Accidents and first aid

Every year in Ireland,hundreds of people die in accidents. Many of these deaths could have been prevented if first aid was given at the scene before emergency services arrive.

What to do

See Accidents and first aid - first aid guide for information on how to deal with common accidents and emergencies, such as choking, poisoning and bleeding.

For detailed information on how to deal with burns and scalds, see Health A-Z: treating burns and scalds 

If someone is injured in an accident:

  • first check that you and the casualty are not in any danger and, if so, make the situation safe
  • when safe, assess the casualty and dial 999 or 112 for an ambulance (if necessary)
  • carry out basic first aid

If they are unconscious and breathing...

If a person is unconscious but is breathing and has no other life-threatening conditions, they should be placed in the recovery position

If they are unconscious and not breathing...

If a person is not breathing normally after an accident you should call for an ambulance and then, if you are able to, start CPR (mouth-to-mouth resuscitation) straight away.

First aid courses

Getting help in an emergency

999 has been the emergency services number in Ireland for many years but you can now also call 112 to get help.

112 is the single emergency telephone number for the European Union. European citizens in distress situations can call the phone number 112 and get through to the emergency services wherever they are.

Many accidents happen when travelling abroad so it is worth remembering that calling 112 can get you the emergency assistance you need when in Ireland or Europe.

If you have suffered an injury (needle stick or other sharps injury, sexual exposure, human bites, exposure of broken skin or of mucous membranes) where there is a risk of transmission of blood borne viruses and other infections, further information on how to manage your situation is at: www.emitoolkit.ie

How to deal with some of the most common accidents and emergencies.

Choking

Adults and children

If the obstruction is mild, encourage the person to continue coughing, and try to remove the obstruction from the mouth.

If the obstruction is severe, give up to five back blows (between the shoulder blades), using the heel of your hand, and then check the mouth and remove any obstruction.

If the obstruction is still there, give up to five abdominal thrusts. Stand behind the person and put your arms around them, with one fist below the rib cage. Link your hands and pull sharply inwards and upwards. Check the mouth and remove any obvious obstruction. This procedure can also be used for children.

If the obstruction does not clear after three cycles of back blows and abdominal thrusts, dial 999 or 112 for an ambulance and continue the procedure until help arrives.

Burns and scalds

Burns and scalds are some of the most common injuries needing emergency treatment in Ireland.

  • remove any clothing or jewellery unless it is attached to the skin
  • as quickly as possible cool the burn with cold (but not ice cold) running water for a minimum 10 of minutes
  • cover the burn with a sterile dressing of non-fluffy material, such as cling film, or a plastic bag, do not put creams on the burn
  • if appropriate raise the limb to reduce the swelling and offer pain relief
  • call 999 or seek medical help unless the burn is very minor

For chemical burns, determine what has caused the injury, remove any clothing affected, brush the chemical off the skin if it is in powder form and rinse the burn with cold running water for a minimum of 20 minutes.

Be careful to not injure yourself, wear protective clothing if necessary. Call 999 or 112 and arrange immediate medical attention.

Babies

Babies can easily choke on food and small objects. For children with a severe obstruction who are distressed, and unable to cry, cough, or breathe, lay them face down along your forearm, with their head low. Give up to five back blows, with the heel of your hand. Check the child's mouth, using one finger to remove any obvious obstructions.

If the airway is still blocked, turn the child onto their back and give up to five chest thrusts. Use two fingertips to push inwards and upwards (towards the head) against the breastbone, one finger's breadth below the nipple line. The aim is to get the obstruction out with each chest thrust rather than necessarily doing all five.

If the obstruction does not clear after three cycles of back blows and chest thrusts, dial 999 or 112 for an ambulance and continue until help arrives.

Any person that has abdominal thrusts performed on them must be seen by a doctor afterwards.

Poisoning

Poisons can be swallowed, absorbed through the skin, inhaled, splashed into the eyes or injected. They can include common household substances such as bleach, prescription drugs or even wild plants and funghi. Once in the body they can enter the bloodstream and be carried to organs and tissues.

Being poisoned is potentially life-threatening. Most cases of poisoning occur when a person has ingested a toxic substance.

If you think someone has swallowed a poisonous substance, call 999 or 112 to get immediate medical help.

The effects of poisoning depend on the substance swallowed but can include vomiting, loss of conciousness, pain or a burning sensation.

If the person is unconscious, try to rouse them and encourage them to spit out any pills but do not put your fingers in their mouth.

While waiting for help make sure the persons airway is open and they are breathing. If they are breathing put them in the recovery position, preferably with their head down so any vomit can escape without being swallowed or inhaled. If they are unconscious, perform mouth-to-mouth resuscitation until they start breathing or medical help arrives. Take care not to contaminate yourself if there is poison around the patient's airway.

Find out what has been swallowed so you can tell the paramedic or doctor. Do not give the person anything to eat or drink unless a health professional advises you to.

If there are no symptoms after a substance is swallowed, consult your GP or your local Emergency Department.

Electricity

If someone has been electrocuted, dial 999 or 112 for an ambulance.

Switch off the electrical current at the mains to break the contact between the person and the electrical supply.

If you cannot reach the mains supply, protect yourself by standing on some insulation material (such as a phone book) and then using something non-conductive, such as a wooden broom handle, push the person away from the electrical source (or the source away from the person if this is easier).

Do not go near or touch the person until you are sure any electrical supply is cut off and it is safe.

If the person is not breathing, commence CPR and call an ambulance. Always seek medical help unless the shock is very minor.

Drowning

Once the person is on land, if they are not breathing then commence CPR. If unconscious but still breathing, put the person in the recovery position, and call an ambulance immediately.

Bleeding

If someone has severe bleeding, the main aim is to prevent further loss of blood and minimise the effects of shock (see box, above left).

First, dial 999 and ask for an ambulance as soon as possible.

If you have disposable gloves, then use them to reduce the risk of any infection being passed on.

Check that there is nothing embedded in the wound. If there is, take care not to press down on the object. Instead press firmly on either side of the object and build up padding around it before bandaging to avoid putting pressure on the object itself.

If there is nothing embedded, apply and maintain pressure to the wound with your hand, using a clean pad if possible. Use a clean dressing to bandage the wound firmly.

If it is a wound on a limb and there are no fractures, raise the limb to decrease the flow of blood. Always seek medical help for the bleeding unless it is minor.

If there is a severed body part (such as a finger) wrap it in a plastic bag, cling film or soft material and keep it cool. If possible, place the severed body part in ice, but do not put it in direct contact with the ice.

Nosebleeds

Get the person to sit down and ask them to tilt their head forward to allow the blood to drain from their nostrils. It may help to place a bowl on their lap or on the floor in front of them to catch the blood.

Ask the person to pinch the soft part of their nose and continue to breath through their mouth. After 10 minutes, release the pressure on the nose. If the bleeding has not stopped reapply the pressure for another two periods of 10 minutes.

If the bleeding is severe or still has not stopped after 30 minutes call for medical help.

Heart attack

Symptoms of a heart attack include:

  • persistant central chest pain, often described as crushing or vice-like
  • this pain can often spread up the neck and down one or both arms
  • profuse sweating, skin cold to the touch
  • ashen face and a blue tinge to the lips
  • breathlessness and extreme gasping for air
  • sudden fainting or dizziness
  • rapid or weak pulse that may be irregular
  • nausea and/or vomiting

If you think a person is having or has had a heart attack make them as comfortable as possible and call 999 or 112 for an ambulance.

Sit the person down, sitting up with their knees bent.

If they are conscious, reassure them and give them a 300mg aspirin tablet to chew slowly (unless there is any reason not to give them aspirin, such as they are under 16 or have an allergy to aspirin). If the person has any medication for angina, such as a spray or tablets, help them to take it. Monitor their vital signs until help arrives.

If the person becomes unconscious, open their airway, check their breathing and, if it has stopped, start CPR.

Stroke

FAST is the most important thing to remember when dealing with people who have had a stroke, the earlier they receive treatment the better. Call for emergency medical help straight away.

If you suspect a person has had a stroke use the FAST guide:

  • Facial weakness: is the person unable to smile, are their eyes and/or mouth droopy?
  • Arm weakness: is the person only able to raise one arm?
  • Speech problems: is the person unable to speak clearly or understand you?
  • Test all these signs and then call 999 or 112 for emergency help if you think a person has had a stroke.

Fractures

It can be difficult to tell if a person has a broken bone, or a joint or muscle injury. If in any doubt treat it as a broken bone.

If the person is unconscious, has difficulty breathing, or is bleeding severely, these should be dealt with first.

If the person is conscious, prevent any further injury by keeping them still until you get them safely to hospital. Assess the injury and decide the best way to get them to hospital. If it is a broken finger or arm you may be able to drive them yourself without causing more harm. If a broken spine or leg is suspected, call an ambulance and do not move the casualty.

Patients with a possible spinal injury (e.g. having fallen from a height or having been involved in a road traffic collision) should be left as they are until the ambulance service arrives.

  • Support the limb: keep them in the position they were found (unless it is an apparently simple limb injury, with no risk of spinal injury and the patient can move themselves). Support the injured part with anything you have handy, for example rolled up blankets or clothes.
  • Get them to hospital: either by driving them yourself (if it is a minor injury) or call for an ambulance.
  • Look out for signs of shock: if the person is pale, cold and clammy, has a weak pulse and rapid shallow breathing, they are probably in shock.

If you suspect shock, and it is not a severe fracture that means you cannot move the person, lie the casualty down. Loosen any tight clothing and raise their legs above the level of their heart, if their injuries allow, by placing something suitable under their feet such as blankets or cushions.

Do not give them anything to eat or drink as they may need a general anaesthetic when they reach hospital.

Anaphylactic shock

Anaphylactic shock is a severe allergic reaction that can occur after an insect sting or after eating certain foods, such as peanuts and shellfish. The reaction can be very fast, within seconds or minutes of contact with the allergen (the thing a person is allergic to). During a reaction chemicals are released into the blood to widen the blood vessels causing blood pressure to fall. Air passages then narrow making it difficult for the person to breath. Their tongue and throat may also swell obstructing their airway.

Patients with anaphylactic reaction may have any of the following symptoms:

  • Rash
  • Difficulty breathing
  • Mouth or facial swelling
  • Collapse or fainting

If you suspect a person is having an anaphylactic reaction call 999 (or 112) straight away.

Then check if the person is carrying any medication. Some people who know that they suffer from severe allergies may carry epinephrine on them. This is a kind of adrenaline and usually comes in the form of a pre-loaded syringe. You can either help the person administer their medication, or if trained, give it to them yourself.

Make sure they are comfortable and able to breath as best they can while waiting for medical help to arrive. If they are conscious, sitting upright is normally the best position for them.

Treating shock

In the case of a serious accident, it is important to watch for signs of shock.

Shock is a life-threatening condition that occurs when the circulatory system fails and, as a result, deprives the vital organs of oxygen. This is usually due to severe blood loss, but it can also happen following severe burns, severe vomiting, a heart attack, bacterial infection or severe allergic reaction (anaphylactic shock).

The type of shock described here is not the same thing as the emotional response of feeling shocked, which can also occur after an accident.

Signs of shock include:

  • pale, cold, clammy skin
  • sweating
  • rapid, shallow breathing
  • weakness and dizziness
  • feeling sick and possibly vomiting
  • thirst
  • yawning
  • sighing

If you notice any signs of shock in a casualty, seek medical help immediately.

  • Dial 999 and ask for an ambulance as soon as possible.
  • Treat any obvious injuries.
  • Lay the person down if their injuries allow it, and raise and support their legs.
  • Use a coat or blanket to keep them warm, but not smothered.
  • Do not give them anything to eat or drink.
  • Give lots of comfort and reassurance.
  • Monitor the casualty. If they stop breathing, start CPR (cardiopulmonary resuscitation).

If you have suffered an injury (needle stick or other sharps injury, sexual exposure, human bites, exposure of broken skin or of mucous membranes) where there is a risk of transmission of blood borne viruses and other infections, further information on how to manage your situation is at: www.emitoolkit.ie

If someone is injured in an accident:

  • first check that you and the casualty are not in any danger and, if so, make the situation safe
  • when safe, assess the casualty and dial 999 or 112 for an ambulance (if necessary)
  • carry out basic first aid

Assessing a casualty

The priorities when dealing with a casualty can be remembered as ABC:

  • Airway
  • Breathing
  • Circulation

Airway

If the casualty looks to be unconcious, check this by asking them loudly if they are OK and if they can open their eyes. If there is a response then you can leave the casualty in the position they are in until help arrives. While you wait keep checking their vital signs, such as their temperature, pulse and whether they are breathing.

If there is no response, leave the casualty in the position they are in and open their airway. If this is not possible in the position they are in, gently lay the casualty on their back and open the airway.

You open the airway by placing one hand on the casualty's forehead and gently tilting the head back, then lifting the chin using two fingers. This is to move the tongue away from the back of the mouth.

If you suspect spinal injury (e.g. if the patient has fallen from a height or has been involved in a road traffic collision), use the jaw thrust technique. Place your hands on either side of their face. With your fingertips gently lift the jaw to open the airway. Take care not to tilt the casualty's neck.

Breathing

To check if a person is still breathing, look to see that the casualty's chest is rising and falling, listen for breathing and see if you can feel breath against your cheek for 10 seconds.

If they are breathing, place them into the recovery position so the airway remains clear of obstructions.

Circulation

As soon as you notice that a casualty has stopped breathing, call 999 or 112 and ask for the ambulance service

If the casualty has stopped breathing you can help maintain their circulation by performing a combination of chest compressions and rescue breaths called CPR, or mouth-to-mouth resuscitation. This will keep them alive until the emergency services arrive.

Agonal breathing is common in the first few minutes after a sudden cardiac arrest (when the heart stops beating). Agonal breathing is sudden irregular gasps of breath. This should not be mistaken for normal breathing and CPR should be given straight away if a patient has agonal breathing.

If you are unsure, commence CPR.

If you have suffered an injury (needle stick or other sharps injury, sexual exposure, human bites, exposure of broken skin or of mucous membranes) where there is a risk of transmission of blood borne viruses and other infections, further information on how to manage your situation is at: www.emitoolkit.ie

If a casualty is unconscious but is breathing and has no other life-threatening conditions, they should be placed in the recovery position.

Putting someone in the recovery position will ensure the airway remains clear and open. It also ensures that any vomit or fluid will not cause them to choke.

To place someone in the recovery position:

  • place the person on their side so they are supported by one leg and one arm
  • open their airway by tilting the head back and lifting the chin
  • monitor their breathing and pulse continuously
  • if injuries allow, turn the person onto their other side after 30 minutes

If you think a person may have a spinal injury, do not move them, place your hands on either side of their face and gently lift their jaw with your fingertips to open the airway. Take care not to move their neck. If their breathing is or becomes noisy then place them in the recovery position.

The recovery position for babies

For babies less than a year old a different recovery position is needed. Cradle the infant in your arms with their head tilted downwards to make sure they do not choke on their tongue or vomit.

Until help arrives, keep checking the baby's vital signs, such as their temperature, pulse and whether they are breathing.

If you have suffered an injury (needle stick or other sharps injury, sexual exposure, human bites, exposure of broken skin or of mucous membranes) where there is a risk of transmission of blood borne viruses and other infections, further information on how to manage your situation is at: www.emitoolkit.ie

If a person is not breathing normally after an accident you should call for an ambulance and then, if you are able to, start CPR (also known as mouth-to-mouth resuscitation) straight away.

CPR, or cardio-pulmonary resuscitation, is a combination of rescue breaths and chest compressions to keep blood and oxygen circulating in the body. You don't have to do moouth to mouth to save a life.

CHECK the person is unresponsive and not breathing.

CALL - Get someone to call 999 or 112 or call yourself, start compressions-push hard and fast in the centre of the chest and do not stop till help arrives. For more information see www.citizencpr.ie

For adults

If you know how to do CPR

  1. Place your hands on the centre of the person's chest and, with the heel of your hand, press down (4-5cm) at a steady rate, slightly faster than one compression a second.
  2. After every 30 chest compressions, give two breaths.
  3. Pinch the person's nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths, each over one second.
  4. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

For children

For children aged one to puberty (usually taken as 12 years).

  1. Open their airway by placing one hand on the child's forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
  2. Pinch their nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth, check that their chest rises. Give five initial rescue breaths.
  3. Place your hands on the centre of their chest and, with the heel of your hand, press down one-third of the depth of the chest using one or two hands.
  4. After every 30 chest compressions (at a steady rate, slightly faster than one compression a second) givetwo breaths.
  5. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

For babies under one

  1. Open the baby's airway by placing one hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
  2. Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, check that their chest rises. Give five initial rescue breaths.
  3. Place two fingers in the middle of the chest and press down one third of the depth of the chest. After 30 chest compressions at a steady rate (slightly faster than one compression a second) give two breaths.
  4. Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

Useful Links

If you have suffered an injury (needle stick or other sharps injury, sexual exposure, human bites, exposure of broken skin or of mucous membranes) where there is a risk of transmission of blood borne viruses and other infections, further information on how to manage your situation is at: www.emitoolkit.ie

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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