All First Aid Measures That Have Changed Since You First Learned
When was the last time you took a first aid course? 80th? 90th? As with everything in the medical field, first aid is constantly evolving, and what you may have learned to do as a first rescuer 10 years ago may be completely wrong today. Let’s take a look at some of the biggest changes in the past few years.
To help make sense of all this medical knowledge, we spoke to Jordan Urada, an emergency worker at HealthONE , who walked us through the most common procedures right now. He was also quick to point out that research is constantly evolving, so if you’re in a position that calls for it, be sure not to miss out on first aid training. Ironically, some of these standards have come in and out of fashion over the years, so depending on when you’ve mastered the basics of first aid , some of your knowledge may be relevant.
CPR has completely changed
Cardiopulmonary resuscitation (CPR) was first introduced in 1960. At the time, the typical procedure was known as the ABC: airway patency, breathing, chest constriction. You started by opening the airway to try to resuscitate the victim by inhaling quickly through your mouth, and then moved on to swinging your chest to get your heart to beat again. Depending on when you learned CPR, you may also have learned to apply pressure to the patient’s trachea to reduce the amount of air entering the stomach. Back in 2010, this procedure changed completely.
Now the recommended method is CAV: chest compression, airway, breathing. One CPR cycle consists of 30 compressions followed by two breaths of approximately one second. The order changed because the researchers found that chest compressions are the most important part, and in many cases, breaths are unnecessary. This type of CPR is best for drowning people and people who have passed out due to breathing problems.
In fact, “ Hand Only CPR ” or “Compression Only CPR” is now recommended for most emergencies we encounter as bystanders (other than drowning or people who pass out due to breathing problems. Regular CPR still remains better in these cases). Ourada notes that in some cases, breathing can do more harm than good, and only compression CPR is recommended:
The American Heart Association is continually researching and considering the most effective way to save lives in community-acquired cardiac arrest. While mouth-to-mouth resuscitation has been a common practice in the past, it has been found that not only does it not help, but can make the situation worse by filling the abdomen with air, making it difficult to effectively compress the chest. It also increases the likelihood of the patient vomiting directly to the face, which – let’s face it – is not only dangerous to the health of rescuers, but also serious. It is now recommended that the most effective way to resuscitate a person in cardiac arrest is consistent, deep, and rapid chest compressions without interruption.
That’s all to say, if you can’t breathe, you should just keep compressing your chest at about 100 per minute (which is about the same as in the song“Lost,” as you may have heard ) until help arrives or the person has clear signs of natural breathing. It is also worth noting that as research on CPR is constantly evolving, it is recommended that you take a course of CPR every two to three years in order to stay in the loop.
Using harnesses is useful (again)
Depending on when you attended the first aid course, you either learned to put a tourniquet on bleeding wounds, or you were strictly forbidden to use them. Likewise, if you’ve ever watched any action movie, you just assume the tourniquet will work for just about any injury. However, studies published in the Journal of Trauma andSpecial Operations Medicine show that the complication rate is quite low. Ourada explains:
Tourniquets were popular for many years, then went out of fashion for a long time due to the risk of limb injury and compartment syndrome. However, in the past few years, after extensive use and study by the military in the wars in the Middle East, tourniquets have regained widespread use and proved to be the most effective way to stop severe arterial (streaming) bleeding in the extremities. … You really want to know how long it is on the limb as it does cause injury, but it takes a long time and ideally the injured person is already on their way to the trauma center during that time.
So when should a tourniquet be used? They are best used to limit severe external bleeding in the extremities. Before applying a tourniquet, you should try to stop open bleeding by applying direct pressure to the bleeding site until it stops. If it doesn’t slow down after about 15 minutes, then it’s time to apply a tourniquet (and no, you don’t need to raise the limb, this was also refuted). To apply the tourniquet correctly, place it two to four inches from the wound, between the wound and the torso. Then, tighten it in a knot around the limb until the bleeding stops. Many first aid kits have tourniquets that can be used, making the process much easier.
While tourniquets are back in vogue, it is still recommended that you only use them with proper training, so if you missed it in first aid it is worth going back.
Do not induce vomiting without calling Poison Control
If you took first aid before 2010, chances are you have learned how to induce vomiting when someone swallows a foreign, possibly toxic, substance. It was so popular that people were told to keep ipecacuanas at home just in case. Turns out this is a terrible idea.
The reasoning is pretty simple. In most cases, conventional treatments, in which someone swallows toxic substances (such as milk, activated charcoal, and ipecaca), are useless and in some cases harmful. Urada says that depending on what the victim has swallowed, vomiting can do more harm when it returns than when it subsides, so it’s always best to seek expert advice rather than resort to some kind of one-size-fits-all treatment plan.
Regardless of whether your first aid teacher told you, you should always call Poison Control (1-800-222-1222) before doing anything.
Don’t store naked numbers in ice
When you lose a toe, say a toe or a toe, the old advice was that the best way to recover it was to put your toe on ice and go to the hospital as soon as possible. While this is partly true and makes the scene in the film great, there is more to it. Putting it right on ice is a bad idea.
When you place an amputated finger directly on ice, you risk damaging it. Ourada explains:
Do not throw your finger directly on stones, as this can freeze and damage the skin and blood vessels. It is best to wrap the amputated part in a cloth or paper towels and then place it in the refrigerator or a cup of ice to cool. Avoid direct contact with ice, do not immerse it in liquid or clog it with water. Go to a trauma center as soon as possible.
Once you arrive at the trauma center, your finger may be reattached if it is still in good shape. If things go well, the victim will fully recover its use.
Likewise, if someone has lost a tooth, the previous recommendation was to just go to the dentist as soon as possible with the tooth in hand. It is now recommended to store the tooth in Hank’s Balanced Salt Solution , Propolis, Egg White , Coconut Water, Ricketral, or Whole Milk. If none of these are available, you can also store the tooth in the victim’s own saliva until it reaches the dentist.
Never put anything in the mouth of a seizure victim
You may have heard that when you see someone having a seizure, you should place an object between their teeth so they can bite so they don’t swallow or bite off their tongue. If your knowledge of first aid is very old, you may have also learned how to restrain a victim. Both of these statements are incredibly flawed. Stroking something into a seizure victim’s mouth can suffocate, and holding on to something can lead to bone fractures or other injuries.
Seizures are difficult to watch because there really is nothing you can do. The best thing you can do is to clear the area and try to make the victim as comfortable as possible. Urada’s suggestions are pretty simple:
The old wisdom says that the victim needs to put something in his mouth, such as a wooden spoon, so that he does not bite his tongue. This is not recommended as you can cause harm by forcibly shoving something into his mouth and also create a choking hazard. The best thing to do if you see someone grabbing is to help lower him to the ground if he’s not already and try to put something soft under his head so that he doesn’t hit his head on the ground while grabbing. …
In addition, the CDC adds that while your first reaction might be to offer water to the victim as soon as they stop grabbing, you should always wait until they are fully alert before doing so.
Retaliate before the Heimlich maneuver
Update: We added this after we discovered that the American Red Cross guidelines had changed. The Heimlich maneuver has long been used to remove a foreign object from a conscious person when he suffocates, but this is no longer the first thing you should do. The American Red Cross now recommends backstabbing prior to performing the Heimlich Exercise (now referred to simply as “pushing to the stomach”).
When someone is gasping for breath, have someone call 911, get consent, then tilt them forward and heel them five times in the back. If that doesn’t work, give five abdominal thrusts. Place the thumb of your fist in the middle of his belly, grab your fist with your other hand and push it until the object is pushed out.
The American Heart Association and the American Red Cross are constantly updating guidance on all changes in first aid procedures . With each version, you will see where it was updated and what came before. We haven’t covered all of the changes here, so be sure to check them out to brush up on more of the basics.