FIRST AID AND ITS SCOPE
By OUR MEDICAL CORRESPONDENT
DURING the last eighteen months many thousands of people all over the country have been studying first aid manuals, attending lectures and practices; and probably most of them have been successful in obtaining first aid certifi- cates. What they have learned will always be useful to them, and indeed it would be all to the good if every household contained at least one member who had some knowledge of first aid and home nursing. But the great majority of the recent recruits to the movement have doubtless been primarily preparing themselves to deal with possible war casualties. They are attached, in some capacity or other, to first aid posts ; and it is probable that not a few of them are doubtful of their own capacities and their abilities to re- member, if they should be put to an actual test, all that they have so carefully been taught.
It might perhaps be useful, therefore, briefly to consider the scope of first aid posts and treatment—in so far as these can be envisaged before the event—in a real emergency. Firstly, there are a number of what may be termed private, or factory, or office first aid posts ; and these are intended to give first aid treatment to any who may be injured in a particular building. At most of these posts there will not be a doctor in attendance, and casualties needing further medical attention, but not obviously severe enough for immediate removal to hospital, will probably be taken to the nearest public first aid post.
At all these public first aid posts one or more doctors will normally be present ; and here minor cases requiring medical help will receive it and thence go, or be escorted, home. People who have been more severely injured will normally be collected and taken by bearer parties or mobile ambulance units from private or office first aid posts, houses, streets, or wherever they may have been hurt, direct to the nearest hospital. They will not normally be taken to public first ,aid posts, although it may well be that some apparently minor cases, who have been taken there, may prove to be more serious ; and these, at the doctors' discretion, will also be transferred to hospital.
Such is the general plan, though it may no doubt have to be modified according to local conditions and circumstances. And all that need be said here about actual first aid posts, of whatever category—since they should all long ago have been adequately equipped—is that they should always be warm. Most persons coming to them will, to some slight extent at any rate, probably be suffering from shock ; and a tempera- ture of 70 degrees is not too high for a first aid post. A temperature lower than 65 degrees should be avoided if possible.
As regards first aid workers, it may be comforting to remember that they will find their work easier in actual practice than when dealing with dummy cases and imaginary lecture-room or competition conditions. They will find that what is to be done will largely dictate itself, and that ninety per cent. of first aid is really no more than educated common sense. In the last resort all repairing of wounds and injuries is done, and as a rule very well done, by nature. The first- aider's object is to see that the grosser obstacles to the eventual cure are removed as quickly as possible. Haemorr- hage must, of course, be suitably checked at the earliest pos- sible moment. When actually confronted by it pressure points, so hard to memorise, will, as most first-aiders will discover, be much easier to find Obstructions to breathing of whatever kind must be re- moved from the patient or the patient from them. They will generally be obvious. Immobility of broken and wounded limbs must be obtained by the best means available. None of these things will be found half as difficult as the imagina- tion sometimes suggests. Nobody expects first-aiders to be skilled physicians or surgeons. Nor should they attempt to be. First aid dressings should be kept to a minimum ; and indeed this is true of all first aid treatment prior to a case being seen by a doctor. As a general rule the less first aid treatment there has been the better. That is not to detract from its immense value or the value of all that has been learned from the very ably planned manuals now commonly used. But all this learning will fall into its place much more naturally and effectively than many first-aiders suppose when they are surrounded with the actually injured and using their own common sense.
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