Initial victim assessment

Life-saving techniques require a specific sequence. Any inappropriate or sloppy movements may only worsen the victim’s medical condition. Therefore, basic first aid training is highly recommended.

Check the ABCs (book excerpt)

► Airways
• Get close to the victim to check whether there is any visible bleeding.
• Check if the victim is conscious by asking simple questions such as: “Are you Okay?”, “Open your eyes,” or “Squeeze my hand.”
Call for help if you are alone.
• For victims who are unconscious: loosen their clothes (tie, shirt, belt, trousers) in order to clear their airways.

• If you do not suspect a neck, back, or head injury:
– Lay them on their back on a hard surface such as the floor or the ground. For a small child or infant, the palm of your hand may provide a firm surface.
– Carefully tip the victim’s head backwards while keeping their mouth open.
– Put one hand on their forehead and with the other lift their chin.

• If you suspect a neck, back, or head injury: open the victim’s mouth according to the chin-lift or the jaw thrust maneuver:

– The head-tilt/chin-lift maneuver:
Kneel down and position yourself at the top of the person’s head.
Place the palm of one hand on the forehead and apply gentle backward pressure using the palm of your hand.
Place the first two fingers of the other hand under the bony part of the chin.
Gently lift the chin forward and support the jaw, helping to tilt back the head.

– The jaw thrust maneuver:
Kneel down and position yourself at the top of the person’s head.
Place your index and middle fingers at the angle of the mandible (the jawbone) on each side of the face.
Put your thumbs on the chin just below the lower lip.
Lift the jaw upward toward you. This procedure will open the mouth to allow breathing.
Do not move the head or hyperextend the neck while performing this maneuver.

►Breathing
• While keeping the victim’s chin up and head tilted backward, bend over and place your ear and cheek close to the victim’s mouth and nose in order to determine if he or she is breathing. Then, check to see if the victim’s abdomen and/or chest is rising and falling. Do this every ten seconds in order to assess the victim’s respiration, which may be slow.
• If the victim is breathing: place them in the recovery position.
• If the victim is not breathing: ask someone to call for help and begin artificial breathing. Immediately give two slow, full breaths.
• If, as a result, you notice a sign of life (pulse, cough, spasm): you are dealing with a respiratory arrest.
Perform artificial breathing until the victim starts breathing.
• If, as a result, you do not notice any signs of life: it may mean you are dealing with cardiorespiratory arrest. Start chest compressions immediately.

►Circulation
• Put your hand on the victim’s neck (directly upon the carotid artery). Check their pulse for a couple of seconds. (In case of an infant, feel for a brachial pulse over the brachial artery in the crook of the elbow.)
• Check the victim’s skin color (flushed or pale) as well as the body temperature (mainly the extremities).
• Investigate the person’s state of consciousness by asking some questions.
• As soon as you have accomplished the above, you may restore the cardiovascular system with resuscitation techniques, if need be.
• If the victim has no pulse and is not breathing: start cardiopulmonary resuscitation (CPR) immediately.
• If the victim has a pulse but is not breathing: perform artificial breathing only.
• If the victim has no pulse and is breathing: monitor their ABCs while waiting for the rescue team.
• Do not leave the victim alone or unsupervised.

The initial assessment must not be interrupted even if you notice that the person is conscious and breathing. Indeed, an underlying problem in the circulatory system may indicate that the clinical condition of the victim is worse than initially assessed, and that immediate action needs to be taken.

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