First aid before help arrives

Basic first aid is a practical skill, and it is better learned on a certified in-person course.

The history of medicine is full of rules that became obvious only after resistance. In the 1840s Ignaz Semmelweis noticed that maternal mortality dropped sharply when doctors treated their hands with chlorinated lime after autopsies and before examinations. The observation proved stronger than the explanations available at the time, but not immediately stronger than professional vanity.

Germ theory later gave the mechanism a language. The practical lesson is wider than hand-washing: a useful procedure can appear before a full explanation, but it has to rest on an observable result, on reproducibility and on subsequent checking — not on the authority of whoever said the rule first.

Reading is useful, but it does not replace practising cardiopulmonary resuscitation, bleeding control and other actions under an instructor.

In an emergency, the safety of the site is checked first. A casualty gains nothing from a second casualty next to him.

Then:

• call the emergency services;
• assess consciousness and breathing;
• do only what you have been trained to do;
• stay until the professionals take over.

It is worth having a first aid kit and checking the expiry dates from time to time. It is even more worth knowing what its contents are for.

Medicines should not be taken simply because they helped an acquaintance or happen to be in the house.

Before use you need:

• the correct name;
• the indication;
• the dose;
• contraindications;
• possible interactions;
• the expiry date;
• an understanding of when a doctor is required.

The presence of contraindications does not prove that a drug works, and the absence of a long list does not prove it is useless. These things are settled by research, not by the elegance of the leaflet.

Reading up on your own helps you ask good questions of a doctor and a pharmacist. It does not turn a person into his own general practitioner.

Particular care is needed with medicines in children, in pregnancy, with chronic illness and when several drugs are combined.

Scepticism towards medicine does not protect against disease. Neither does blind trust. What is needed is a system in which an important decision can be explained, checked and, if necessary, revised.

The main shortage in such a situation is not knowledge but readiness to start. A ring usually forms around a person lying on the ground, everyone waiting for someone more competent to step forward. That is why in-person courses teach a simple thing: address a specific person, not the air — “you, in the blue jacket, call for help.” A request with an address breaks the circle of onlookers and appoints someone responsible. An impersonal one dissolves in it without trace.

What can be done with no training at all is worth a good deal too: make sure the site is safe, call for help, stay, and hand the casualty over to the crew when it arrives. The rest is better done by hands that have already done it under an instructor’s eye.