DR ABC

When approaching what looks like a seriously injured or

unconscious person to administer first aid. This "DR ABC" can
help you to remember what to do.

DANGER

Check the area, make sure YOU are safe

and so are people around you.
RESPONSE
Can the casualty hear your voice? Can they
open and close their eyes? are there any
movements? Do they respond to touch?
AIRWAY
Is there a blockage in the throat or have
they swallowed their tongue? Is the head in
a suitable position (check first aid manual
for details) to allow breathing? Care should
be taken not to make anything worse but
the airway MUST be cleared if it is blocked.
BREATHING
Can the casualty breathe clearly? Once the
airway is clear, is there any other problem the lungs for example?
CIRCULATION IS there a pulse? Is the heart beating? Is
the pulse weak / strong / racing
(A First aid manual or website will give you more detailed
information. This quiz is a revision test and not designed to
replace a comprehensive first aid course or manual.)

Expired air resuscitation (EAR) is a way of breathing

air into someone to supply that person with the oxygen needed for
survival. EAR is given to victims who are not breathing but still
have signs of circulation.
EAR works because the air you breathe into the victim
contains more than enough oxygen to keep that person alive. The
air you take in with every breath contains about 21% oxygen , but
your body uses only a small part of that. The air you breathe out
of your lungs and into the lungs of the victim contains about 16%
of oxygen , which is enough oxygen to keep someone alive.
You will discover whether you need to give EAR during the
first two steps of the ABC in the primary survey when you open
the airway and check for breathing. If you can't see, hear, or feel
any signs of breathing, you must begin EAR immediately.

EAR TECHNIQUE
Ti give EAR, first turn the victim onto the back and keep the
airway open with head tilt and jaw support. Place one hand on the
top of the head and tilt the head back. Support the jaw with your
fingers in a "pistol grip" position. Head tilt and jaw support not
only open the airway by moving the tongue away from the back of
the throat, but they also move the soft tissue flap, called epiglottis,
from the opening of the trachea. If you know or see that the victim
is wearing dentures, don't automatically remove them. Dentures
can help the EAR process by supporting the victim's mouth and
cheeks during mouth-to-mouth resuscitation. If the dentures are

loose, the head-tilt and jaw- support technique may help keep
them in place. Remove the dentures only if they are broken or
become so loose that they block the airway or make it difficult for
you to give breaths. Begin the mouth-to-mouth method of EAR by
giving full 5 breaths in 10 seconds. If you don't see the victim's
chest rise and fall as you give each breath, you may not have the
head tilted back far enough to open the airway adequately. Tilt
again the victim's head and try again to get air into the lungs. If
your breaths still don't go in, the victim's airway may be blocked
and need to be cleared. Check for signs of circulation after giving
the 5 full breaths. If the victim has signs of circulation but isn't
breathing, continue EAR by giving 1 breath every 4 seconds (15
breaths per minute). Take a breath yourself and breathe into the
victim.

Do not stop EAR unlesson of the following occurs:

The victim begins to breathe unaided.

The victim has no signs of circulation. If so, begin CPR.
Another first aider takes over for you.
Emergency personnel arrive on the scene and take over.
You are physically unable to continue.

External Cardiac Compression (ECC) is now the

accepted method of treating sudden cardiac arrest. The technique
is described, with particular emphasis on the steps which can
cause serious trauma, if not properly performed. Ventilation of the
lungs is of paramount importance.

The incidence of cardiac arrest seems to be increasing and

appears to be higher in infants, perhaps because of the large
proportion of cardiac surgical procedures in this age group.
Survivals depend on several factors, the most important of which
are the time elapsed before treatment is begun, the location of the
patient at the time of cardiac arrest, and the primary disease of
the patient. Use of external cardiac compression diminishes
delay, makes the location of the patient less important, and
produces less trauma in a critically ill patient. Blood pressures
achieved by the external method are comparable to levels
reached by direct massage of the heart. The myocardium is not
traumatized by the external method, which is also less fatiguing to
the operator.

The complications of external cardiac compression are traceable

to excessive pressures and to pressure over wrong areas of the
chest, and are therefore avoidable. Pressure should be applied to
the sternum in the mid-line only, just above the xyphoid process.
Two cases of ruptured liver in children are mentioned, and reports
of other injuries are discussed in connection with specific errors in
technique.

The R.I.C.E. method of injury treatment can relieve pain, limit

swelling and protect the injured tissue, all of which help to speed
healing.
Keyword

Action

Rest

Rest reduces further damage - stop activity as

soon as the injury occurs.
Avoid as much movement as possible to limit
further injury.
Dont put any weight on the injured part of the body.

Ice

Ice cools the tissue and reduces pain, swelling and

bleeding.
Place ice (wrapped in a damp towel) onto the
injured area. Don't put ice directly onto bare skin.
Hold the ice pack firmly in place with a bandage.
Keep ice on the injury for 20 minutes every two
hours, for the first 48 hours.

Compressio
n

helps to reduce bleeding and swelling.

Ensure that bandaging is not so tight that it cuts off
circulation or causes tingling or pain past the
bandage.
Bandage the injury between ice treatments.

Elevation

helps to stop bleeding and reduce swelling.

Raise the injured area on a pillow for comfort and
support.
Keep the injured area raised as much as possible.

T.O.T.A.P.S. is an effective injury assessment tool.

Keyword
Talk

Action
Ask the player what happened.
Where does it hurt?
What kind of pain is it?

Observe

Look at the affected area for redness or swelling

Is the injured side different from the other side?

Touch

Touch indicates warmth for inflammation, and also

assesses pain.

Active
movemen
t

Ask the injured player to move the injured part

without any help.

Passive
movemen
t

If the player can move the injured part, ask them to

try to move it through its full range of motion.

Skill test

Did the active and passive movements produce

pain? If not, can the player stand and demonstrate
some of the skills from the game carefully?
If an injury is identified, remove the player from the
activity immediately.

S.A.M.P.L.E. is a mnemonic to help you remember the things

you should check for when performing a secondary survey. The
aim of this is to find out the history of what has happened. Once
you have begun treatment for initial injuries such as no breathing,
severe bleeding etc you need to find out the following:
Signs and Symptoms what clues does the casualty show of what
might be wrong. For example swelling
around the ankle may indicate a fracture
(among other things)
Allergies
is the casualty allergic to anything.
Remove anything which is causing an
allergic reaction.
Medication
is the casualty on any medication? how
long for? have they taken it recently?
Past medical history has this hap-penned before? it may be a
repeat problem
Last meal
useful to tell the ambulance crew in case
an anaesthetic is needed later
Event history
what caused the injury/accident?
sometimes called the mechanism of injury
All of this may help you work out what is wrong and it will be
useful to tell the ambulance crew all of this when they arrive (so
keep a note)

For an unconscious casualty, this may be difficult but there may

be clues such as a medical bracelet/medication in handbag.