Jim:
As a CPR/First Aid instructor, I’d like to comment on the recent article: First Aid: From Sprained Ankles to Gunshot Wounds, by Big Country. As an “EMT in training” Big County made a few mistakes in his article. He uses the old mnemonic ABCs for CPR and first aid care, this is an older guideline that was updated in October of 2010 by The International Committee on Resuscitation (ILCOR). In collaboration with the AHA, ILCOR produced the first International CPR Guidelines in 2000 and an International Consensus on CPR and ECC Science with Treatment Recommendations in 2005. Once again, in collaboration with the AHA, ILCOR is now coordinating an evidence-based review of resuscitation science, which will culminate in a Consensus Conference in February 2010. The proceedings of this meeting, was published in October 2010. Instead of the the “ABCs” of resuscitation we now use the memory acronym AB-CAB. Most of these changes are due to two factors in Basic life support (BLS) , simplicity of care and effective treatment of an ill or injured patient.
We no longer use a “pulse check” to see if someone’s heart is beating because under most circumstances, if you are not breathing you will have no heartbeat! The heart and the lungs work together as one system. If you stop breathing, your heart stops pumping and visa-verse. Another thing to come out of the 2010 consensus was that if someone has had Sudden Cardiac Arrest (SCA) They are having a circulation problem NOT an oxygen problem, and studies show that compressions should start ASAP with as little interruption as possible (even for rescue breaths) as possible.
Although he does give great instruction on how to wrap a sprained ankle he neglects the basics of care of a strain or sprained joint. The acronym R.I.C.E. should be your guide. (Rest – stay off the foot, Ice – Use a cooling agent to ease swelling, Compression – use an Ace type bandage to keep swelling from returning, and Elevation – Keep the affected area above the heart). Memorize RICE , and you’ll remember how to properly care for these type of injuries.
In my article on what goes into a well stocked first aid kit I wrote that the one of most essential things you could have in a first aid kit was a triangle bandage. In his kit he never mentions it, but in his first aid application Big Country mentions using one several times.
He also mentions to to check the “pulse” in that part of the body, to see if there is sufficient blood flow. Easy to do if you have a stethoscope, but what if you didn’t have one in minimal kit he recommends? Simple, the same way nurses do, by checking the capillary refill in the finger or toe nails. Squeeze the fingernail for approximately four seconds, then release and watch to see if the blood refills the area in approximately two seconds.
All the other recommendation he makes are spot on! And my recommendation is to go and take a first aid and CPR class and make sure your training is current! – KM of FrostCPR.com