citizenAID Instructor Upgrade Plus Package
Course Content
- Introduction
- The citizenAID System
- How important is learning First Aid by Sir Keith Porter
- Why Trauma patients die by Sir Keith Porter
- The development of CitizenAID by Sir Keith Porter
- Overview of citizenAID by Keith Porter
- CitizenAid - Helping Others and the Law
- Run-Hide-Tell
- Using S.L.I.D.E
- Using SLIDE - an example
- What3Words - location app
- Silent Emergency calls
- citizenAID Tourni-Key Plus tourniquet
- Tourni-key plus - demo
- citizenAID pocket guide
- Fatal Fractures by Professor Sir Keith Porter
- citizenAID scenario and first aid videos
- citizenAID - Immediate actions in an active shooter or knife attack
- citizenAID - Immediate actions following a suspect or exploded bomb
- citizenAID - Public information film from citizenAID - Response to a bombing
- citizenAID - Recovery Position
- citizenAID - Wound Packing
- citizenAID - Improvising a Sling
- citizenAID - Improvising a Tourniquet
- citizenAID - Improvising a Double Tourniquet
- citizenAID - Airway Burns
- citizenAID - Reconstruction
- Summary
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Get StartedWhy Trauma patients die by Sir Keith Porter
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Can I say it is a great pleasure to be here today and to talk to you all. How many of you are important people? Raise a hand. Absolutely right. All of you are very important. And why I say that is whether you are talking about a cardiac arrest and BLS and defibrillation or trauma, managing the unconscious patient and bleeding, unless people get that right, you are not going to have a live patient by the time the patient gets to a hospital. So your contribution in first aid is enormous and I thank you all for that because I am sure indirectly through training you have been responsible for saving people's lives because someone's gone on and we hope taken notice of what you have done and saved lives. I am going to look at my colleague there because I know he works for South Central Ambulance Service. I am not going to put you on the spot, but you will know and perhaps there are other ambulance people here as well, that when you go to a cardiac arrest, if someone's not been doing BLS then the chances of survival are pretty minimal. We agree? Yeah, absolutely. Yeah. Okay. So let us not underestimate what you do as first aiders. So I want to talk a little bit about why trauma patients die. Why do trauma patients die? Why do they die? They are not breathing. They are not breathing, yeah. Why do they die? Cat haem. Catastrophic hemorrhage. Yeah. Okay. So I could go now, couldn't I already? Because that is the main things to talk about. I am off. Let us look at this in a bit more of detail. First thing is trauma is becoming a global epidemic. It is the commonest cause of death between the ages of 1 and 44. So with a bit of laxity, that is everyone in this room. But it is fundamentally a big issue and it is anticipated that by 2030 it is going to be the commonest cause of death. And the reason for that is that many of our sort of third world countries are purchasing cars, having motorbikes, often unregulated. They do not have the sort of health and safety regs as we have. So trauma is the future epidemic. Here are three quotations and I am just going to give you a moment just to look at those and then you might think, "Well, how are these relevant to trauma?" And then I will try and give you my explanation, really. So the first one from the Israeli Army, "He who looks to heaven will soon be there." And of course the inference there is if you are lying on your back and if you are unconscious and if your airway is not open, then you may well die as a consequence. Fundamental first aid. Cannon was a US surgeon. And this statement is from 1918. 1918. And he says, "Shock may hinder bleeding." And if you think about it, the body's response when you bleed is over time your pulse rate goes up, but your blood pressure goes down. And if you have got a low pressure system then you are going to bleed out less. So those of you who have watched... I mean my favorite, medical program used to be "Casualty" on a Saturday. And there used to be a paramedic on there called Josh, if my memory serves me right. And I watched Josh learn cannulation and I watched him infuse litres of saline solution into patients. Now what we do know is that when you are shocked, the worst thing you can do is to give people lots of fluid because it is going to wash away that clot that is formed, it is going to dilute your clotting factors and the outcome is worse. So in fact, I am quite pleased if they closed down the hospital, or the practice where Josh worked, because that was completely unsound. And those of you who who have been in the game long enough will have heard about, let us put an IV up, let us give fluids. And now of course we give no fluids or the minimal amount of fluids in shock patients until they can get to a hospital alive. So what Cannon said in 1918 was so very, very relevant. All that said, all that said, again Ursula's comment here, "Shock is a momentary pause in the process of death." Yes, your patient may have a low blood pressure, they may have all the features of shock. You do not give them... You may not be able to, but if you, the ambulance service should not give them volume. If they have got uncontrolled non-compressible bleeding, they need to be in hospital. But that hospital needs to be reactive and they need to get on and tackle the cause of the blood loss, I.e. Take them to theater, turn the tap off if you would like. And then that patient's got a chance to recover. So it is one thing to accept they are going to be shocked, but equally one's got to have a plan to resolve that problem. So that is why in those particularly unwell patients in the pre-hospital phase, to get them to a hospital as quickly as they can post first aid and with the ambulance services is so time critical. So shock occurs in three fundamental phases, really. There are those people who are irretrievably dead when they are injured. And I will show you some of those. There are the intermediate group, the 30% here. These are out of trauma deaths, where they die after a period of time, often because of lack of oxygen, hypoxia or lack of blood, hypervolemic shock. That is 30% in this group. And then there is a 20% group where they are late deaths, they die of infection, they die of multi-system organ failure. And when you look at this group, quite often you find that their initial management was delayed or inappropriate. They were hypoxic or they were hypervolemic for a long time. So these are very important thing. Now, I appreciate these are somewhat out of... They are not out of date, but they are historical data. With the advent of mobile critical care teams and with helicopter services, the number of intermediate deaths has got somewhat less and particularly with the advent of major trauma systems, but it is still a big issue and where as first aiders you can make a big impact. If your head comes off, not even the best first aider and/or surgeon in the world can do anything about that. But for these intermediate deaths, you can manage the airway, you can deal with the shock scenario. And indeed, here are cases I have been involved with. Decapitation is irretrievably fatal. This is a guy that has been crushed between a lorry and a concrete stanchion and he has bled to death as a consequence of his injuries. Here is a guy who has fallen over, in fact, did have an obstructed airway and was not found for a long period of time. And he has got cold, hypothermic and that has contributed to this. And here is a guy who has gone through a hedge in the middle of the night and is found the next morning and he has had an airway issue throughout the night and has died as a consequence. So these are under those circumstances, non-survivable injuries. But these perhaps should not be really. This is a machete wound to the chest. And that is a liver injury. Both, this is causing a combination of blood loss and hypoxia. Your lungs are not working effectively if you have got a big wound into your chest. Here you are bleeding. So what are you going to do for this machete wound to the chest, by the way? How are we going to manage that? Big machete wound opens up the chest. No, no dead right. All you do is you put your hands on this, you push it down to where it should be. Probably be a big bit of cling film would almost seal that off. You seal it really, just like any open chest wound. This just happens to be a rather generous open chest wound. And indeed, that was what happened in this particular case because he is in theater, you cannot tell from this picture. Push that down. You can put your hand onto the lung in there and you could see the heart. But if you push all that down, close it, seal it and the patient can then breathe normally. The mechanics are restored to some extent and they can breathe. These are sort of big patient's injuries, which you can make a big difference with. And so you will be aware that we have been through Iraq, we have been through the Afghan wars and the one thing that drives change is war in terms of clinical care. And Kelly said this before that you have to develop novel and new techniques to help patients. And hence we have come a long way in the last couple of decades. This is quite a busy, albeit, colorful slide. And this is your chances of survival up here and this is your injury severity score. We will not go into this in too much detail, but anything over an injury severity score of 15 is major trauma. In the intensive care unit that I work in at the moment, we have patients who you would think are very seriously injured and their injury severity scores are in the late 30s. So for people to survive with injury severity scores at the top end is absolutely remarkable. And 75, you should be dead. And you can see this is the British military performance year on year in Afghanistan. As you can see... Well, Iraq and Afghanistan. How their clinical care has got better by necessity. They have learned how to better manage hemorrhage. They have learned how to... The surgical techniques and everything else that goes with it. But all was learned by the military is being translated into civilian practice. So in relation to first aid as an example then insignificant trauma, one should be using splinters of the pelvis as a matter of routine through a pelvic binder. There is a patient in here, believe it or not. Now, these are many of the late deaths. And as I said early on, many of the late deaths occur because the patient did not get appropriate care in the first five, 10, 15 minutes after injury. The patient here is a 38 year old lady, a mother of two children who went out with her daughter on an evening out. She does not normally go out much and they decided we take mum out. And they have quite a lot to drink. They go into town in the middle of Birmingham. And whilst waiting, I think for a taxi, they sit on a wall. She is sitting on the wall, what she does not realise, there is there is a six foot drop the other side. And she falls backwards and bangs the back of her head and she is unconscious. The girls with her dial 999. They try to give them advice as to how to position her in relation to her airway. They have all had a bit too much to drink to respond appropriately. And when the ambulance crew get there about 18 minutes later, she has still got an obstructed airway and a mouth full of vomit. So in fact, she has had a major hypoxic lack of oxygen, brain injury and as a consequently, she subsequently dies. But in that passage of care, she has got ventilatory support here. She has got nutritional support. She has got specialist filtrations because her kidneys are not working. She has got multi system organ failure. But just to take home, that many of these late deaths are because we just do not get the care right at the outset. If we look at the history of trauma in the UK, it is a bit of a checkered history, if you like. That from 1988, the Royal College of Surgeons of England looked at 1000 deaths, trauma deaths. And they unanimously agreed that a third of those trauma deaths were preventable. I can tell you now that we currently think probably 20% of trauma deaths are preventable. So all you got to do is think of five people who have died. One of those is probably a preventable death. So we do have a big issue still with preventable deaths. So there is poor management, I think was very much part of the 1988 report. In 1994, Latif Hussain and others published a paper again on poor first aid and preventable deaths. And in 2007, the National Confidential Patient Inquiry into Deaths reported that over 60% of patients, over 60% of patients had suboptimal care. And that is a bad indictment. And that is in the pre-hospital care and in hospital care. So that really identified a problem. And it is very interesting that if you ask people what is the cause of people in terms of those with very severe injuries, how are they caused? Many people now say it is down to young motorcyclists, young people driving, driving too fast, alcohol, etcetera. But in fact, the biggest cause of major trauma in this country now is elderly people falling from a standing height. So, you know, you are asked to go around next door, their mum who lives there, who is... Yeah, could be you, Mike, so be careful. [chuckle] Your next door neighbor's mum is visiting and she has had a fall. She has just fallen in the lounge. We might think that is fairly innocuous, but our elderly people have often got very significant injuries. And they are not always as obvious. So that is our big problem in the UK with our elderly fallers which I will come back to. And in terms of trauma deaths, the majority of our trauma deaths still occur in the pre-hospital environment. So these people are often alive to begin with but there is a failure, it actually being able to deliver appropriate, timely first aid and timely care during that phase. So in Birmingham, let us go back a week. Friday, Saturday, Sunday, a week ago, we had three people with major stabbings, all of which were in cardiac arrest by the time the ambulance service arrived, all of which had suffered quite significant blood loss, so is a real issue. So we now think that the... I talked about the third of preventable deaths back in the 1988 study. Now our current research and current publications will suggest that is round about the 20% figure. And bear in mind, this is a big meta analysis. So a collection of data from 14 higher middle class countries. So we just really still have a persistent problem. All that said, if it is a pre-hospital death, it is quite difficult to find out how and why that patient died. Sometimes as a practitioner or a researcher, it is quite difficult to get access to the coroner's reports. There is a declining number of post-mortems done. And the in thing now is that instead of doing a post-mortem on someone who has died, they will do a CT scan, which is pretty much as informative. So that is changing a bit, but historically it has always been difficult to find out exactly why people died. What we do know and the thing I have been trying to make clear to you is there is a therapeutic vacuum. A therapeutic vacuum. And that is the time between the person being injured and the arrival of the professional ambulance service. And what we have to make sure we do is to somehow educate the general public so that we can bridge that gap. And the problems are, you told me this, I told you I could go, when you told me the cause of death early on, it is opening the airway and it is the arrest of hemorrhage. And actually it is also keeping the patient warm because what we do know is if a patient gets cold, then their blood clotting systems do not work as well. And therefore they are going to become coagulopathic. That means they tend to bleed from their injuries or their bleeding will not stop. So there is a common theme pervading through here, but please latch on to this therapeutic vacuum because I think you can bridge that gap. You have probably heard these terms before, really. It is to stay and play or to scoop and run. The answer actually is to scoop and play. So you pick the patient up, you move them quickly and you continue to manage them and treat them on the way to hospital. I appreciate in first aid, you are waiting perhaps for the ambulance to arrive. But what we do know is that when you analyse the figures in patients with significant injuries, that if there is a delay of getting their definitive care, either surgery for more than 60 minutes, then the outcome is worse. We do know that if you have got severe trauma, all these patients I have been talking about, then they really need to be in hospital as quickly as possible. So it is the minimal first aid, the minimal paramedic input pre-hospitally, the best infusion is diesel. And that is the foot on the floor of the ambulance to get to hospital very quickly. They do not need IV fluids and they need to go to a hospital that can deliver the care that the patient needs. And I will come back to that. However, if you are delivering first aid, say in a sports ground and someone's got a tib and fib fracture. Yes, you immobilise it, you splint it. You give them effective analgesia. And theoretically, you could stop to have a coffee on the way to a hospital because that is not going to materially affect the outcome in this particular patient. Though, do not give the coffee to the patient, they might need an anesthetic. But I am not advocating that. I am just saying in those less serious injury, there is more time to get their care absolutely right. Effective, timely immobilisation of their fracture. Effective splintage, good pain relief or the pain relief that you are permitted to give as you work. For all the... I mean, so often, our patients who are close to cardiac arrest due to blood loss in trauma, we often move them to a hospital so they can have their bellies or their chests open with virtually no care of their fractures because they are not dying of their fractures in that moment in time. They are dying of blood loss. So that is why those critically injured must be in hospital as quickly as possible. Now, where you take your patient to is a matter of debate. Go back 20, 30 years and patients went to the nearest hospital. But that was not good advice. And we learned from the Orange County study in the USA that if you take patients to a major trauma center, then your outcome is significantly better. And they showed an improvement in the mortality rate, from 40% down to about 8% when they centralised taking patients to a major trauma service. And our colleagues in Australia have shown this very well in Victoria State and in the UK. Since we have had major trauma centers, then that has showed a significant decrease in the mortality of trauma. And we have not had a patient arrest and die in an ambulance by bypassing a local hospital. They have had people who have arrested when they were put in the ambulance... So they had already arrested. But we have not had anyone arrest and die in an ambulance, really. So we cannot be critical of the transporting time. And we are very happy to allow a patient to be in an ambulance for 60 minutes transport distance, because we know if they go to the local hospital, many of the local hospitals cannot deliver the care that you necessarily need. But if you live in a big area like Lincolnshire or Cambridge, it may be necessary to do a stop-off because the traveling times are just too great. And that is why you then have to have a slick system in that stopover hospital, so that patient can then be very quickly moved on to a major trauma center. If you take the same patient and this is statistical stuff here, but if you take the same injured patients, the same degree of injury into a normal local hospital compared to a major trauma center, then you are 3.8 times more likely to die in the local hospital. So if you ever... You may or may not be involved in patient transport, but a lot of time relatives say, "I do not want to go to to Oxford because Reading is my local hospital," as an example, but Reading probably cannot... Do not have neuro-surgical services whereas Oxford does. So this is why it is time critical to get the patient to the right hospital in the right time at the right place. And so often, of course, people are way outside that timeline. And that is why if one is in a very rural and a very remote area, it is desirable to have a system in place of first aid education to bridge that gap. And again, in the US, about 33 million people are way out, a 60-minute timeline for receiving any support in clinical care. I just want to draw attention to a couple of papers now that give us the answers. In fact, the answers that they are going to give are very much the ones you gave me, but just shows you a bit of science can come to the same conclusion as your experience. But this paper by Redmond and others are looking at preventable deaths. And there are two studies here. One, they are both conducted in the same way. But the Latif Hussain, excuse me, paper back in 1987 to 1990 looked at trauma deaths and decided that in this particular study, 11% of deaths probably had a probability of survival of greater than 50%. A similar study was undertaken in 2011 to 2013. By this time, 43% of patients in this study had a probability of survival of greater than 50%. And you might think, well, the care's got worse. But of course, our expectations of patient survival, because care's got so much better, has gone up and gone up and then gone up. So here, we would not expect someone to be bleeding to death from their injuries. But back in the late '80s and '90s, we were not good at managing big patients with bleeding, particularly in a hospital. So these are very similar studies using the same methodology. But what I really want to do is to just dwell on the reasons why some of these patients are dying. Both of these studies recognise the challenge is sometimes in finding out the information, but they were able, in all the cases they used in this study, to get access to the coroner's report, or the ambulance report or a pathologist or post-mortem result. I had mentioned briefly injury severity. I am not going to go into math lessons, but I had said anything with an injury severity over 15 is major trauma. Less than 16. Yeah, less than that is not major trauma. But in this particular series, you have got 22 patients who are dying with injuries that are not really normally significantly life-threatening, but these patients have died, so there is something wrong in the care. And I told you about the patients in our intensive care unit who are alive. So they would... I have got patients in injury severity of 39 at the moment. So they would be in that top cohort. So you would probably expect those to live. But there is a large number of patients here who in this study were probably expected to live but did not. And therefore, there is a failure in the system. There are those down here with very high injury severity score who are not going to survive. But so many patients are dying, seemingly when they should not. Now, this is quite an important slide. So of those study, then we have a bystander present when the incident occurred, when someone was injured, someone present within minutes. And then of course, there is this inevitable delay because some people collapse in their home on their own, etcetera, or found collapsed in a field a day after injury. But just remember that figure because despite there being bystanders present, bystander intervention in terms of first aid is only attempted in 33% of cases. And there have been quite a lot of publications that come up with a similar figure. Now, you might say you dial 999 and the ambulance service, through their their system will give you some advice. It is one thing to give advice. It is whether the person is actually going to follow that advice. So in all these trauma calls, 999s, only one in three of those cases is first aid attempted. So if you have got an obstructed airway, then your chances of survival are clearly very small. If you are bleeding and particularly if you are bleeding out, proactively bleeding, big stab wound or RTA with big injuries, then you may be bleeding to death because our public are not actually attempting first aid. In terms of the patients in this study, then in the initial study here, 58 patients probability to survival greater than 50%, 13 of those 58 had airway problems and no one is effectively managing their airway. And the airway does remain a big problem. So I am going to take studies right up to 2017. I do not need to go into any detail, but the big question raised in this particular study, 2017, why not deliver first aid training? So we know we have got an issue, but you know that anyway. And when we look at those who have significant brain injuries in this particular cohort, then a lot of the brain injuries here have occurred, or the insults have been due to poor airway. They have had an injury, but it has been made a lot worse by failing to manage the patient's airway. Now, this is quite interesting because I see this a lot than you may or may not see it in your first aid practice. But there is a collision on the rugby field and there is a guy lying motionless and he is not breathing. He has had a big impact on his head. A guy comes off his horse, forced to the ground, bang their head. They are seemingly not breathing when someone first arrives. Or you go to an RTC, road traffic collision. And when they first arrive, the police are doing basic life support and the patient recovers quite quickly. And then when that happens, you think, "Oh, had they really arrested or not?" And there is this condition which is not been recognised for too long, called impact brain apnea, which means an impact if someone bang you on the head, brain in there, apnea, not breathing. And one sees this quite frequently, that following that injury, the brain if you like, has a big shake up, a big concussion. And the response is that you do not breathe afterwards. And unless someone does some BLS, then you are going to die. Same thing you see occasionally in patients who are struck by lightning, they do not breathe, but you give them BLS over a period of time, they breathe and they fully recover. So that is what happens here. I do not need to go in this, but they are short on oxygen or no oxygen, their carbon dioxide goes up. And they are only saved if they get appropriate first aid. And I do not know if you ever hear about, there is another... You can get impact cardiac arrest as well that someone's kicking a football and the football hits a 14 year old boy in the central of the chest. And that can be enough to stop his heart. It is called commotio cordis, but do not worry about that. But if you are onto it with effective BLS, it is entirely recoverable. Many of those will go back into normal rhythm. Some will need be in ventricular fibrillation and will need an AED. But if the right person is there to deliver first aid early, then you are going to save a life. So I am going to go back and summarise that we... This is the second of those two studies, but the failing here is the is effective first aid. In the second cohort of those patients, only 25% actually had effective first aid. So that summarised what I have tried to say thus far, that there is a therapeutic vacuum that is in the hands of bystanders. Unless they have been trained by your good selves, they will not know what to do. And the two most important things is their airway management and the control of bleeding. And this is all part of the trauma chain of care. And we have to make an impact on that if we are going to see better outcome. You are going to hear more about lack of trained first aid early on when the Manchester Arena report comes out early in November. So people are dying. People are dying in the pre-hospital setting from preventable problems with lack of airway control and lack of effective ventilation and lack of hemorrhage control. I alluded to the Manchester Arena. Let us just look at this in the disaster medicine in a bit more detail, if I may. Let us look at blast. Let us talk a little bit about blast and ballistics. But if a bomb were to go off in here now, then that would generate a massive pressure effect, an overpressure, which only goes on for a millisecond. And afterwards, as that pressure comes down below normal atmospheric pressure, you then have this phase of a negative pressure. And it is in this phase where things like dirt, debris is drawn into wounds or drawn into your body cavity if you have got a big open injury. And we can classify these injuries. So the primary injury when a bomb goes off is the blast wave. You saw that on my diagram. There is a big blast wave. It would knock... It would throw some of you through the windows, through the walls, that blast wave being in a closed space. Many of these bombs are packed with the fragments. If it was the bomb in Soho years ago, it was packed with nails and bolts. So there are all sorts of bits people pack into these bombs. But when they go off, of course, then these fragments can penetrate your body. So you have got a wound. You may not know what is in there as a first aider, but they can penetrate your body. And as will come out of the Manchester report, a horrible thing to think about, but the person who blows themselves up, if they are carrying the bomb themselves, then their body, you do not see much of their body, but bits of their body end up in other people injured, which is a big potential infection risk. So there is a secondary, a brain injury. And then the tertiary. So it might be that I am blown out through that window and I hit the lamp post out there. So I am injured when I hit that lamp post. Or actually the bomb goes off, but I am injured personally when the ceiling falls in. And that is when people often get their fractures or their internal injuries or their brain injuries with this. And then there is the quaternary blast effects, which are usually due to burns or due to crush injuries. So that gives you a spectrum of injury. And the Omagh bombing is one that we all remember. The thing about the Omagh bombing is it led to the creation of a formal training package in what to do in the event of a major incident. The Major Incident and Medical Management, MIMMS support course generated by Tim Hodgetts. And that did a lot to provide formal training in how you manage these things. And then of course, the Madrid bombing, the person here is actually deceased, but this life would have been saved with a simple use of a tourniquet or your lanyard or your tights or your scarf or whatever. So these are horrendous incidents, but there are many preventable deaths in this cohort. And then there are bullets. We see a shooting or a... Pardon, a patient that has been shot arrives in where I work at the Queen Elizabeth Hospital in Birmingham about once every two to three weeks. We see a minimum of two stabbings a day. It is Friday night today. It has also been... People are being paid. So we will probably see five or six stabbings tonight and a similar number tomorrow night. Hopefully, no bombing. So violence is around us and you never know where you might be in the vicinity of that and where you might be... You may wish to then try and help that situation. So bullets generally, the bigger the bullet, the bigger the velocity of the bullet, the more damage it is going to cause. The Bataclan, multiple scenes, multiple incidents in Paris stretches the emergency services. One has to have a system of how one is going to manage that. And of course, it is kind of ironic actually after the incident in Thailand in the last... I think yesterday, isn't it? Where a guy amongst other things used a knife to kill lots of children. I suspect when we find out a bit more about that, there will be lots of those kids whose lives would have been saved had there been an effective means of controlling a hemorrhage, whether it is a tourniquet or a clotter hemostatic dressing.
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The development of CitizenAID by Sir Keith Porter
Importance of First Aid in Trauma Management
Introduction
Greetings to everyone gathered here today. In this discourse, we delve into the critical role of first aid in trauma management.
Recognizing Importance
Addressing the audience, it's imperative to acknowledge the significance of every individual present. Regardless of title or rank, each of you holds immense importance in the realm of first aid.
Saving Lives Through First Aid
First responders play a vital role in ensuring patient survival, whether it's administering CPR, managing bleeding, or maintaining airways.
Understanding Trauma
Trauma, a growing global concern, claims lives across various age groups. By 2030, it's projected to become the leading cause of death.
Quotations Reflecting First Aid Principles
Noteworthy quotes underscore the fundamental principles of first aid, emphasizing the critical need for prompt action in emergencies.
Addressing Trauma Deaths
Understanding the root causes of trauma-related fatalities is essential for improving outcomes.
Three Phases of Trauma Deaths
- Irretrievable deaths upon injury
- Intermediate deaths due to factors like hypoxia
- Late deaths from complications such as infections
Impact of Effective First Aid
Timely and proper first aid can mitigate the severity of injuries, significantly improving patient prognosis.
Challenges and Solutions
Despite advancements, challenges persist in delivering effective pre-hospital care.
Barriers to Effective First Aid
Studies reveal a concerning lack of bystander intervention in emergencies, highlighting the need for widespread first aid education.
Study Findings
Research underscores the critical importance of managing airways and controlling bleeding in preventing trauma-related deaths.
Disaster Medicine
Preparedness and response strategies are crucial for managing mass casualty incidents.
Blast and Ballistic Injuries
Understanding the dynamics of blast and ballistic injuries aids in implementing effective medical management during crises.
Lessons from Past Incidents
Historical events like the Omagh bombing underscore the importance of formal training in disaster response.
Conclusion
In conclusion, the significance of first aid in trauma management cannot be overstated. It's a collective responsibility to ensure swift and effective intervention to save lives.
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