- Understand the role and limits of a first aider.
- Secure the scene and protect yourself from infection.
- Assess a casualty and give a complete alert.
1The first aider's role: protect, alert, assist
First aid is the help given by a person on the spot, with little or no equipment, until medical help arrives. It has three aims: preserve life, prevent deterioration and promote recovery.
The approach fits in three words: protect (yourself, the casualty and bystanders), alert (emergency services or the nearest health facility, according to your organisation's medical plan) and assist (the right actions, within the limits of your training).
In humanitarian settings, medical help may be hours away. A first aider must therefore be able to monitor a casualty for a long time and know the organisation's medical evacuation plan (MEDEVAC): who to call, which vehicle, which health facility, how far away.
2Securing the scene and protecting yourself
Before touching a casualty, look around: traffic, fire, electric wires, unstable buildings, a hostile crowd, the risk of a second explosion after a first one. An injured first aider is one more casualty. If the danger cannot be removed, and only if it is possible without risk, move the casualty; otherwise, wait for the right resources.
- Wear gloves whenever there is blood or body fluids; if none are available, use a clean plastic bag.
- Wash your hands before and after, or use alcohol-based hand rub.
- If the casualty's blood comes into contact with a wound or mucous membrane, or after a needle-stick: wash, then seek medical advice immediately for possible post-exposure prophylaxis (to be started as soon as possible, within 72 hours at the latest).
3Assessment: response, airway, breathing
The assessment follows a fixed order, dealing first with what kills fastest.
- Response: speak loudly, tap the shoulders. "Can you hear me? Open your eyes."
- Catastrophic bleeding: visible heavy bleeding is treated immediately, before anything else.
- Airway: in an unresponsive casualty, gently tilt the head back and lift the chin.
- Breathing: look, listen and feel for no more than 10 seconds. Gasps (infrequent, noisy breaths) are not normal breathing.
If the casualty is not breathing normally: have someone call for help and fetch a defibrillator, and start resuscitation (day 2). If they are breathing: recovery position, then a full head-to-toe check (wounds, pain, deformities) and monitoring.
4Calling for help: a clear and complete message
Who to call depends on the context: the national emergency number if it exists and works, otherwise the organisation's medical or security focal point, the referral health facility or the local Red Cross or Red Crescent. These numbers must be in every vehicle and in the security plan.
The message always follows the same order:
- Where: exact location, landmarks, GPS coordinates if possible.
- What: type of accident or illness, number of casualties.
- Condition: response, breathing, bleeding, actions already taken.
- Who: your name and a call-back number. Only hang up when the other person tells you to.
The worker who fell from the scaffolding
School rehabilitation site
You are monitoring the works for your organisation; you are the only team member trained in first aid.
A worker has fallen from 3-metre scaffolding. He is lying next to an electric cable torn loose by the fall. His co-workers want to lift him up.
Decision 1 of 3What do you do first?
Decision 2 of 3The power is off. The worker responds, complains of back pain and can no longer feel his legs properly. You:
Decision 3 of 3What do you include in the alert?
Key takeaways
Protect before helping, limit movement when a spinal injury is suspected and give a complete alert.
Exercise: your emergency sheet
For your workplace, fill in a one-page sheet: emergency numbers that actually work, the nearest health facility and its level (health post, hospital with surgery), travel time by day and by night, the location of the first aid kit and the PEP kit, and your organisation's MEDEVAC procedure. Post it up and keep a copy in every vehicle.
Key points
- Protect, alert, assist: always in that order.
- Scene safety first, including the risk of a second explosion.
- Gloves and hand hygiene; exposure to blood: PEP within 72 hours.
- Assessment: response, catastrophic bleeding, airway, breathing (10 seconds at most).
- Alert: where, what, condition, who; do not hang up first.
Further reading: course references
- International Federation of Red Cross and Red Crescent Societies (IFRC) (2020). International First Aid, Resuscitation, and Education Guidelines. www.ifrc.org/document/international-first-aid-resuscitation-and-education-guidelines
- WHO, War Trauma Foundation, World Vision International (2011). Psychological first aid: guide for field workers. www.who.int/publications/i/item/9789241548205
- WHO and ICRC (2018). Basic Emergency Care: approach to the acutely ill and injured. www.who.int/publications/i/item/basic-emergency-care-approach-to-the-acutely-ill-and-injured
- International Committee of the Red Cross (ICRC) (2006). First aid in armed conflicts and other situations of violence. shop.icrc.org
Daily quiz
3 questions to check what you have learned. Answer them all to complete the day.