Module 1 of 2 · 35 minutes
The first three minutes
By the end of this module you will be able to
- Carry out a primary survey in order
- Recognise time critical conditions and act
- Use the recovery position correctly
- State what awareness level training does not cover
Work through it
1 interactive for this module, built on the WAJD Teach engine. Nothing moves until you ask it to, and every one has a written version if you would rather read it.
Amara Before anything else. Does this make me a first aider?
Nadia No. And I want that at the top rather than in a footnote, because burying it is how people end up believing they are qualified.
Amara What is missing?
Nadia Everything requiring hands. Compression depth and rate. Opening an airway. Managing a real collapsed person while frightened. Those have to be practised on a manikin and assessed by an instructor.
Amara Then what is this for?
Nadia The sequence. Because the commonest reason people do nothing in an emergency is not cowardice. It is not knowing what order to do things in, so they stand there.
Amara Give me the order.
Nadia Danger. Response. Shout for help. Airway. Breathing. Danger first, always, because a second casualty helps nobody and that is the step adrenaline removes.
Amara Shout for help. Just shout?
Nadia No, and this is the detail that changes outcomes. Point at a specific person and name the task. You, in the blue coat, ring 999 and come back and tell me you have done it.
Amara Why so specific?
Nadia Because a general shout in a crowd produces nothing at all. Everybody assumes somebody else is already doing it. Naming one person and one task breaks that instantly.
Amara Then airway and breathing.
Nadia Head tilt, chin lift. Then look, listen and feel for no more than ten seconds. And here is the thing I most want you to remember from this whole course.
Amara Go on.
Nadia Agonal gasping is not breathing. In the first minutes of a cardiac arrest people often make irregular, noisy gasps. It looks like breathing to a frightened bystander, and it is the single commonest reason nobody starts CPR on somebody who could have survived.
Amara So gasping means?
Nadia Treat it as cardiac arrest. 999, get an AED, start compressions.
Amara Let us do the time critical ones. Stroke.
Nadia FAST. Face drooping, Arms cannot stay up, Speech slurred, Time to ring 999. And note the time symptoms started.
Amara Why does that matter?
Nadia Because treatment options depend on it, and nobody at hospital will know it unless somebody who was there tells them. That one piece of information from a bystander can change what treatment is possible.
Amara Sepsis?
Nadia Suspected infection plus deterioration. Slurred speech or confusion, extreme shivering or muscle pain, no urine in a day, severe breathlessness, a feeling of impending death, mottled or discoloured skin.
Amara And I should say the word?
Nadia Say the word sepsis out loud when you call. It starts a different pathway. A described patient with an unnamed suspicion does not get the clock started.
Amara Severe bleeding?
Nadia Firm direct pressure on the wound, with something clean if you have it and your hand if you do not. Do not pull out anything embedded, pack around it. Lie them down and ring 999.
Amara Last question, and it is the one that stops people. Can I be sued for helping?
Nadia That fear prevents far more help than it should. The Social Action, Responsibility and Heroism Act 2015 requires a court to consider whether somebody was acting for the benefit of society and intervening in an emergency.
Amara So what is the sensible position?
Nadia Act reasonably, within your competence, and do not attempt things you have not been trained in. Somebody in cardiac arrest is not going to be made worse by a bystander trying. They are dying already.
The written material
What this cannot do
Stated first, because burying it is how people end up believing they are qualified. Reading cannot make you competent at CPR, at managing a casualty, or at anything requiring hands. Chest compression depth and rate, airway opening and the practical management of a collapsed person must be practised on a manikin and assessed by an instructor.
Employers must carry out a first aid needs assessment under the Health and Safety (First Aid) Regulations 1981 and provide adequate trained first aiders. This course does not count towards that.
What it does is put the sequence in your head, because the commonest reason people do nothing is not lack of courage. It is not knowing what order to do things in.
The primary survey, in order
Danger. Check it is safe for you first. A second casualty helps nobody, and this is the step people skip when adrenaline is up.
Response. Shake the shoulders and shout, are you all right.
Shout for help early, and get somebody specific to ring 999. Point at a person and name the task: you, in the blue coat, ring 999 and come back and tell me you have done it. A general call for help in a crowd produces nothing, because everybody assumes somebody else is doing it.
Airway. Head tilt, chin lift.
Breathing. Look, listen and feel for no more than ten seconds. Agonal gasping is not breathing: irregular, noisy gasps in the first minutes of a cardiac arrest are a sign of arrest, and mistaking them for breathing is the commonest reason bystanders do not start CPR.
If not breathing normally: 999, get an AED, start chest compressions.
If breathing and unresponsive: recovery position, and stay with them, because breathing can stop at any point.
- Danger, Response, Shout for help, Airway, Breathing
- Name a specific person to ring 999 and report back
- Agonal gasping is cardiac arrest, not breathing
- Breathing and unresponsive: recovery position and continuous monitoring
The conditions where minutes decide the outcome
Severe bleeding: firm direct pressure on the wound, with something clean if available and with your hand if not. Do not remove an embedded object, pack around it. Lie them down and ring 999.
Stroke: use FAST. Face drooping, Arms unable to hold up, Speech slurred or confused, Time to ring 999. Note the time symptoms started, because treatment options depend on it and nobody at hospital will know it unless you tell them.
Heart attack: central chest pain or pressure, possibly spreading to arm or jaw, with breathlessness, sweating or nausea. Ring 999, sit them down, and if aspirin is available, they are conscious and not allergic, 300mg to chew slowly.
Sepsis: suspected infection plus deterioration. Slurred speech or confusion, extreme shivering or muscle pain, passing no urine in a day, severe breathlessness, a feeling of impending death, or mottled or discoloured skin. Say the word sepsis out loud when you call, because naming it starts a different pathway.
Anaphylaxis: an adrenaline auto injector into the outer thigh, ring 999, lie them flat with legs raised unless breathing is difficult. A second dose after five minutes if there is no improvement and one is available.
Choking and the recovery position
Choking with an ineffective cough: five back blows between the shoulder blades, then five abdominal thrusts, alternating. If they become unresponsive, start CPR. Anyone who has received abdominal thrusts needs medical assessment afterwards, even if they seem fine.
If the cough is still effective, encourage them to keep coughing. A person who can cough forcefully is moving more air than you will move for them.
Recovery position: for anyone unresponsive but breathing normally. It keeps the airway open and lets fluid drain rather than being inhaled. Stay with them and keep checking breathing, because it can stop.
Knowledge check
The knowledge check and your certificate need a free account, so that your progress and results can be saved as evidence.
The learning itself stays free and open. You are reading all of it right now without an account.