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First Aid

One of the most common causes of death for victims of a road crash is anoxia - a lack of oxygen supply - caused by a blocked airway. On average, it takes less than four minutes for a blocked airway to be fatal. Even in areas with highly structured emergency care, the norm for ambulance response to a road crash is ten minutes. Many people will die if nothing is done to correct the slow response time to anoxia. The application of first aid techniques, in particular the proper positioning of the victim prior to the arrival of the emergency response teams, can mean the difference between life and death in a road crash.

Delivery of effective first aid is one of the activities in the management of the casualty which is a crucial determinant of the severity of injury eventually received and the chance of survival.

- The European Transport Safety Council, A strategic road safety plan for the European Union (EU), Brussels, 1997

There is a wealth of medical evidence to suggest a 'golden hour' exists for casualties after a road crash. Within this time, road crash victims stand a greater chance of survival and a reduction in the adverse consequences of their injuries, if life-saving measures are immediately applied and followed by quality health care assistance. Immediate on-the scene rescue and assistance is vital, especially if emergency care response is absent or significantly delayed.

Imagine that a victim has a haemorrhage following a road crash: if nobody applies pressure to the wound to stop the bleeding, even the most sophisticated or quickest emergency service in the world will only arrive on the scene in time to certify death.

- Dr. Eric Bernes, Global First Aid Programme, International Federation of Red Cross and Red Crescent Societies, Geneva

Anyone trained in First Aid can provide assistance at the scene of a road crash; either because they are in one of the vehicles involved, live close by or are in a passing vehicle. Frequently they can transport the injured person to health professionals, if an ambulance is not available. The quality of this assistance is strongly dependent on the individuals having received adequate training in first aid.

"Most deaths occur outside healthcare facilities. Some of them are unavoidable on account of the severity of the initial injuries. Among the remainder, a considerable proportion could be avoided, as is apparent from a comparison of the differences in mortality rates from trauma in different countries." (World Health Organization).

First Aid consists of methods and techniques that enhance practices related to the prevention, the preparedness and the immediate response to health emergencies. First Aid can be provided not only in relation to road safety, but also in the household, workplace, and recreational areas.

Beyond health matters, first aid knowledge also increases the social responsibility of the society and strengthens humanitarian values.

Many countries offer a legal immunity from charges of negligence if a bystander attempts, in good faith, to aid a victim. This is contingent, however, on the rescuer acting within reasonable bounds of his or her scope of training or capacity.

Increasing global awareness

  • The First Aid Day across the world in 2002 was dedicated to road safety.
  • From October 2003, it was obligatory for all new drivers in the European Union to know how to respond to a road crash.
  • The EU supports road safety and First Aid in member and candidate countries.
  • The World Health Organization's (WHO) World Health Day 2004 was dedicated to road safety.

First Aid training for drivers

According to the EU directive 2000/56/EC, all EU countries were requirered must by 1 October 2003, have taken the necessary measures to ensure that applicants for driving licences must know how to behave in the event of an accident, and the measures that they can take to assist road accident victims; including emergency action such as evacuation of passengers and basic knowledge of first aid. The directive points also the requirement of first aid training and refresher courses for professional drivers.

In April 2001, the Economic and Social Council of the United Nations (UNECOSOC) adopted a new resolution highlighting the role and importance of first aid training and equipment for road users through specific recommendations, applicable in United Nations member states from 2003. This work results from a close collaboration between the European Federation of Road Traffic Victims and the International Federation of Red Cross and Red Crescent Societies.

First aid training can also target other population categories, for example children, cyclists or professional drivers. In some countries the taxi drivers function as the emergency transport service system.

First Aid standard

Education in the protection and saving of lives share universal foundations, being practical and giving confidence to act. This education is gained through awareness and refreshment initiatives such as media campaigns, training courses either in a classroom environment, CD-ROM or through an internet based e-learning system. It can also take place through involvement in community or group activities. It is essential that first aid education shows consideration for and pays respect to local conditions, culture and capacities.

Furthermore, training people to cope with road injuries should include information related to reducing both the risk of a crash by wearing reflective materials or not driving after drinking alcohol, and the severity of injury by wearing helmets when riding a motor cycle or scooter.

First Aid basic training

  • How to enhance road safety practices - wear reflective materials; helmet; fasten seat belts; respect speed limits; don't drive after drinking alcohol.
  • How to act safely and protect the scene - to prevent further crashes and minimize the risk for those rendering assistance; ensure self-protection.
  • How to summon help - report the crash to the emergency services, and give relevant information.
  • How to make an emergency removal of an injured person from the scene, when necessary and possible.
  • How to assess the physical state of the injured person - check vital functions: consciousness, circulation, breathing as well as the psychological needs of those affected.
  • How to respond to visible bleeding, unconsciousness, breathing problems, shock and bone trauma - to enable the injured person to be relieved and to survive whilst awaiting the arrival of professional health care services.
  • How to monitor the situation and offer psychological support - to be able to sustain the assistance provided, while taking care of wounds as well as the psychological condition of the injured person.

Emerging good practice

Many institutions, like Red Cross Red Crescent National Societies, organize first aid education, training, networks or events. Below are few examples of emerging good practices.

Training specific groups

In Kumasi, Ghana taxi drivers have been trained in first aid. A study showed that 61 per cent of them had used their skills within the first year. The Thai Red Cross has recently established a first aid training centre. It has provided training to taxi and bus drivers as well as other segments of the population. Similar initiatives exist in Bulgaria, Tunisia, Yemen and Cote d'Ivoire. Police and fire response personnel have received training in the Republic of Korea, Cook Islands, Ecuador and Slovenia. Children of different ages have taken part in first aid courses in Germany and Nepal.

Partnerships

Corporations, such as petroleum and other local transport companies, support first aid training programmes in Fiji, Philippines and Gambia.

Drivers' licence

In Bosnia and Herzegovina, among other countries, learner-drivers are obliged by law to obtain a first aid certificate before being awarded a drivers licence.

First Aid posts on roads

Most countries operate first aid posts along roads and highways. In Iran and Viet Nam permanent posts are staffed year-round. In Togo, 90 posts are open during the summer. In Tunisia, Saudi Arabia, Bolivia and Philippines special posts are set up along roads during religious events. In some countries a network of petrol stations is used for the posts.

Multinational campaigns

The EU is supporting information and awareness campaigns on road safety and First Aid, encouraging European citizens to learn First Aid and to know what to do in case of road crashes. The two European Red Cross Campaigns have also promoted preventive measures, e.g. how to make the journey to and from schools safe.

National road safety councils

The Red Cross in Costa Rica is a member of many local road safety councils. In the Czech Republic, the Red Cross is a member of the National Council for Road Safety.

World First Aid Day

Many countries celebrate World First Aid Day by launching events focusing on themes such as road safety.

First Aid kit

While respecting local rules and regulations, the contents of a first aid kit should allow the user:

  • to act safely and be guarded against body fluid contact;
  • to control visible bleeding;
  • to stabilise bone trauma;
  • to prevent victim heat loss and deterioration into shock;
  • to protect wounds, and;
  • to write the alert message.

Scissors and a torch can be useful. The kit should be packed in a solid, visible and protective container. A summary sheet should be placed inside with step-by-step guidance and telephone numbers of the emergency services. A warning device such as the high visibility triangle to alert others to the situation and prevent further crashes occurring can be of great value.

Publications

Anyone can save a life, Road Accidents and First Aid, British Red Cross, 2001.
This publication gives an overview of state-of-the-art knowledge of first aid in relation to road crashes. Report is available at Firstaid@redcross.org.uk

Capacity of National Societies with regard to Road Safety. International Federation of Red Cross and Red Crescent Societies. 1999. This report gives an overview of the Red Cross Red Crescent's road safety and first aid initiatives.

WHO report on Road Traffic Injury Prevention, 2004. The report was launched on World Health Day, 7 April 2004. It is the first major report on the topic produced and issued by the WHO in collaboration with the World Bank. The report can be obtained by contacting the WHO at VIP@who.int or downloaded from here:
http://www.who.int/world-health-day/2004/infomaterials/world_report/en/

Practical guide on road safety. A toolkit for National Red Cross and Red Crescent Societies, IFRC/GRSP 2007. The guide describes the activities of National Red Cross and Red Crescent Societies in the field of road safety and suggests possible improvements. It includes 20 recommendations that can be undertaken.


This topic is based on joint GRSP/International Federation of Red Cross and Red Crescent Societies publication: First Aid: it saves lives on the road. It benefited from comments from the World Health Organization.

If you want to learn or enhance your life-protection and -saving skills and knowledge, please refer to your local association or organization offering first aid training courses (for example, your local Red Cross or Red Crescent branch).