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First aid first.

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First Aid↗

The earliest days of first aid.

First aid, as a profession in its own right, has a history of only 120 years. It evolved from the teachings of the Royal Humane Society and military surgeons, who saw the wisdom of training in splinting and bandaging for battlefield wounds. In 1878 two Aberdeenshire military officers, Surgeon-Major Peter Shepherd of the Royal Herbert Military Hospital, Woolwich, London, and Colonel Francis Duncan established the concept of teaching first aid skills to civilians. This radical new enterprise, conducted under the auspices of the newly formed St John Ambulance Association, was a natural evolution from the body's philanthropic and ambulance transport work. Shepherd conducted the first class in the hall of the Presbyterian school in Woolwich using a comprehensive first aid curriculum that he had developed. Within months of that first class, local Woolwich civilians used their skills when the pleasure boat Princess Alice sank in the Thames at Woolwich, killing 600 people. Within a decade, the new discipline of first aid spread rapidly throughout the world, and by the end of the 19th century, hundreds of thousands of St John first aid certificates had been awarded in four continents. Shepherd's pioneering classes changed the world's concept of the need for the provision of skilled prehospital care.

Curriculum↗

First aid and first aiders who work in health food, processing and light engineering in Nottingham.

One hundred and forty nine first aiders working in a health authority, 26 in a light engineering company and 35 in food processing plants completed an anonymous questionnaire about their training and first aid work. Information was also gathered on views about its value, the role of cash bonuses and its promotion amongst other staff. The response rate was 88%. The majority of first aiders were in their 30s and had practised first aid for less than a decade. At least 80% intended to revalidate their certificate and continue to practise. First aid was used most in food processing plants and least in the health authority. Offers of help had seldom been refused. Over 90% of respondents thought first aid was worthwhile.

Data Collection↗

[Basic life support skills of the first aid course II/standard first aid course ambulance personnel].

This study was undertaken to evaluate thirteen elements of basic life support skills of the First Aid Course II/Standard First Aid Course (FAC II/SFAC) ambulance personnel and to determine the effects of FAC II/SFAC education and basic life support instructor courses. Ninety-eight FAC II/SFAC ambulance personnel were enrolled in this study. It was found that only half of the personnel possessed the skills required for assessing respiration, mask holding and producing adequate tidal volume by the bag-valve-mask devices at the acceptable levels. Regarding the effect of the time that had passed following FAC II/SFAC education, we did not find any correlation between the time and the levels of skills. However, there was a tendency in which the skills for assessing mental status/respiration and for manual airway control were less adequately possessed by FAC II/SFAC personnel who did not take basic life support instructor courses, particularly those who had completed FAC II/SFAC education more than four years prior to this study. Since airway control and respiratory management play a key role in saving patients in life-threatening conditions, we need to critically reevaluate how the initial FAC II/SFAC education and continuing education programs can best be implemented.

Ambulances↗

[Helicopters and medical first aid units. Role of Medical First Aid Unit 94].

For the transport of injured and sick patients, the helicopter (even the mono-turbine type) offers greater advantages when compared to land vehicles: - more comfort (less vibrations, accelerations and decelerations); - a greater speed, that is to say a 61 p. 100 gain of time upon the distance and a gain from 29 up to 44 p. 100 upon the total amount of time taken up by each transport. This gain in time enables valuable specialised medical teams to be more available: - more precise time-tables than by land which namely makes it easier to receive the patients. The drawbacks are linked with the risks which are not nonexistent but rather less serious than by land. The drawbacks also depend upon the weather-conditions (although this factor does not matter much in our area), upon nuisances such as the noise (which is more important but far more transitory than by ambulance) and chiefly upon the cost of air-transport. In fact, the mean cost of a medical land transport amounts roughly to one thousand Francs, a quarter of which only does represent the actual cost of medical aid. For a similar transport, the helicopter comes to a 47 mns flight. There are several ways of making good use of a helicopter. Practical problems have been solved. The "SAMU 94" experience goes back to 1973 and includes over 500 transports by helicopter essentially with the help of the teams and the helicopters belonging to the Paris Base (Civil Protection and the Fire-Brigade). For flights over urban areas, it is to be desired in the future that only twin-turbine helicopters should be used.

Accidents, Traffic↗

Help: first aid issues.

First aid is the initial and immediate care given to a victim outside the hospital environment, with the purpose of assuring life and avoiding worsening conditions until he/she receives qualified assistance. Providing immediate aid to someone requires tranquility and, above all, knowledge on what has to be done or not in each situation. In addition to being treated by health professionals, the chances that a victim will receive early treatment by others are large. However, in Brazil, access to information, and the possibility of reviewing it whenever necessary, may contribute greatly to the process of assimilation of this knowledge, in addition to exercises on simulated cases. Informatics has been shown as an extremely useful tool in the development of educational software, considering its multiplicity of resources and providing for the users: motivation for an interactive experience, an individualized teaching that takes into account his/her own rhythm and desired complexity level, besides making possible the user's capacity for solving problems through simulated situations. Considering that, the number of individuals of the population prepared to act as First Aid helpers in situations of life threatening accidents or sudden illness is still very scarce. The ever increasing use of the computer as a mean of spreading information in schools, enterprises, and even households and considering the advantages of an educational software for the users regarding storage and retrieval of information when needed, we proposed the creation of an interactive teaching software. This software is being developed using Storyboard live. The methodology is the following: literature review, selection of images, development of the program, application tests. The initial selected issues are: assessment of the victim, cardiorespiratory arrest and resuscitation, airway obstruction, wounds, and hemorrhages. After utilizing the program, the user should be able to solve hypothetical situations with minimal initial care and maximal physical comfort for an accident or sudden illness victim.

Computer-Assisted Instruction↗

[A resuscitation aid in the first aid and medical care for the victims of severe trauma received in emergency situations].

On the basis of their own experience in combat casualty staging, emergency situations and various publications the authors theoretically substantiate the necessity to reinforce the structures of pre-medical and medical care with reanimation teams which must be equipped with adequate assets capable to meet with emergency situations. The article contains information about training, equipment and organic structure of these teams. Taking into account the pathophysiological mechanism of severe injuries the authors give characteristics of the volume of medical care provided by these teams at various periods of casualty staging. The article stresses the necessity to combine the conduction anesthesia with central analgesia. The authors substantiate the necessity of the quest for a new analgetic as a drug of choice at the pre-hospital period, and describe its desired characteristic features: effective analgesia without breathing depression or circulatory iatrogenic disorders; long-term analgetic effect which gives the possibility to perform evacuation to the secondary care medical unit; possibilities for national fabrication of this drug in large quantities, impossibility of addiction to this drug.

Combined Modality Therapy↗