From: jim.speirs@canrem.com (Jim Speirs) To: macman@bernina.ethz.ch Subject: Teaching First Aid Article #53. ===== Teaching First Aid Velma Carter The Leader, February 1976 Accidents happen swiftly and without warning. That is why it is best to 'be prepared' to act quickly and correctly according to the situation. As Lord Baden-Powell said in his book, Scouting tor Boys, "Remember your motto Be Prepared. Be prepared for accidents by learning beforehand what you ought to do in the different kinds that are likely to occur. "Be prepared to do that thing the moment the accident does occur." Many Scouters take on the task of teaching first aid themselves, while others hand it over to a St. John Ambulance instructor, a doctor, nurse or experienced first aider. Whichever method you pursue, it is important to stress what B.-P. stressed: "You are not a doctor. As a first aider you should send for a doctor at once except for minor injuries. Your job is to keep the patient from getting worse until medical attention can arrive; by preventing shock, stopping bleeding, giving artificial respiration or doing what ever else is necessary." Teaching first aid is no longer confined to a 'classroom' environment. It can be taken anywhere the fundamentals, once learned, can be applied. But how? Since a first aider is usually only called upon to act in a real emergency there is no chance for a dry run--unless you use your imagination! Plan your training to show the logical connection between first aid and natural hazards. Whatever the injury, it can be linked with normal Scouting activities. For example, just travelling to and from the meeting hall, a first aider may encounter a car accident, a fallen cyclist or an injured pedestrian. While playing a wide game, someone may fall and receive a concussion; or trip with resulting bruises, cuts or sprained ankle. A first aider should be prepared for accidents at camp too; cuts and bleeding from using an axe while cutting firewood, burns and scalds from building a fire and cooking, water accidents requiring artificial respiration, and the list goes on. While engaged in normal activities, such as a hike, point out the likely hazards: a sprained ankle, sunstroke, poison ivy or insect bites. Try holding a short quiz during a break on the trail, asking the treatment for any mishap that could occur. Point out what natural materials are available to make an improvised stretcher or splints. It is important for first aiders to become familiar with the equipment that might be necessary during an emergency situation. Prevention is also an important part of first aid. Stress the points that would prevent a mishap from occurring -- correct footwear for hiking to prevent blisters or sprained ankles, hats for sunstroke, knowledge of plant life for poison ivy or oak. What about an injured first aider? Most training is done on a victim. Does the first aider know how to take care of himself? What happens if he sprains an ankle, badly burns himself or has a hard-to-get-at injury? If there is no one else about, the first aider should be prepared to take care of himself. Hold a first aid contest to test the knowledge and abilities of your group related to a situation taught earlier. As a second part to the contest, have a 'self-help' problem. Example: The first aider's right arm is injured, possibly a simple forearm fracture. It must be immobilized with a basic arm sling. Have a right-handed person place a sling on his right arm and a left-handed person on his left arm. Since first aid is already an integral part of the Cub and Scout program, (Cub Blue Star Requirement #6, First Aid Badge; Scout home and safety, water activities, winter first aid, First Aid Badge, Citizen Badge, Winter Scouting Badge, Exploring Badge and Camp Craft Badge) it is best incorporated throughout the year in small doses. Realism plays a valuable part in teaching first aid. It helps to ready your students for emergency situations. They will be able to recognize the symptoms of shock and see the difference between a compound fracture, a simple fracture and a dislocation, 'up-close'. In a realistic setting, casualty simulation shows that not only is there an injury to be treated efficiently and speedily, but also the type of reaction a victim is liable to have. It helps in quick assessment of injuries, handling the patient and applying the essential first aid. Getting your 'victim' to act accordingly may not be as easy as it sounds. Coach the boys to act the part, using facial expression, body tension and appropriate sound effects. Facial expression is very important to a first aider, since it helps assess the severity of the situation. Is the mouth tense? relaxed? sagging? The eyes -- are they alert? dull? eyelids drooping ? Since casualty simulation is a teaching aid, it should be treated as such. Be sure your group does not get over-exuberant in applying the make-up. Trying to make someone look extremely gory will only create a phony atmosphere that will inhibit the learning environment. The idea is to become adept in first aid, not make-up techniques. You can keep casualty simulations in a controlled classroom atmosphere, but it is more effective when practised (when your group least expects it) with other activities. For example, one enterprising Scouter 'set up' an accident for his Scouts who were taking first aid. "Borrowing" two senior Cubs (so no one from the troop would be noticed as missing) he had the boys made- up to look as if they had fallen from the choir loft that was in the church above their meeting hall. The boys were sprawled out in awkward positions, displaying bruises, cuts, broken bones and signs of shock. When everything was set, the Scouter went downstairs to the meeting hall asking all his first aiders to come and help. This type of unexpected accident simulation can be done just about anywhere, especially at camp, and is a great learning experience. If there is any initial panic on the part of the first aider, he must recognize it, overcome it and proceed to help the victim. What You Need for Casualty Simulation - wax or plasticine - grease paint sticks: red, white, black, blue (lipstick will do for red, eyeshadow can be used) - white latex or surgical adhesive - small, dull bladed kitchen knife or coffee sticks for applicators - squeeze type plastic spray bottle to spray on perspiration - red blood colouring. Mix colouring with thin solution of cocoa to simulate blood. - cold cream - dry rouge - liquid make-up - petroleum jelly - glycerine, mixed half and half with water for simulated perspiration - simulated bleeding device. Using half pint of plastic squeeze bottle, a 3-foot length of 1/8" plastic or rubber tubing (drug store or hearing aid supply house). Instructions Application of grease paint: Apply a thin coating of cold cream and wipe off excess. Smooth grease paint on thinly; avoid using too much. Avoid sharp lines and streaks. To obtain a dull finish and help set the grease paint, powder the area lightly Removal: Apply cold cream generously and wipe off the area with tissue. Hot water and soap completes removal. Mixing Colours Mix the colours in the palm of one hand and apply to the working area with fingers of the other hand. Structural Make-up One of the features of casualty simulation is structural make-up. Irregularities of bone, jagged skin, burnt flesh can be simulated with plasticine or wax. Casualties will usually have the same basic characteristics: dishevelled hair, rumpled and dusty or dirty clothes with collar open, tie loosened and other realistic effects. Nearly all cases will require shock make-up to some degree. Facial expression is important and should be appropriate to the condition; reflecting pain, apathy, exhaustion, anxiety or what ever the case may be. Victims should wear old clothing and shoes during the exercises. This allows first aiders to cut trousers to treat simulated broken bones, cuts, and burns. Clothing can be dirty and torn to indicate the result of an accident. It also eliminates stained uniforms.