Role of the First Aider


In this topic you will learn about the roles and responsibilities of the First Aider.

Aims of First Aid

First aid is the initial care of the ill or injured. Always remember that the term ‘First Aid’ means exactly what its name implies. 

It begins when the first aider arrives at the scene of an incident. Your task as a first aider is to prevent things getting worse.

First Aid continues until the patient recovers, or medical aid arrives. Medical aid is treatment by a health care professional – doctor, registered nurse or ambulance paramedic.

As a first aider, there are a series of roles and responsibilities that you must adhere too.  The following is a list of the various roles and responsibilities for you to remember. 

1.	You must prevent further danger to yourself to others or to the patient. Your own safety comes first.  Then the safety of others, and then, only if it is safe to do so, you should assist the injured person.
2.	You must not provide medical aid. Medical aid can only be provided by a doctor, registered nurse or ambulance officer.
3.	You must prevent the patient's condition becoming worse. If you can do nothing else, you must at least try to prevent the patient from getting any worse.
4.	You must prevent delay in the recovery of the patient. Recovery depends on how quickly you respond and how soon medical aid is obtained.
5.	It is not your responsibility to protect the long term health of the patient. First aid is about initial care. Long term health is not your problem.
6.	You must prevent any harmful intervention. You must protect the patient from those who don't know what they are doing.

A First Aider should:
•	Assess the situation quickly.
•	Ensure safety
•	Identify the nature of the injury or illness.
•	Manage the patient promptly and appropriately.
•	Organise bystanders.
•	Get help.
•	Gather and provide necessary information and, where possible, keep a written record.
•	Stay with the patient until help arrives.

The first aider must obtain consent, where possible, before applying first aid.
If the patient is unconscious, the law will imply consent.
Where a patient is a child, the consent of the parent or legal guardian should be obtained, where possible.
Note: The age of consent for treatment varies between States and Territories in Australia.

Priorities in First Aid
First Aid is an enormous collection of techniques and priorities and at times it can seem that there is too much to remember.
When faced with a real first aid emergency you may find yourself asking, "What do I do first?"
For example, there is no point splinting a fracture if the patient is not breathing.
Similarly, you should not spend time getting ice to put on a sprain if the patient is bleeding to death.

The steps for a first aider to follow are:
Step 1 Check for Danger 
Step 2 Check for Breathing
Step 3 Control any severe bleeding 
Step 4 Attend to any other injuries

Call Ambulance
When managing a patient, you may need to ring for an ambulance.
The following sequence takes you through the steps you typically follow when calling for an ambulance.

There are several numbers you can call in order to reach an ambulance.  From all landline phones the number to dial is triple zero.  From mobile phones you can dial 112 which will bring you into contact with the local emergency line.  Any other number you call will be incorrect.

Once you have called this number the person who answers will ask what service you require.  Your options are fire brigade, police and ambulance.  You say ambulance.

The phone operator will ask where are you located.  You must give them information that is as precise as possible.  Therefore you must tell them the number, street name and suburb that you are located in. Providing a landmark, such as a building, may be helpful, but you should also tell the ambulance service the street number and name of the nearest cross street.

They will then ask you how many patients there are.  If there is only one patient you must say one.
The operator will ask what is wrong with the patient. It is best only to say what you are sure of, rather than risk giving incorrect information.

The operator will ask you if there are any other services required, you must request only those services that you require.

After you hang up you must wait with the patient until the ambulance arrives.

Infection Control

When performing first aid, it is important to take precautions, such a wearing gloves, to protect against infection.

The actual risk of transmission in first aid is extremely low but you should take steps to minimise the transfer of infectious diseases.

Infectious diseases are diseases which can be transmitted from one person to another.

Infectious diseases can be spread: 
·	By coughing or sneezing
·	By touch
·	By an exchange of body fluids (body fluids include blood, vomit, urine and saliva) All body fluids should be regarded as contaminated.
·	By cuts or abrasions caused by contaminated objects, such as razor blades 

The following list is a selection of various diseases and their infectious properties.

Non transferable diseases include the following:
·	Asthma is not a transferable disease.
·	There is no evidence to show that Cancer is a transferable disease.
·	Diabetes is not a transferable disease.
·	Epilepsy is not transferable.
·	Heart Disease is not transferable.

Infectious but not usually life threatening include the following:
·	Influenza (the flu) is not usually life threatening, but some strains are dangerous to babies, the elderly and people with low resistance to illness.
·	The common cold is highly contagious, but is not usually life threatening.
·	Herpes is not usually life threatening but it if there are sores it is contagious. It is extremely painful and has no real cure.
·	Mumps is not usually life threatening, although complications can arise (e.g. deafness).
·	Glandular Fever is very infectious but is not usually life threatening.  It can take a long time to recover from glandular fever.
·	Measles is a common, contagious childhood disease.  It sometimes leads to a form of encephalitis which can be fatal.  Adult measles can be a very distressing illness.
·	Tuberculosis (TB) can be life threatening but is controllable if caught early.  TB was considered a terminal disease up until the early part of 20th Century.

The following is a list of diseases that are infectious and life threatening:
·	There are many types of hepatitis, and all are dangerous.  Hepatitis B kills more people than AIDS. There are many types of hepatitis, and all are dangerous.
·	HIV (Human Immunodeficiency Virus) is a very serious condition which usually progresses to AIDS (Acquired Immunodeficiency Syndrome) and eventually death. At present there is no known cure.
·	Meningococcal is transferable, and can be fatal, especially in the very young.

This is not a complete list.  There are many other transferable diseases and you as a First Aider must be aware that just because a person looks well, it doesn't mean that they are not carrying some form of virus or bacteria. 

Disease can enter the body through the mouth and nose.  Some diseases, such as colds and flu, can be carried on droplets in the air, so simply by breathing these droplets it is possible to become infected.

If you are giving mouth to mouth breaths on a patient, it is wise to use a mask or face shield, if available, to prevent infection in this manner.

Disease can enter the body through breaks in the skin.  Whenever possible wear disposable gloves and clothing that will protect you from splashed blood and body fluids.

If broken skin does come into contact with blood or body fluids, immediately wash thoroughly with soap and running tap water and seek medical aid.

Disease can enter the body through the mucous membranes found on the inside of the mouth or eyes.

You should wear appropriate protective clothing.  You can protect your eyes by wearing clear plastic, wrap-around safety goggles.  You can protect your mouth by using a resuscitation mask or face shield.

If blood or body fluids do come into contact with your mouth, lips, tongue or eyes, immediately wash thoroughly with clean, cold running tap water and seek medical advice.

Disease can enter the body through the contaminated objects piercing the skin with such things as Hypodermic needles or razor blades.

If you suspect that you have come into contact with contamination of any sort, you should wash the area with soap and water, and contact your doctor or local hospital as soon as possible.

In this topic you learnt about the roles and responsibilities of the First Aider. The items covered were:
·	The aims of First Aid
·	The responsibilities of the First Aider
·	Priorities in First Aid
·	The steps to call for an ambulance
·	How to minimise your risk of infection

For further information about this topic, see Chapters 1 and 4 of Australian First Aid