Part 13: First Aid

Abstract

The International First Aid Science Advisory Board identified 38 questions in first aid practice that had not been subjected to an evidence review process or that needed to be updated since the 2005 process. Two or more members of the International First Aid Science Advisory Board volunteered to independently review the scientific literature and complete an evidence-based review worksheet summarizing the literature (see Part 2 of this supplement for additional information). After the evidence was presented to the full board, a draft consensus summary of the scientific evidence and a draft consensus treatment recommendation were developed and represented at a subsequent meeting. Thus, each question, evidence-based review, draft summary of science, and draft treatment recommendation was presented and discussed on 2 separate occasions, and a Consensus on Science and Treatment Recommendation was reached by the Board. This document is a report of the group's consensus.As in 2005, the worksheets revealed the continuing paucity of scientific evidence to support specific first aid interventions. Very little research is being conducted in first aid, and most of the recommendations are extrapolations from research and experience in other medical venues, animal studies, and case series. It is hoped that this document will be a stimulus to future research in first aid. First Aid for Medical Emergencies SummaryThe medical questions addressed include poisoning, anaphylaxis, oxygen administration, and aspirin administration for a suspected coronary event.No changes were recommended for first aid management of acute poisoning.In reviewing epinephrine administration for anaphylaxis, evidence was found that laypeople and some medical and prehospital professionals are unable to recognize the signs and symptoms of anaphylaxis and therefore cannot, without training, make an independent decision to administer epinephrine with an auto-injector or to administer a second dose if the first is not effective. This issue takes on added importance in view of legislation in some jurisdictions that permits these actions.No evidence was found, except in decompression injuries, to support the routine administration of oxygen by first aid providers.The administration of aspirin to a victim experiencing chest discomfort is problematic. The literature is clear on the benefit of early administration of aspirin in an acute coronary event, except when there is a clear contraindication, such as aspirin allergy or a bleeding disorder. Less clear, however, is whether first aid providers can recognize the signs and symptoms of an acute Consensus on ScienceThere are no human studies on the effect of treating oral caustic exposure with dilution therapy. One in vitro LOE 5 chemistry study 2 demonstrated no benefit from the addition of large volumes of diluent to either a strong base or a strong acid. Five LOE 5 animal studies 3-7 demonstrated histological benefit to the esophagus when a diluent was administered following exposure to an alkali or acid. Treat...

Part 9: First Aid

“…It also stated that if an individual with a suspected cervical spine injury had to be turned onto his or her side, the high arm in endangered spine (HAINES) position seemed to be safer. 10 An extensive literature search and use of GRADE methodology resulted in some studies from the 2010 review being excluded from the 2015 review and other newly identified studies being included. The revised 2015 recommendations reflect this rigorous evidence evaluation process.…”

Part 1: Executive Summary

“…In the 2010 review of educational topics, no evidence was found to support or recommend any method of evaluating or monitoring a first aid trainee's educational progress or the specific frequency of retraining to retain skills and knowledge. 133 The task force decided to investigate the basic question, is there documented evidence of benefit in terms of patient outcomes as a result of first aid training?…”

Effects of passive leg raising on cardiovascular functions as analyzed by fingertip pulse pressure profiles

“…The aim of this procedure is to improve blood circulation by facilitating venous return from the lower limbs [1][2][3][4][5][6][7][8][9][10]. However, several studies have cast doubts on the efficacy and duration of the effects of PLR [2][3][4].…”

“…However, several studies have cast doubts on the efficacy and duration of the effects of PLR [2][3][4]. Possibly due to this controversy, in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of 2010 [8], PLR was neither recommended nor prohibited for the treatment of hypovolemic shock.…”