Editing First aid (section)

== Key basic skills ==
Certain skills are considered essential to the provision of first aid and are taught ubiquitously.

=== Displacement skills ===
If there are dangers around (such as fire, electric dangers or others) the patient has to be moved to a safe place,<ref name=":2" /><ref>{{Cite web |last=Community Emergency Response Team of L.A. |date=2024-10-31 |title=Lifts and carries |url=https://cert-la.com/cert-training-education/lifts-carries/ |website=CERTLA}}</ref> (if it is safe for the first aid provider to do so), where providing the required first aid procedures is possible.

—'''In case of a possible severe spinal injury:''' when a patient seems to have a possible serious injury in the spinal cord (in the backbone, either at the neck part or the back part), that patient must not be moved except if that is necessary, and, when necessary, it must be done as little as possible and very carefully (see mentions about this type of injury in the gallery of drawings below). These precautions avoid many risks of causing further damages for the patient's mobility in the future.

Usually, the patient needs to end up lying down, in a face-up position, on a sufficiently firm surface (for example, on the floor, which allows to perform the chest compressions of cardiopulmonary resuscitation).
{{Gallery|File:Recovery_position_maneuver.jpg|—A victim with a serious injury in the spine (in the back or the neck), which indicates a risk to the future mobility, can be carefully transferred by several rescuers that work coordinately.<br />The victim’s head and back would be held in the same position they were.|File:Rautek-maneuver.png|—When there is a victim with a serious injury in the spine (in the back or the neck) and a rescuer without instruments, the rescuer can try to carry the victim carefully through the Rautek maneuver (as in the picture), trying to keep victim’s head and back in the same position they were.<br />The victim's head can be supported on the rescuer to try to soften the movements.<br />A second rescuer can hold the legs.|File:Blanket-Pull.png|—A victim without a serious injury in the spine (in the back or the neck) can be pulled through the floor, which is easier on a blanket, carpet or another tissue located under most of the body.<br />—Carrying on a base to victims with a suspected spinal injury would require to place them carefully, while keeping their head and back in the same position they were, on a higher or much thicker base (as a litter or mattress), for a better displacement.|width=225|height=225|align=center|title=Displacement of victims to a safe place}}

=== Checking skills ===
They evaluate the condition of the victim,<ref name=":2">{{Cite book |last=American Red Cross |title=CPR/AED for Professional Rescuers |year=2016 |edition=2nd}}</ref> first attending to the main threats for life.

The preferred initial way of checking consist of asking, commonly by touching the patient in one of his shoulders and shouting something, such as: "can you hear me?"

In some cases, the victim has a wound that bleeds abundantly, which requires its own additional treatment to stop the blood loss (usually, it would begin by keeping the wound pressed).

If the patient does not react, the heartbeats can be checked in the carotid pulse: placing two fingers on any side of the neck (on the left or the right side), near his head. In cases where checking the carotid pulse is impossible, heartbeats can be perceived in the radial pulse: placing two fingers on a wrist, under the part of the thumb, and applying moderate pressure. Breathing can also be checked additionally, placing an ear on the mouth and, at the same time, watching the chest rising by the effect of the air. It is recommended not to waste too much time of first aid in checking (professional rescuers are taught to take 10 seconds in it).

{{Gallery|File:Carotidian_pulse_(clear).jpg|Checking of heartbeats in the carotid pulse.<br/>This is usually the fastest method of checking the patient's condition.|File:Pulse2.jpg|Verification of heartbeats in the radial pulse, pressing moderately on a wrist, under the part of the thumb.|File:Checking_respiration3.jpg|Check of patient's breathing, listening the air inside of the mouth and watching the chest swelling.|width=200|height=200|align=center|title=Check of patient's condition}}

=== Cardiopulmonary resuscitation (CPR) ===
{{For|the proper sequence of first aid reactions to a cardiac arrest|Cardiopulmonary resuscitation#Order of CPR in a first aid sequence}}{{For|cardiopulmonary resuscitation (CPR) practice|Cardiopulmonary resuscitation#Compressions with rescue breaths}}
Cardiopulmonary resuscitation (CPR) is the method of first aid for treating victims of cardiac arrest (complete stop of heartbeat).

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| caption1          = Traditional maneuvers of cardiopulmonary resuscitation (CPR) have included in the present the use of automatic defibrillators.
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=== Airway, Breathing, and Circulation skills ===
[[File:Tongue blocking airway.svg|right|thumb|300px|In case of tongue fallen backwards, blocking the airway, it is necessary to hyperextend the head and pull up the chin, so that the tongue lifts and clears the airway.]]<!-- Before editing this section to change circulation to Compressions, please read the article at ABC (medicine) -->
ABC method stands for ''Airway'', ''Breathing'', and ''Circulation''.<ref>{{Cite journal |last1=Eisenburger |first1=Philip |last2=Safar |first2=Peter |year=1999 |title=Life supporting first aid training of the public—review and recommendations |journal=Resuscitation |volume=41 |issue=1 |pages=3–18 |doi=10.1016/S0300-9572(99)00034-9 |pmid=10459587}}</ref><!-- Before editing this section to change Circulation to Compressions, please read the article at ABC (medicine) --> The same [[mnemonic]] is used by [[emergency medicine|emergency health professionals]].

It is focused on critical life-saving intervention, and it must be rendered before treatment of less serious injuries.

Attention must first be brought to the [[airway]] to [[basic airway management|ensure it is clear]]. An [[airway obstructions|obstruction]] (choking) is a life-threatening emergency. If an object blocks the airway, it requires [[Choking#General strategy: "five and five"|anti-choking procedures]]. Following any evaluation of the airway, a first aid attendant would determine adequacy of [[breath]]ing and provide [[rescue breathing]] if safe to do so.

Assessment of [[Circulatory system|circulation]] is now not usually carried out for patients who are not breathing, with first aiders now trained to go straight to chest compressions (and thus providing artificial circulation) but [[pulse]] checks may be done on less serious patients.

Some organizations add a fourth step of "D" for ''[[Bleeding|Deadly bleeding]]'' or ''[[Defibrillation]]'', while others consider this as part of the ''Circulation'' step simply referred as Disability. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments or examination, as required if they possess the proper training (such as measuring pupil dilation).<ref>{{Cite web |url=https://www.resus.org.uk/resuscitation-guidelines/abcde-approach/ |title=Guidelines and Guidance: The ABCDE approach |website=Resuscitation Council (UK) |url-status=live |archive-url=https://web.archive.org/web/20050812085403/http://www.resus.org.uk/pages/alsABCDE.htm |archive-date=12 August 2005 |access-date=2 May 2019}}</ref>

Some organizations teach the same order of priority using the "3Bs": ''Breathing'', ''Bleeding'', and ''Bones'' (or "4Bs": ''Breathing'', ''Bleeding'', ''Burns'', and ''Bones''). While the ABCs and 3Bs are taught to be performed sequentially, certain conditions may require the consideration of two steps simultaneously. This includes the provision of both [[artificial respiration]] and [[cardiopulmonary resuscitation|chest compressions]] to someone who is not breathing and has no pulse, and the consideration of [[cervical spine]] injuries when ensuring an open airway.

==== Preserving life ====
The patient must have an open airway—that is, an unobstructed passage that allows air to travel from the open [[mouth]] or uncongested [[human nose|nose]], down through the [[human pharynx|pharynx]] and into the lungs. [[Conscious]] people maintain their own airway automatically, but those who are unconscious (with a [[Glasgow coma scale|GCS]] of less than 8) may be unable to do so, as the part of the brain that manages spontaneous breathing may not be functioning.

Whether conscious or not, the patient may be placed in the [[recovery position]], laying on their side. In addition to relaxing the patient, this can have the effect of clearing the tongue from the [[pharynx]]. It also avoids a common cause of death in unconscious patients, which is choking on regurgitated stomach contents.

The airway can also become blocked by a foreign object. To dislodge the object and solve the choking case, the first aider may use [[Choking#General strategy: "five and five"|anti-choking methods]] (such as 'back slaps, 'chest thrusts' or 'abdominal thrusts').

Once the airway has been opened, the first aider would reassess the patient's breathing. If there is no breathing, or the patient is not breathing normally (e.g., [[agonal breathing]]), the first aider would initiate [[Cardiopulmonary resuscitation|CPR]], which attempts to restart the patient's breathing by forcing air into the lungs. They may also manually massage the heart to promote blood flow around the body.

If the choking person is an infant, the first aider may use [[Choking#Infants|anti-choking methods for babies.]] During that procedure, series of five strong blows are delivered on the infant's upper back after placing the infant's face in the aider's forearm. If the infant is able to cough or cry, no breathing assistance should be given. Chest thrusts can also be applied with two fingers on the lower half of the middle of the chest. Coughing and crying indicate the airway is open and the foreign object will likely to come out from the force the coughing or crying produces.<ref>{{Cite web|url=https://medlineplus.gov/ency/article/000048.htm|title=Choking - infant under 1 year: MedlinePlus Medical Encyclopedia|website=medlineplus.gov}}</ref>

A first responder should know how to use an [[Automated external defibrillator|Automatic External Defibrillator]] (AED) in the case of a person having a sudden cardiac arrest. The survival rate of those who have a cardiac arrest outside of the hospital is low. Permanent brain damage sets in after five minutes of no oxygen delivery, so rapid action on the part of the rescuer is necessary. An AED is a device that can examine a heartbeat and produce electric shocks to restart the heart.<ref>{{Cite journal |last=Nessel |first=Edward H. |date=2012 |title=Treating Sudden Cardiac Arrest and the Use of Automated External Defibrillators in the Community Setting |url=https://www.thefreelibrary.com/Treating+sudden+cardiac+arrest+and+the+use+of+automated+external...-a0285436339 |journal=AAMA Journal |volume=25 |page=9}}</ref>

A first aider should be prepared to quickly deal with less severe problems such as [[wounds|cuts]], [[Abrasion (medical)|grazes]] or [[bone fracture]]. They may be able to completely resolve a situation if they have the proper training and equipment. For situations that are more severe, complex or dangerous, a first aider might need to do the best they can with the equipment they have, and wait for an ambulance to arrive at the scene.