Getting there first

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Getting there first

With thousands of people injured every year in the UK, it is more important than ever for pharmacy teams to understand the basics of first aid and be able to offer customers tips and advice

Pharmacies are in a fantastic position to help customers prepare for and treat minor accidents and injuries. Having the confidence to advise customers about basic first aid and products to have in their arsenal has the potential to save trips to the GP, minor injuries unit or A&E.

Cuts and grazes

Cuts caused at home are very common and there can be some surprising culprits behind the injuries. In fact, in 2015, 338 people were admitted to A&E with wounds caused by spiky or sharp plants.

The first step is always to clean the wound, either by rinsing with water or an alcohol-free wipe, to reduce the risk of infection. If the wound is bleeding then it should be raised above the level of the heart – for a hand or arm, hold the injury above the head, if it’s a lower limb then the person should lie down and raise the affected area.

Wounds that dry out do not heal as effectively. A moist environment is best to avoid scarring as the conditions promote new cells to grow. Applying a sterile dressing such as a plaster will keep the wound under the ideal conditions, ensuring it heals as quickly as possible.

If there is a foreign object in the wound, or the bleeding doesn’t stop, the person should seek medical assistance.

Sprains and strains

These common injuries to ligaments and muscles occur if a joint is overstretched or twisted by a sudden movement. A sprain occurs when a ligament has been twisted or torn, whereas a strain is a partial tear of an overstretched muscle. RICE therapy is the recommended way of caring for a strain or sprain:

  • Rest: stop exercise or activities and avoid putting weight on the injury
  • Ice: use a cold compress like an ice pack or cold pad to reduce the swelling and pain. Do not leave on for more than 10 minutes at a time
  • Compression: wrap a soft layer of padding, such as a bandage, around the area to support it, ideally stretching from below the injury up towards the next joint. For an ankle injury, bandages should cover from the toes up to just under the knee
  • Elevate: the injury and support it with something soft, such as a pillow.

If a customer cannot move the limb at all then referral to the GP may be necessary. Otherwise rest should be advised.

Burns and scalds

The most important step with a burn or scald is to begin cooling the wound as quickly as possible by running it under cool water for at least 20 minutes, or until the pain has subsided. It is not advisable to use creams, gels or ice to cool a burn as they may damage the skin, exposing the wounded area to infection. Jewellery and clothing around the affected area should be removed, unless it has become stuck to the burn. The area should then be loosely covered with cling film to prevent infection. Any pain can be treated with oral paracetamol or ibuprofen.

Burns that require urgent hospital attention include: a burn that is larger than the person’s hand; burns on the face, hands, arms, feet or genitals that cause blisters; burns that cause white or charred skin; and all chemical and electrical burns.

Dehydration and heatstroke

Dehydration and heat exhaustion are caused by loss of salt and water from the body. Extended exposure to the heat can cause people to sweat excessively, which can be very dangerous if these fluids aren’t replaced. Headache, dizziness and pale, clammy skin indicate dehydration, as do cramps in the arms, legs and stomach. Taking on plenty of fluids is the best remedy, but it may be necessary to drink a hydration solution as water alone could flush out already depleted minerals.

If someone has heatstroke, they need to be monitored carefully. Heatstroke also causes hot, flushed and dry skin, a bounding pulse and a deteriorating level of response. Cooling the person down is imperative, so they should be moved to a cool place and a fan or a wet sheet or sponge should be used. Someone should call 999 for an ambulance and continue to cool them down whilst waiting for help, checking their pulse and responsiveness if necessary.

Skills shortage

Three of the UK’s largest charities are seeking public support for first aid to become a compulsory part of the school curriculum, following new research which shows that more than nine in 10 adults would not be able to save lives in first aid emergencies.

Earlier this year, the British Red Cross, St John Ambulance and the British Heart Foundation (BHF) called on people to take part in the Government’s call for evidence on Personal, Social, Health and Economic education (PSHE), and join their push for first aid skills to be taught in all schools.

The push comes after research commissioned by the British Red Cross asked more than 2,000 UK adults about their knowledge, confidence and willingness to intervene if someone was bleeding heavily, was unresponsive and breathing, or was unresponsive and not breathing. The research showed:

  • Only one in 20 people would feel knowledgeable, confident and willing to act in those three scenarios – 95 per cent of people would not 
  • Seven in 10 adults lack the knowledge and confidence to act if someone collapsed and was unresponsive and breathing
  • Nearly seven in 10 people polled lack the knowledge and confidence to act if someone was bleeding heavily
  • In addition to these scenarios, eight in 10 adults also said they lack the knowledge and confidence to act if a baby was choking.

Further research carried out by the BHF in 2017 showed that 60 per cent of adults would be worried about knowing what to do if they witnessed someone having a cardiac arrest and only 20 per cent of respondents were able to correctly identify the signs of a cardiac arrest.

Meanwhile, a survey by St John Ambulance has found that 80 per cent of people feel that first aid lessons should be compulsory in all schools. 

First things first

A good first aid kit will contain all the products people need to treat every eventuality. Some of these won’t be needed very often, but others will get more regular use. Here’s a round up of the most commonly used items.

Dressings

Firstly, it is important to identify the most appropriate type of dressing for every wound. Smaller wounds should only require a plaster, but larger wounds will require a sterile wound dressing.

Advise customers that to apply sterile dressings, they should place the pad directly over the wound and then wind a bandage around it. If there isn’t a proper dressing available, a sterile pad or clean cloth should be placed on the wound and secured with adhesive tape. A rolled bandage can then be used to apply to the wound.

Bandages

There are two main types of bandage. Rolled bandages are used to secure dressings in place or support injured limbs. Triangle bandages are larger and can be used as slings or folded to stop a limb from moving.

When applying a bandage, it is important that the person is comfortable and the area is supported to prevent any harsh movements. A bandage needs to be applied fi rmly to provide proper support or pressure to a wound. But the bandage should not be too tight. This can be checked by pressing an area of skin beyond the bandage. If colour does not return to the skin within two seconds, the bandage should be loosened and re-tied.

Antiseptics

Antiseptic cream is a useful tool in fi rst aid as it can be used in a number of situations. Applied before a dressing on an open wound, it can help to protect against infection while soothing pain and aiding the healing process. Antiseptic cream can also be used on minor grazes, small areas of sunburn, dry skin and nappy rash. Antiseptics come in gels, creams and sprays. Before applying a gel or cream, hands must be thoroughly washed to further reduce the risk of infection. Sprays can be ideal for children as they are a no-touch approach that should not aggravate the injury.

Bite creams

Bite creams containing an antihistamine, crotamiton or hydrocortisone can be used to relieve itching and swelling caused by insect bites. Applying the cream to the affected area can relieve most symptoms.

First aid kit

The NHS suggests that a basic first aid kit should contain:

  • Plasters in a variety of different sizes and shapes
  • Small, medium and large sterile gauze dressings
  • At least two sterile eye dressings
  • Triangular bandages and crepe rolled bandages
  • Safety pins
  • Disposable sterile gloves
  • Tweezers
  • Scissors
  • Alcohol-free cleansing wipes
  • Sticky tape
  • Thermometer (preferably digital)
  • Cold packs
  • Skin rash cream
  • Cream or spray to relieve insect bites and stings
  • Antiseptic cream
  • Painkillers
  • Cough medicine
  • Antihistamine tablets
  • Distilled water for cleaning wounds
  • Eye wash and eye bath.

Nine in 10 adults would not be able to save lives in first aid emergencies

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