Introduction and Primary Assessment

A first aider has a number of roles and responsibilities in an emergency situation but all first aiders should be aware of the key aims of first aid.

Preserve life

Your first aim is to preserve life by carrying out emergency first aid procedures. For example, opening a casualty’s airway or performing cardiopulmonary resuscitation (CPR). Preserving life should always be the overall aim of all first aiders. Remember though, this includes your own life! You should never put yourself or others in danger. This is why the first stage in assessing a casualty (think DRABC) is to conduct a risk assessment and check for any dangers to yourself or bystanders.

If a situation is too dangerous to approach, you should stay back and call for professional help.

Prevent deterioration

The second aim of first aid is to prevent the casualty’s condition from deteriorating any further. For example, asking a casualty with a broken limb to stay still and padding around the injury will prevent the fracture from moving and causing further injury or pain. In addition, this aim includes preventing further injuries. You should attempt to make the area as safe as possible and removing any dangers.

If removing danger is not possible you should attempt to remove the patient from the danger or call for specialist help.

Promote recovery

Finally, you can promote recovery by arranging prompt emergency medical help. In addition, simple first aid can significantly affect the long-term recovery of an injury. For example, quickly cooling a burn will reduce the risk of long-term scarring and will encourage early healing.

WHAT ARE THE MAIN HEALTH AND SAFETY REGULATIONS?

(a) The Management of Health and Safety at Work Regulations 1999

Also known as the ‘Management Regs’, these came into effect in 1993. Main employer duties under the Regulations include:

• Making ‘assessments of risk’ to the health and safety of its workforce, and to act upon risks they identify, so as to reduce them (Regulation 3);
• Appointing competent persons to oversee workplace health and safety;
• Providing workers with information and training on occupational health and safety; and
• Operating a written health and safety policy.

(b) The Workplace (Health, Safety and Welfare) Regulations 1992

• The main provisions of these Regulations require employers to provide:
• Adequate lighting, heating, ventilation and workspace (and keep them in a clean condition);
• Staff facilities, including toilets, washing facilities and refreshment; and
• Safe passageways, i.e. To prevent slipping and tripping hazards.

(c) The Health and Safety (Display Screen Equipment) Regulations 1992

The main provisions here apply to display screen equipment (DSE) ‘users’, defined as workers who ‘habitually’ use a computer as a significant part of their normal work. This includes people who are regular users of DSE equipment or rely on it as part of their job. This covers you if you use DSE for an hour or more continuously, and/or you are making daily use of DSE.

Employers are required to:

• Make a risk assessment of workstation use by DSE users, and reduce the risks identified;
• Ensure DSE users take ‘adequate breaks’;
• Provide regular eyesight tests;
• Provide health and safety information;
• Provide adjustable furniture (e.g. Desk, chair, etc.); and
• Demonstrate that they have adequate procedures designed to reduce risks associated with DSE work, such as repetitive strain injury (RSI).

(d) The Personal Protective Equipment at Work Regulations 1992

The main provisions require employers to:

• Ensure that suitable personal protective equipment (PPE) is provided free of charge “wherever there are risks to health and safety that cannot be adequately controlled in other ways.” The PPE must be ‘suitable’ for the risk in question, and include protective face masks and goggles, safety helmets, gloves, air filters, ear defenders, overalls and protective footwear; and
• Provide information, training and instruction on the use of this equipment.

(e) The Manual Handling Operations Regulations 1992

The main provisions of these Regulations require employers to:

• Avoid (so far as is reasonably practicable) the need for employees to undertake any manual handling activities involving risk of injury;
• Make assessments of manual handling risks, and try to reduce the risk of injury. The assessment should consider the task, the load and the individual’s personal characteristics (physical strength, etc.); and
• Provide workers with information on the weight of each load.

(f) The Provision and Use of Work Equipment Regulations 1998

The main provisions require employers to:

• Ensure the safety and suitability of work equipment for the purpose for which it is provided;
• Properly maintain the equipment, irrespective of how old it is;
• Provide information, instruction and training on the use of equipment; and
• Protect employees from dangerous parts of machinery.

(g) The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995

Under these Regulations, employers are required to report a wide range of work-related incidents, injuries and diseases to the Health and Safety Executive (HSE), or to the nearest local authority environmental health department. The Regulations require an employer to record in an accident book the date and time of the incident, details of the person(s) affected, the nature of their injury or condition, their occupation, the place where the event occurred and a brief note on what happened.

The following injuries or ill health must be reported:

• The death of any person;
• Specified injuries including fractures, amputations, eye injuries, injuries from electric shock, and acute illness requiring removal to hospital or immediate medical attention;
• ‘Over-seven-day’ injuries, which involve relieving someone of their normal work for more than seven days as a result of injury caused by an accident at work;
• Reportable occupational diseases, including:
• Cramp of the hand or forearm due to repetitive movement;
• Carpal tunnel syndrome, involving hand-held vibrating tools;
• Occupational asthma;
• Tendonitis or tenosynovitis (types of tendon injury);
• Hand-arm vibration syndrome (have), including where the person’s work involves regular use of percussive or vibrating tools; and
• Occupational dermatitis;
• Near misses (described in the Regulations as ‘dangerous occurrences’). The HSE has produced a list of the kinds of incidents regarded as ‘dangerous occurrences’.

(h) The Working Time Regulations 1998 (as amended)

These Regulations implement two European Union directives on the organisation of working time and the employment of young workers (under 18 years of age). The Regulations cover the right to annual leave and to have rest breaks, and they limit the length of the working week. Key protections for adult workers include:

• A 48-hour maximum working week. Employers have a contractual obligation not to require a worker to work more than an average 48-hour week (unless the worker has opted out of this voluntarily and in writing);
• Minimum daily rest periods of 11 hours, unless shift-working arrangements have been made that comply with the regulations; and
• An uninterrupted 20-minute daily rest break after six hours’ work, to be taken during, rather than at the start or end of the working time.

Extra protection is available to young workers (workers aged 15 to 18). In particular, young workers:

• Are entitled to a daily uninterrupted rest break of 30 minutes after working more than 4.5 hours;
• Are entitled to an uninterrupted 12-hour break in each 24 hour period of work.
• Are entitled to weekly rest of at least 48 hours in each seven-day period (and unlike adult workers, they cannot be made to take this rest over two days averaged over two weeks); and
• Cannot normally work more than eight hours a day or 40 hours a week. These hours cannot be averaged out. There is no ‘opt-out’ for young workers.

All full-time workers are entitled to 5.6 weeks’ paid holiday each year, reduced pro-rata for part-time workers. These basic limits on the working week make a vital contribution to health and safety at work.

• Employers have the right to ask their staff to enter into a written agreement to opt out of the 48-hour limit, for a specific period or indefinitely.
• However, if such an agreement is opted into, a worker is entitled to bring the agreement to an end without the employer’s consent.

First Aid Kits

A properly equipped first aid kit can save vital minutes in an emergency. In addition to your first aid kit at home, keep one in your car and boat and take a portable kit on camping trips and holidays. Make sure you:

• Label the kit ‘First Aid’
• Use a container that is childproof and waterproof
• Replace items as they are used, do not keep medications for any length of time and safely dispose of a prescribed medicine once the course of treatment is completed
• Tape a card, listing emergency phone numbers and the blood group, allergies and special medical problems of family members to the container
• Keep the kit handy but beyond the reach of children •keep this book close to the kit for quick reference.

HOME KIT

First aid kit for a family should contain the following:

• Adhesive dressing strips for minor cuts and grazes
• Adhesive tape to hold dressings in place
• Paracetamol analgesic tablets for headaches and minor pain
• Antihistamine cream for bites and stings
• Antiseptic solution
• Cotton buds
• Disposable latex gloves
• Medicine measure
• Roller bandages in a range of sizes
• Round‐ended scissors (use only for first aid)
• Safety pins
• Splinter forceps or remover
• Sterile combine dressing for severe bleeding
• Sterile eye pads wrapped singly
• Sterile gauze swabs for cleaning wounds
• Sterile non‐adherent absorbent dressing for burns
• Thermometer in a protective case
• Triangular bandages
• Tubular gauze finger bandage with applicator
• A full range of quality first aid kits that have approval are available from vital first aid

CAR KIT

Remember to always keep a copy of Vital First Aid in your glove box. Your car kit should contain a least a selection of the dressings, pads and bandages listed above, scissors and safety pins.

Dressings

A dressing is a protective cover placed over a wound, before it is bandaged, to help:

• Control and absorb bleeding and discharge
• Relieve pain
• Prevent infection and further injury.

A variety of sterile, non‐adhesive dressings can be bought, but any clean, absorbent material that does not stick, such as cotton, linen or gauze, is suitable.

Do not apply cotton wool or fluffy material directly to a wound, because the fibres will stick.

Do not touch the wound or any part of the dressing that will be in contact with the wound.

Pads

Pads, made from layers of cloth, gauze or bandages, are sometimes placed over a dressing to apply pressure, increase the absorption of fluids or help protect skin.

Ring Pad

A ring pad holds a bandage away from a wound if there is an object embedded in the wound or a broken bone protruding through the skin. However, a standard dressing placed around the object has the same effect – but easier.

To make a ring pad: wind one end of a narrow bandage around your fingers to make a loop, then bring the other end through the loop and pass it over and under until a firm ring has been made.

Bandages

Bandages are used to:

• Control bleeding
• Keep dressings and pads in place
• Help reduce or prevent swelling
• Support a limb or joint, relieving pain
• Restrict movement and, when used with splints, immobilise a limb or joint.

Ready‐made bandages, usually of calico, crepe or gauze, are available. Modern crepe, elastic or con‐ forming bandages are easy to apply, and they maintain an even pressure because they follow the body’s contours. They are available in a variety of widths for different parts of the body. Tubular gauze bandages are also easy to apply because they do not need to be tied and are available in sizes to fit different parts of the body; they are particularly useful for fingers and toes. In an emergency you can, however, improvise, using a sheet, pillowcase, stockings or other materials for bandages.

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