If you’re anything like me, you probably did a first aid course and prayed desperately that you would never ever have to use this knowledge ever. It’s a strange way to do a course if you think about it. It should come as no surprise then that 77% of people lack either the knowledge or confidence to administer first aid in an emergency scenario. That’s an interesting statistic, until you or someone you know goes into cardiac arrest, and then it becomes a horrifying number.
About a year ago, I had to use my first aid training. I was walking around the lake near my house, and I noticed an elderly lady trying to prop her husband’s head up. It was drooping like he had fallen asleep. I also noticed that he was urinating himself which is often an early indicator that every muscle has relaxed. I began running through DRSABCD before I knew it. I had none of my pharmacist medicines with me, but it didn’t matter. A competent first aider is worth all the pharmacist medicines in the world when you’re dealing with cardiac arrest.
What happened? I’ll tell you at the end. First, I am going to run you through the basics. The reality is, everyone should be doing a first aid refresher every three years. If I had a dollar for everyone who stared at the poster hung in my pharmacy and said DRSABCD? I thought it was just DRABC, I could retire right now.
Danger
You cannot administer first aid if you yourself get caught in danger in the process. All you are doing is adding another person who needs help. Are there live wires at play which need to be turned off before you rush in to help? Is there a sweeping current which might carry you away as well? Is there a lengthy drop which you could fall down in your attempts to help. If so, the most responsible thing to do is to step back and proceed no further.
Response
If someone can respond to you, it is a game changer. You might have a better idea what you are dealing with (“My right leg is broken” or “I am bleeding from the abdomen”). Whilst this doesn’t mean you are out of the woods, it does immediately rule out the need for CPR which is good news. I have always liked the idea of asking their name, and then ‘where is your wallet’. Firstly, if they are semi-conscious, a wallet will often provide you with a name which can be used to keep their attention. You might also find medic alert information in the process.
Send
Crucial. Sending for help is the unsung hero of DRSABCD for one very good reason. CPR rarely brings anyone back to consciousness. However it is amazing at keeping the patient alive until trained paramedics arrive on the scene. You are literally keeping their heart going. But f you don’t send for help, your efforts might be in vain.
Airways
If you receive no response, you must instantly check their airways. If they are choking on their own tongue or some foreign object, no amount of CPR is going to do any good. If there is something there, roll the patient onto their side so that it can drain. Many people are reluctant to move people in case there has been a spinal injury. In this case, you just need to triage the most pressing issue. A spinal injury is much less important than suffocation. Once the airway has been unblocked, return the patient to lying on their back.
Breathing
If they are now physically able to breathe, you should check if they are doing this by themselves. We often talk about look, listen and feel. Can you see their chest rising? Can you hear them breathing? Can you feel it from their mouth and nose? If so, gravy! Put them in the recovery position, and monitor them until help arrives. Now, if they are not breathing but every 30 seconds, they seem to gasp a quick deep breath, this is not breathing. You need to treat that as though nothing is happening, and move onto the next step.
Compressions
A quick note for the folks who haven’t renewed since last century: This used to be circulation, but people kept taking too long looking for a weak pulse, and every second wasted lessens the chance of survival. Now, if they aren’t breathing, you just dive straight into CPR. If they did have a heartbeat already, the worst you can do is raise their blood pressure and break a rib or two. But these are small fry compared to the whole ‘not breathing’ thing. The standard ration is 30 compression and two breaths. I often tell people to work to the tempo of a song in their head. Ironically, Stayin’ Alive by the Bee Gees is the perfect speed, and keeps you motivated. Chances are, you don;t like that song anyway, so you aren’t tainting anything good with a negative brush. Apologies to any Bee Gees fans out there.
Defibrillate
This might arrive with the paramedics, a nearby business might bring one out to you, and you can even purchase them at pharmacist medicines. This is the thing which brings people back into consciousness. And you don’t need to be a doctor to make it work. The machine talks you through every step of the way, and it is probably the easiest part of DRSABCD.
This is a helpful reminder. But it is no substitute for doing a first aid course. St John’s Ambulance Australia offers a great first aid course, and while it might be frightening, it could save a life. It did for me. The elderly gentleman I encountered on my walk survived his heart attack because a few people walking by knew what to do, and weren’t afraid to do it.
Godspeed you,
Floyd
