the dr iveway to meet the ambulance, another father organised gates and access – a pretty slick operation.

The ambulance took 12 minutes to arrive – the longest 12 minutes I have ever experienced. I watched every breath of little R. Wiped his mouth clear when there was a build up of mucous and comforted him.

The ambulance officers arrived and assumed that we had been negligent and were not watching the kids in the pool. We had no idea how long R had been under for but knew it could only have been moments… but how many? The ambulance officer left me with R as she administered oxygen, her partner removed the mother to give more space to work and to try and collect a story. The oxygen mask was on and the ambulance officer had got a description of what had happened, I told her I was worried I was so rough on the poor boy. Only at the moment when she said to me “don’t worry, you have saved his life.” I sat back on my heels, looked at one of my friends a nd the reality of the situation dawned on me. At this very point my brain kicked along with a whole lot of emotion.

* How did it feel in comparison to what you had learnt

I don’t think anything can prepare you for the emotion afterwards, it is huge.

The physical sensation of compressing a chest was also something I wasn’t prepared for, despite my senior first aid training on the Annie doll.

* Did you feel prepared for the incident

It’s important to realise that I didn’t feel anything at the time, I went into autopilot mode to fix the boy. There was a sense of detachment in hindsight, something that I think was essential. If I had become emotional I suspect my judgement may have been clouded.

Was I prepared? I guess so. Thank God.

* Anything unusual about the incident.

I would hope the entire incident was unusual, but I suspect these close calls happen more than we are aware. It’s only the tragedies we hear about in the media.

I was listening to an interesting discussion about First Aider responsibilities and rights.

We are all aware that there is no requirement to go to the aid of another person. That is there is no Duty of Care required by a passer by, however this is where it becomes interesting. Did you know that when you take on that Duty of Care you take on the responsibility accorded by law for the protection of that life? This means that you do not have to cease providing that care until you believe that there is a better qualified individual group prepared to take over that responsibility.

The following two stories help to explain what this means.

One of our trainers was called up to the floods a couple of years back near the Victorian border. An incident occurred where by a mother was having trouble coping with the loss of home, belonging and her kids were running amok as they were also under stresses. She was nursing a young baby, who was screaming and reacting to all of the stress in and around her. The Mother went very quiet, she was starting to shows signs of heat stress and there was a smell and behaviour similar to being intoxicated. A young police officer was telling her that she needed to get the children under better control and was starting to take out his stress on her, which thankfully brought her to the attention of our first aider. Our first aider approached the scene summarised the situation and realised that the mother needed to re-hydrate and appeared to be having a diabetic episode (medication not with her as misplaced during evacuation) . He asked the police officer to settle down.
As you can imagine no Ambulances available, so the safest way was to utilise police vehicles for transport. He requested this of the young officer who told him he wasn’t interested in helping someone who was drunk and unable to keep their kids in order. Our first Aider sent for the police officer in charge of the venue and explained the situation, The young officer was “encouraged” to become a lot more cooperative as the situation was a potential life death situation, therefore as a police officer his duty of care was to follow the instructions given by the first aider. Mother received treatment at the hospital and family doing well.

Another of our first aiders attended an incident where a child was knocked of his bike. He witnessed the accident and so stopped his vehicle in a position to offer protection from oncoming vehicles. He had ascertained that there was a likelihood of a broken arm and had organised ambulance attendance. So was in the process of determining other injuries when he was forcibly pushed out of the way, causing him to almost fall on the casualty. As he turned he saw a woman grab the boys arm where it was broken and give it a squeeze, to which the boy emitted a suitable loud scream. Our first aider demanded that the woman remove herself from the scene for the safety of the child that she had almost made unconscious from the pain of her idiocy. Her response was very surprising as she demanded that she be allowed to continue as she was a divisional superintendent of a respected organisation known normally for their first aiders. Our first aider however had began treatment and had therefore assumed duty of care. He reminded her that he would take this duty very seriously including her forcible removal if required.
Police arrive at this point and she heads in their direction whilst our first aider continues examination and monitoring of the incident. Police officer comes across to our first aider and demands to have a word with our first aider, who politely declines stating he has assumed responsibility of duty of care and will remain with the casualty until suitably trained care arrives where he can pass on his responsibility with confidence. The police officer becomes more demanding and our first aider tells him to wait his turn and if he wants to arrest him after the Ambo’s arrive that is fine, but in the meantime he had his work to do and the police officer would be better suited ensuring the accident scene remains safe.
Ambos arrive address our first aider by name, which attracts the attention of the police officer who was still trying to hassle our first aider. Short discussion followed along the lines of:
Police Officer: do you know this man
Ambos: yes he trained us.
P: so he is an Ambo?
our first aider: no I retired.
Ambos: that is a pity you were one of our best instructors.
conversation continued..
Police Officer comes over to our first aider and starts to ask questions relating to the incident, whilst Ambos make ready for transport and securing casualty. As the situation is described to the police officer, woman decides it is time to start to retreat. Police officer has words with woman and explains in no uncertain terms about ensuring she behaves better in future.

Once you begin first aid your duty of care is to your casualty until no longer able to continue that duty or until you pass it on to someone that can perform that duty better. A good course will empower you to act with confidence and utilise the people around you to get the best for your casualty. You owe it to them.

We are not offering a legal opinion, nor does the above constitute a first aid course, I strongly recommend that you contact a good first aid organisation in your area. A good course, means that they have a suitable mannequin to student ratio (not more than two students per mannequin). Class sizes are manageable look for a course with less than 20 students, unless they are supplying an additional trainer per 10 students above this number. That the instructor has had life experience and not just book knowledge, through their experiences you will gain a greater insight into the process needing to be observed in a real incident.

Burns occur when the skin starts to rapidly degrade through heat. However I like to broaden that definition slightly because chemicals do not necessitate the sense of heat to degrade the skin. Therefore I prefer the definition of any substance, force, or heat that rapidly degrades the skin. Lacerations do not rapidly degrade, and the various forms of necrosis are also longer term.

Burns can be broken into 3 formats for the medical fraternity.
First degree burns show redness;
Second degree burns show vesication (blistering);
Third degree burns show necrosis through the entire skin.
However for first aiders, we are really interested in two types:
Superficial: painful, red and blisters.
Possible causes: sunburn or hot water.
Deep burns: skin may be charred, no pain except in outer areas of burn, pale and waxy.
Possible Causes: electricity, molten metal, hot embers.

What to do next to assist the victim?

The next part as a first aider is to take into the account the area of the burn. This is a little more difficult to explain, you could use the rule of 9′s each arm is worth 9 points, head is worth 9 points, upper chest 9, lower chest, back upper, back lower, upper leg, lower leg are all worth 9 points. anything with a score of 9 points needs to go to the hospital. However this changes with kids and infants. So it is best if you consider that every person that is larger than your hand, should be encouraged to seek medical aid, burns to the throat, Always refer, the face or genitalia should be referred if larger than an SD card. Any deep burns refer to medical aid.

However we have gotten ahead of ourselves. Treatment whilst in your care. Immerse the burnt area under water (not for throat burns, get them off to hospital straight away) for most burns 20 minutes or if shivering begins, chemical burns are better with 30 minutes. Remove clothing, do not remove if stuck to the body, cut around the clothing instead. cover with non stick dressing, burn sheet or burn dressing. If possible elevate burnt limb. Refer to medical support if required, see above. (my suggestion, call the ambulance/paramedic or get someone to call the ambulance/paramedic for you whilst cooling the burn if you feel it will need to be referred.

remember the suggestions here do not constitute a first aid course, I strongly recommend that you contact a good first aid organisation in your area. A good course, means that they have a suitable mannequin to student ratio (not more than two students per mannequin). Class sizes are manageable look for a course with less than 20 students, unless they are supplying an additional trainer per 10 students above this number. That the instructor has had life experience and not just book knowledge, through their experiences you will gain a greater insight into the process needing to be observed in a real incident.

We all know that first aid in the workplace is about minimising harm to yourself so we dont get injured ourselves, HOWEVER what takes place when you see someone collapse and your immediate instinct is to render them assistance?
We can go back to the basics of apply  first aid, First letter D for danger.  But that is our mate, our work colleague, our family member our Child.  Does the concern for our own safety still hold true?

YES! You need to make sure you don’t become a casualty yourself.  if you find yourself becoming a casualty that means that the person coming to your rescue needs to make a choice between two people who are injured, what if they start work on you and the one you tried to save dies?  Their one chance of life became the reason for their death.  YOU need to keep a clear head and ensure that you are of assistance to them by making sure you do take into consideration the circumstances of their injury and the likely hood of any dangers.

So what do you do?  Check for dangers, if a danger is identified that you are unable to manage on your own, call for help (most have a mobile phone these days so call 000 and inform the call centre of your need.  Using items that are nearby see if it is possible to move the danger or the person away from the danger if safe to do so.  Sometimes it is just as important to do nothing as it is to do something, if the person is responsive and sitting in a car that has become electrified, simply by talking to the person in the car it is sufficient to ensure that they are kept safe and reassured that an ambulance is on the way.  Where as the moment you touch any part of the car you become the source of the grounding of that electricity, resulting in the electricity potentially killing you both.

Think always that your job is to support the casualty to the best of your ability and to keep both of you safe.  Your Mate, family member or Child is counting on you to make sure you dont become a casualty as well and that you can give real support in their time of need by doing the right thing.