First Aid Basics for Nurses
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Direct answer
Danger, Response, Airway, Breathing, Circulation — DRABC orders the first three minutes of any emergency before any diagnosis is attempted: make sure the scene does not create a second casualty, check response, open the airway, look for breathing for no more than ten seconds, and start chest compressions if absent. Adult CPR runs 30 compressions to 2 breaths at 100 to 120 per minute, 5 to 6 centimetres deep. Beyond resuscitation, first aid is a small set of high-yield actions: direct pressure and elevation for bleeding; cool running water for about 20 minutes on burns (never ice); five back blows then five abdominal thrusts for the choking adult; immobilisation for suspected spinal injury; and for snake bite in India — immobilise the limb at heart level, no incision, suction or tight tourniquet, and shift to a hospital with anti-snake venom.
What you must remember
- DRABC and CPR numbers: compressions 100 to 120 per minute, depth 5 to 6 cm, 30:2 ratio; use an AED as soon as available; children get 2 initial rescue breaths with about 5 cm depth (one-third of chest depth for infants).
- Severe bleeding: direct firm pressure with a sterile pad, elevate where possible, add layers over soaked dressings; tourniquets only for uncontrollable limb haemorrhage, with the time written down.
- Burns: cool with running water about 20 minutes within three hours of injury; remove rings; cover with clean cloth or cling film; never apply ice, toothpaste or ointments; do not burst blisters; assess percentage by the rule of nines and refer.
- Choking adult: 5 back blows between the shoulder blades, then 5 abdominal thrusts (Heimlich), alternating; for an unconscious choker, start CPR and check the mouth each cycle.
- Fractures and spine: immobilise in the position found, splint across joints, pad the splint; suspected spine — manual in-line stabilisation and log-roll, no twisting.
- Snake bite (Indian protocol): reassure, immobilise the limb at heart level, remove rings, no incision, suction or tourniquet, no oral intake, note the time of bite, and transport lying on the side; polyvalent anti-snake venom per the National Snake Bite Management Protocol, with adrenaline ready for anaphylaxis.
- Animal bite and rabies categories (WHO): category I (touching) — wash, no vaccine; category II (nibble, minor scratch) — wash 15 minutes with soap and water, vaccinate; category III (transdermal bite or bleeding scratch, bat contact) — wash, rabies immunoglobulin into the wound, and the full vaccine course (intramuscular days 0, 3, 7, 14, 28).
- Poisoning: never induce vomiting (especially corrosives and petroleum products); keep the container or a sample; call poison control.
A roadside scene managed in order
A two-wheeler skids outside the college gate: a rider is on the road, not moving; traffic is still flowing. The nurse first directs a bystander to stop traffic — danger before heroics. No response to shouting; she opens the airway with a head-tilt-chin-lift (jaw-thrust had facial injury suggested spine trauma), looks and feels for breathing for ten seconds: absent. Compressions begin in the centre of the chest, hard and fast, 30:2 with the pocket mask from her bag; a bystander fetches the nearest AED; another calls 108. The rider gasps after three cycles — she rolls him into the recovery position, gives a scalp wound direct pressure, and keeps talking to him until the ambulance arrives. At handover she gives times: collapse, CPR start, return of breathing. Nothing dramatic was done — DRABC, pressure, position, packaging — precisely what the exam, and the road, demand.
Where Indian first-aid exams concentrate
The persistent favourites are the snake-bite do-nots (no incision, no suction, no tight tourniquet — the traditional tourniquet teaching is now condemned) with the ASV principle, and the WHO rabies categories with their wash-and-immunoglobulin logic — category III wounds receive RIG infiltrated into and around the wound. CPR numbers are asked as arithmetic (rate, depth, ratio), and the recovery position as a description. Indian framing earns marks: 108 ambulance linkage, the National Snake Bite Management Protocol, and Good Samaritan protection when acting in good faith. Viva traps include burn cooling (20 minutes of running water, not ice) and the reasons vomiting is never induced in poisoning.
Frequently asked questions
What is the correct adult CPR sequence and ratio?
Confirm unresponsiveness, call for help and an AED, then 30 compressions (5 to 6 cm deep, 100 to 120 per minute) to 2 ventilations, minimising interruptions.
How is a snake bite managed as first aid in India?
Reassure, immobilise the limb at heart level, remove constrictions, avoid incision, suction and tourniquets, note bite time, and shift urgently to a hospital for polyvalent anti-snake venom with anaphylaxis preparedness.
What are the WHO categories of animal exposure and their management?
Category I (touch) needs washing only; category II (nibble or minor scratch) needs 15 minutes of washing and vaccination; category III (transdermal bite) needs washing, immunoglobulin infiltration into the wound and full vaccination.
Why is running water the first aid for burns?
About 20 minutes of cool running water within three hours limits the depth of thermal injury by dissipating heat; ice causes further tissue damage, and home applications like toothpaste add infection risk.
When is a tourniquet justified in bleeding control?
Only for life-threatening limb haemorrhage not controlled by direct pressure, with the application time recorded.