First Aid Information

DEFINITION, IMPORTANCE AND APPLICATION PRINCIPLES OF FIRST AID

1. What is First Aid, Its Importance and Objectives

1.1. Definition of First Aid

First aid refers to non-medical interventions performed at the scene of an accident or life-threatening situation, using available resources without seeking medical equipment, with the aim of saving lives or preventing the situation from worsening until medical assistance arrives.

First aid should not be confused with emergency treatment, which involves the use of medication by individuals with medical training and legal authorisation. First aid culminates in emergency treatment/care and continues until the injured person reaches the place where they will be treated.

 

1.2. Purpose of First Aid and Critical Processes

The fundamental purpose of first aid can be summarised under three main headings:

1. To maintain vital functions.

2. To prevent the situation from worsening.

3. To facilitate recovery as far as possible.

The objectives of first aid include opening the airway, stopping bleeding, preventing shock, and quickly transporting the injured person to a healthcare facility.

 

Critical Periods (Golden Hour and First 72 Hours):

The first half hour of intervention at the scene is called the ‘Golden Hour’. Approximately 50% of accident deaths occur within the first half hour due to major bleeding, and 10% occur within the first five minutes due to respiratory arrest. The response time for casualties requiring emergency airway opening and respiratory intervention is limited to a few minutes. Therefore, with correct and effective first aid, there is a chance to prevent approximately half of these deaths.

In the case of disasters, the first 72 hours after the disaster are the most critical hours in terms of saving lives.

 

2. Who Can Provide First Aid?

Anyone who has received first aid training can perform first aid procedures. First aid procedures are simple, well-defined methods that can be performed by any knowledgeable individual and are life-saving in nature.

 

2.1. The Role of the Public in Disasters

The role of individuals trained in first aid is critical in disasters because external help may be delayed in reaching the scene of a major disaster, sometimes taking up to 24 hours. As 80% of deaths occur within the first hour or two, it is vital for the community to intervene on its own.

In earthquakes in particular, only a small proportion (3%) of those rescued were saved by professional search and rescue teams; the rest were pulled from the rubble by their neighbours. Therefore, ensuring that the public has good first aid training helps to facilitate the response phase.

 

2.2. Characteristics and Duties of the First Aider

The basic duties of the first aider are divided into three categories: Protection, Reporting and Rescue (PRR).

 

Characteristics of the First Aider:

• Remaining Calm and Cool-Headed: They should not panic, but act thoughtfully. They should remain cool-headed and behave in a way that calms those around them.

• Knowing Their Limits: They should not attempt anything they feel they lack the knowledge to do; they should call for help.

• Ensuring Their Own Safety: They should not put their own life at risk.

• Communicating: They should calm the patient and their relatives, preventing them from panicking by not allowing them to see the injury.

• Organising: They should organise those around them to work when necessary.

 

3. Steps of First Aid Applications (KBK and 6T Procedures)

First aid applications should be carried out systematically according to the Six T steps (Telephone, Triage, Treatment, Transport, Treatment, Transport).

 

Step 1: Protection (Precaution and Personal Safety)

Protection involves identifying potential hazards at the scene and creating a safe environment.

• Identifying Hazards: The rescuer must check for elements that could pose a danger to themselves, the casualty, and those around them (fire, chemicals, sharp metal fragments, unsecured debris, gas leaks).

• Ensuring Safety: The scene should be clearly marked and triangular reflectors should be used. Smoking should be prohibited at the scene to prevent possible explosion and fire risks.

• Gas Risk: If gas or the smell of gas is present, the area should be ventilated and the use of lighting or communication devices that could cause sparks should be prohibited.

• Removal from the Hazardous Environment: If the scene cannot be made safe, the casualty must be removed from the environment as quickly as possible using the easiest and safest method of transport to a safe place.

 

Step 2: Reporting (Telephone/Emergency Call)

The accident or medical emergency should be reported to the 112 Emergency Call Centre as quickly as possible.

 

Points to Note When Calling 112:

1. Remain calm or ensure that a calm person makes the call.

2. Provide the exact address and location information clearly.

3. Report the nature of the incident, the number of patients/injured persons and their condition.

4. The name of the caller and the number from which the call was made should be provided.

5. Information should be provided if any first aid has been administered.

6. The telephone should not be hung up until the person on the 112 line confirms that they have received all the necessary information.

 

Step 3: Diagnosis and Triage (Assessment and Classification)

Diagnosis involves assessing those affected by the incident. Triage is the process of determining the priority of intervention when there are multiple casualties.

 

a) Diagnosis (ABC/CAB Assessment)

The patient/injured person's level of consciousness is determined (by gently tapping their shoulder and asking, ‘Are you okay?’). After checking consciousness, the ABC/CAB of Basic Life Support (BLS) is assessed.

 

Step	Description
A (Airway)	Ensuring airway patency.
B (Breathing)	Ensuring breathing/checking whether breathing is adequate.
C (Circulation)	Ensuring circulation (checking pulse) and controlling severe external bleeding.

 

Important Note: If the emergency situation requires first aid for cardiac arrest (heart failure) and the patient has collapsed, and there is no circulation (C), Basic Life Support (BLS) is initiated according to the CAB sequence without assessing A and B. If the emergency situation requires first aid for trauma, injury, or drowning, the assessment is performed in the ABC sequence.

 

b) Triage in Disasters

Triage (trier: prioritisation) aims to save as many lives as possible by using limited resources in the most effective way in disaster situations.

Triage in disasters is usually performed using the Simple Triage and Rapid Treatment of the Injured (START) method.

 

Triage Colour	Meaning and Priority	Intervention
RED (Emergency)	Seriously injured patients in life-threatening condition. This group requires urgent intervention and has a chance of survival. Respiratory distress, uncontrollable bleeding, shock.	Treatment, stabilisation and transfer are carried out immediately.
YELLOW (Second Priority)	Moderately injured individuals. No immediate life-threatening condition, but their condition may deteriorate.	Intervention occurs after the red group has been treated. They should be reassessed frequently.
GREEN (Minor)	Minor injuries. No immediate life-threatening condition. Walking, minorly injured disaster victims.	They can be kept in a safe area. They can assist when needed.
BLACK (Hopeless/Deceased)	Those who have lost their lives or have a very low/hopeless chance of survival. No breathing, no pulse.	No intervention is performed; they are left at the scene.

 

Step 4: Rescue (Intervention and Treatment)

Rescue (intervention) involves responding to patients/casualties at the scene quickly, calmly and consciously.

 

Responding to Basic Life-Threatening Conditions:

1. Airway Obstruction: If the patient is unconscious and having difficulty breathing, aspiration of a foreign object should be considered and first aid measures such as the Heimlich manoeuvre should be performed immediately.

2. Bleeding: Severe bleeding can lead to shock and death. To stop the bleeding, direct pressure is applied to the injured area. The bleeding area should be kept above heart level to reduce blood flow. A tourniquet should be applied if necessary.

3. Shock: Controlling bleeding, immobilising fractures and preventing shock are the primary objectives of first aid. First aid measures for shock:

   • The injured person should be laid on their back with their feet raised about 30 cm (shock position).

   • The injured person should be covered to maintain body temperature.

   • Nothing should be given by mouth (food, drink, cigarettes). Only the lips may be moistened with cotton wool to relieve the sensation of thirst.

 

Step 5: Transport (Transfer)

Transportation (transfer) involves safely transferring the casualty to a healthcare facility in the most appropriate position for their injury, in a manner that does not worsen their condition.

• Spinal Protection: It should be borne in mind that there is a suspicion of neck and spinal injury, especially in trauma patients. Therefore, the patient should be transported without disturbing the head-neck and body axis.

• Transport Equipment: Special transport stretchers, such as scoop stretchers or spine boards, should be used for the safe transport of patients with fractures, dislocations, and spinal injuries.

• Emergency Transport Methods: In situations requiring rapid rescue, such as fires, medical care such as spinal immobilisation may be compromised. In these situations, carrying methods such as carrying in the arms, on the back, on the shoulders, or dragging are used.

 

4. First Aid Applications According to Disaster and Accident Types

4.1. First Aid and Rescue in Traffic Accidents

Emergencies such as traffic accidents are among the leading causes of injury.

 

Incident Site Management and Safety:

1. Vehicle Safety: The first team arriving at the scene should secure the vehicle, disconnect the battery, turn off the ignition, and remove the key. Fuel leakage should be checked to prevent fire risk.

2. Personal Safety: The first aid provider should ensure their own safety and, if necessary, seek assistance from law enforcement to stop traffic and disperse the crowd.

3. Life-Saving Priorities: First aid must be administered immediately to the victims. A neck brace should be applied, assuming spinal injury in the neck area.

 

Rescue and Transport:

• Entrapment: The basic rule in rescue operations is that the victim should be removed from the wreckage, not the wreckage from the victim.

• Evacuation: In cases of ejection from a vehicle, motorcycle accident, or collision with a pedestrian, the casualty should be sent to the nearest healthcare facility after receiving first aid and appropriate packaging (stabilisation). The casualty should be medically reassessed after being removed from the vehicle.

• Basic Trauma Support: Basic trauma life support should be administered immediately in trauma cases.

 

4.2. First Aid in Earthquakes

In an earthquake, first aid for the injured is at least as important as hospital treatment.

• Extrication Principle: The foremost rule is to extricate the injured person by pulling them out along their body, without bending their body or twisting their neck and waist to the right or left.

• Crush Syndrome: Treatment measures initiated under the rubble are critical for patients with crush injuries caused by heavy objects.

  • Upon physical contact, the team doctor first establishes an intravenous line and administers serum (isotonic fluid) to prevent crush syndrome. If the casualty trapped under the rubble cannot be removed immediately, 1-2 litres of bolus and 250-500 cc of maintenance fluid per hour should be administered.

  • A neck brace must be applied.

  • The person trapped under the rubble should never be given food or drink.

 

4.3. First Aid in Avalanches

Victims trapped under an avalanche lose their lives by drowning, freezing, or trauma.

• Airway Clearance: The first intervention for an injured person extracted from an avalanche is to clear the airway. Snow and ice particles that entered the patient's throat during the slide must be removed. If breathing is not possible, artificial respiration should be performed.

• Hypothermia and Transport: When extracting the victim from under the avalanche, their position should be maintained and they should be transported to a point where there is no avalanche risk. They should be covered to prevent heat loss. Providing warm drinks to those who are conscious is beneficial.

• Prohibitions: Applying heat to frostbitten areas, rubbing them, and bursting blisters is inadvisable.

 

4.4. First Aid for Lightning Strikes

Lightning strikes are among the natural phenomena that cause the most deaths.

• Safety: Electricity does not accumulate in the body of someone struck by lightning; therefore, there should be no hesitation in touching the injured person.

• Cardiac Intervention: As the patient's heart is likely to have stopped, cardiopulmonary resuscitation (CPR) must be performed to restore a pulse and breathing.

• Transport: Even if the person struck by lightning appears to be in good condition, they must not be moved. The injured person must be transported to the nearest medical facility using appropriate methods.