How to Give First Aid to Accidental Patients

Before You Do Anything: Stay Safe

1. 1Look around. Check for traffic, fire, fuel leaks, live electrical wires, unstable structures, glass or other hazards that could injure you or make the situation worse.
2. 2Do not become a second victim. If the scene is dangerous, wait for the police, fire service or ambulance, and keep others away.
3. 3Switch off the engine of crashed vehicles if you can do so safely, and put on hazard lights. Place a warning sign or triangle behind the vehicle.
4. 4Use protection if available: gloves and a face shield, or a clean plastic bag over your hands when dealing with blood.
5. 5Ask bystanders for help, assigning clear tasks such as calling for help, directing traffic and bringing a first aid kit.

Call for Help Early

Call 112 or the hospital ambulance number as soon as you recognise a serious accident. Give:

• The exact location, with landmarks.
• The number of people injured, and the kind of accident.
• The condition of the patients: conscious or not, breathing or not, bleeding.
• Any hazards, such as fire or traffic.
• Your name and phone number.

Stay on the line if the operator asks, and follow their instructions. If you are alone with a serious casualty, put the phone on speaker and continue first aid.

Check the Person: DR ABC

Use a simple sequence to find and treat the most dangerous problems first.

D: Danger

Already checked: is it safe to approach?

R: Response

Gently shake the shoulders and ask loudly, "Can you hear me? Open your eyes." If they respond, keep them still and talk to them. If they do not, shout for help.

A: Airway

If the person is unresponsive, make sure the airway is open. Tilt the head back gently and lift the chin. If you suspect a neck injury, use a jaw thrust instead (lift the angles of the jaw forward without tilting the head), if you know how. Look in the mouth and remove any visible obstruction such as vomit, blood or loose teeth, but do not poke blindly.

B: Breathing

Look, listen and feel for breathing for no more than 10 seconds. Normal breathing is regular and quiet. Gasping or snoring sounds are not normal breathing.

• If breathing normally: place the person in the recovery position (on the side, with the top knee bent and head tilted back) unless you suspect a spinal injury, in which case keep them still and support the head and neck while you wait for help. Keep monitoring.
• If not breathing normally: begin CPR.

C: Circulation

Look for severe bleeding, and control it. Check skin colour and warmth. Pale, cold, clammy skin and rapid pulse suggest shock.

CPR for an Unresponsive Person Who Is Not Breathing

1. 1Call for help and ask someone to bring an AED if available.
2. 2Lay the person on their back on a firm surface.
3. 3Place the heel of your hand on the centre of the chest, the other hand on top, arms straight.
4. 4Press hard and fast, about 5 to 6 centimetres deep, at 100 to 120 compressions per minute, allowing the chest to rise fully between compressions.
5. 5If trained, give two rescue breaths after every 30 compressions. If untrained, give hands-only CPR.
6. 6Use the AED as soon as it arrives.
7. 7Continue until help arrives or the person starts to breathe normally.

Controlling Severe Bleeding

Severe bleeding can kill in minutes.

1. 1Apply direct pressure to the wound using a clean cloth, gauze or even your hand if nothing else is available. Press firmly and continuously.
2. 2Do not remove soaked dressings; add more on top and keep pressing.
3. 3Raise the injured limb above the heart level if there is no suspected fracture.
4. 4Apply a pressure bandage once bleeding slows, firmly but not so tight that it cuts off circulation.
5. 5For life-threatening limb bleeding that does not stop with pressure, apply a tourniquet 5 to 7 centimetres above the wound (not over a joint), tighten until bleeding stops, note the time and do not remove it. Use a commercial tourniquet or a strip of strong cloth with a stick to twist.
6. 6For an embedded object, do not remove it. Pad around it and bandage to hold it still.
7. 7Lay the person down and keep them warm to reduce shock.

Recognising and Treating Shock

Shock occurs when the body is not getting enough blood flow. Signs include pale, cold, clammy skin, rapid weak pulse, fast breathing, confusion, thirst and weakness.

• Lay the person down, raise their legs about 30 centimetres if there is no suspected leg, pelvic or spinal injury, and keep them warm.
• Control any bleeding.
• Do not give anything to eat or drink.
• Keep reassuring them and monitor until help arrives.

Suspected Spinal or Head Injury

Suspect a spinal injury if the person fell from a height, was in a high-speed collision, was hit on the head or has neck or back pain, tingling, numbness or weakness.

• Do not move them unless there is immediate danger, such as fire or traffic.
• Hold the head and neck still in the position found, placing your hands on either side of the head.
• Tell them not to move.
• Do not remove a helmet unless it blocks the airway. If you must remove it, do so with a second person, supporting the head and neck.
• Watch for vomiting, drowsiness, confusion, unequal pupils, fits or clear fluid from the ears or nose, which suggest a serious head injury.
• If the person vomits and must be turned, roll them as a unit with the head, neck and body kept in line.

Fractures and Dislocations

• Keep the person still and support the injured part in the position found.
• Splint above and below the injury with rolled newspapers, boards or sticks, padded with cloth, and tie with bandages. Do not tie over the fracture.
• Do not try to straighten a broken or dislocated limb.
• Cover open wounds with a clean dressing, and do not push the bone back in.
• Apply a cold pack wrapped in cloth to reduce swelling.
• Check circulation beyond the splint: warmth, colour and sensation of fingers or toes.

Burns

• Stop the burning: move away from the source, put out flames by stop, drop and roll, or smother with a blanket.
• Cool the burn with cool running water for at least 20 minutes, within three hours of injury.
• Remove rings, watches and tight clothing near the burn before swelling, but do not remove clothing stuck to the skin.
• Cover loosely with clean, non-fluffy material such as cling film or a clean cloth.
• Do not apply ice, butter, ghee, toothpaste or ointments, and do not burst blisters.
• Seek emergency care for large burns, burns on the face, hands, feet or genitals, chemical and electrical burns, and any burn in a child or older adult.

Choking

• If the person can cough, encourage them to keep coughing.
• If they cannot breathe, speak or cough, give up to five back blows between the shoulder blades with the heel of your hand, then up to five abdominal thrusts (Heimlich manoeuvre). Alternate until the object clears or the person becomes unresponsive, then start CPR.
• For infants, use five back blows and five chest thrusts, never abdominal thrusts.

Electric Shock

Do not touch the person while they are in contact with the source. Switch off the power at the mains, or push the person away using a dry non-conductive object such as a wooden stick. Then check breathing, begin CPR if needed and treat burns. All electric shock victims need medical review.

Drowning

Get the person out of the water safely, without risking your own safety. Call for help. If they are not breathing, start CPR, beginning with five rescue breaths if you are trained, because drowning is primarily a breathing problem.

What Not to Do

• Do not move the person unless there is danger or you need to open the airway.
• Do not give food, water, tea or alcohol.
• Do not remove embedded objects.
• Do not leave the person alone, except to call for help if you have no other option.
• Do not apply home remedies to wounds or burns.
• Do not crowd the casualty or allow bystanders to pull or lift them.
• Do not assume a person who looks fine is fine. Internal bleeding and head injuries may not show up immediately.
• Do not pull a person from a vehicle unless there is fire or danger.

While You Wait for the Ambulance

• Keep the person warm with a blanket or jacket, and protect from heat or rain.
• Stay with them, talk calmly and monitor breathing and responsiveness.
• Note any changes, the time of the accident and any first aid given.
• Gather information about medical conditions, allergies and medicines if available.
• Prepare to hand over details to the paramedics.
• Keep the road clear and direct the ambulance to the spot.

Legal Protection for Helpers

India's Good Samaritan guidelines protect people who help accident victims from harassment and legal liability. You are not required to give your name or stay at the hospital, unless you choose to be a witness. Hospitals must not demand payment before starting emergency treatment for accident victims.

Be Prepared

• Take a first aid and CPR course.
• Keep a first aid kit at home and in your vehicle, with gloves, sterile dressings, bandages, triangular bandage, tape, scissors, antiseptic wipes, a thermometer and a blanket.
• Save emergency numbers on your phone.
• Know where AEDs are in your neighbourhood and workplace.
• Teach family members, including children, how to call for help.

Care at Trustmed Hospital

Trustmed Hospital in Badshahpur, Gurugram, provides 24-hour emergency care with an ambulance service, orthopaedic and surgical teams, operation theatres, ICU and diagnostics for accident victims. In an emergency, call +91-8700232311.

Frequently Asked Questions