Emergency First Aid Priorities

by Troy Edick
(US)

Some back ground on myself. I spent 16 years in the military, most of which was a marine corp Hospital Corpman. So field medicine and emergency survival medicine is my back ground.

The first is always ABCD ( airway, breathing, circulation, deformity). The reason behind this is simple priority.


Airway

If you don't have any airway, nothing else is going to matter. The heart in a health person will last no longer than 5 minutes at best without air. So this is your priority to establish an usable air way.


Breathing

Then breathing, is the person breathing once you have established an airway. If not give a two breaths. When opening the airway depending on if suspecting a spinal injury or not there is two methods. Head tilt chin lift if no fall or suspected spinal injury.

If possible spinal injury use what is known as a modified jaw thrust, which allows for stabilization of the cervical spine, while opening the airway.


Circulation

Once you have established the patent airway and given your breath assess circulation. Does he have a heart beat. If yes then continue on. If no that is the next priority. Because a person will not breath if you don't have a heart beat.

Something to remember. You can have a heartbeat without breathing, but will never breath without a heart beat. If no heart be start CPR. Chances are during a survival situation you will not get past this step. Most heartbeats can not be reestablished without receiving defilibration. However it is not always true so you must try. Because younger folks or hypothermic folk can and will respond to chest compressions. It is always better to try then to give up.

If you do have circulation, and are breathing move onto the next step.


Deformity

Deformity covers several areas. do a quick head to toe sweep of the body with your hands starting at the back of the head moving down the body. Check you hands often, for blood.

Normally I like to teach check you hands after every major area. ie. Head neck. Check hands. Back check hands, chest check hand, etc.

Treat all major bleeding as you find it. Which can be done by just applying direct pressure with one hand while you continue the sweep. You never know, the person may have a worse bleed farther down.

After you do this, you can treat any deformities. Which is mostly immobilization in position that deformity was found. Never move a deformed limb, unless there is no pulse below the deformity. Then and only then do you move it. Applying gentle traction and extending the limb out. Check for circulation after that below injury.


Shock

Then treat for shock. The most common cause of shock is poor blood volume circulation or loss. Not necessarily blood loss, but just not perfusing the brain, and vital organs. So elevate the legs, and keep the person warm.

There isn't much you can do in the field for treating an unconscious patient. Most people who are unconscious in the field are that way do to one of the above.


Sorry this is a little long winded. I am very passionate about field medicine.


Troy Edick