First aid – be brave and take action

First aid is a subject that most people rarely encounter under normal circumstances. But when the situation calls for it, we need to stay calm and take the right action. The few minutes before the ambulance arrives can determine whether people who are sick or victims of an accident will live, die, or suffer long-term harm.

Anyone can find themselves in life-threatening situations, hoping that someone will help them. However, many of us feel overwhelmed in this type of situation and fail to provide first aid out of fear of doing something wrong. Tens of thousands of people die of a cardiac arrest every year in Germany. Only just over 40 percent of first aiders provide immediate heart compressions. But it only takes 3 to 5 minutes without life-saving action before the person suffers irreparable brain damage. After 10 minutes, resuscitation measures are usually too late.

The emergency services can be called by dialing 112, free of charge, from a land line or cell phone. This number is valid throughout Europe.

Calling the emergency services is usually the first part of the emergency chain, followed by first aid measures, until the ambulance can take over and get the sick or injured person to hospital.

What questions need to be answered when calling the emergency services?

• Where: when calling the emergency services, we need to give the exact location of the emergency, i.e. the town, street, building number, and, where relevant, the floor.

But don’t hang up then, as other issues need to be clarified:

• What has happened?
• How many sick or injured people are there?
• What are the injuries or illnesses, and do they appear to be life-threatening?

First, check whether the person is really unconscious. To do this, grip the person firmly by the shoulders and shake them gently. If they begin to respond, alert the emergency services if necessary.

If the person fails to respond and their eyes remain closed, they are unconscious.

In this case, it is useful for others to help, so call loudly for help and ask bystanders to alert the emergency services. If there is nobody around to help, you need to call 112 yourself.

Further action is required before the emergency services arrive.

• Check breathing: we can feel, and usually hear, breathing by putting our own cheek and ear close to the person'’ mouth and nose. We can also watch to see whether their chest is moving. This needs to be done for around 10 seconds. Look for normal breathing – single, irregular, deep breaths or gasps are not proper breathing and can occur in the early phase of a cardiac arrest.
• Recovery position: an unconscious person has no cough reflex and can suffocate on their own saliva, vomit or blood. If they are on their back, their tongue can also block their airways. For these reasons, someone who is unconscious but still breathing normally should be put in the recovery position. To do this, kneel beside the unconscious person and bring their far arm up to the opposite cheek. Then grasp their far leg above the knee and roll the person onto their side. The back of the hand of the upper arm stabilizes the head beneath their cheek, and their open mouth is the lowest point.
• To prevent them getting cold, cover the person with a survival blanket and push it beneath their body too. The silver side should be facing the patient.
• Check their breathing at least once a minute until the emergency services arrive.

This Johanniter Accident Aid video explains how to put an unconscious person into the recovery position.

Heavy bleeding must be stopped, as the loss of even one liter of blood in adults can lead to shock.

How to proceed:

• First, put on some disposable gloves.
• Just elevating a bleeding arm or leg can reduce the bleeding.
• Press a clean cloth or the palm of your hand flat against the wound.
• From two packs of bandages, create a compression bandage. To do this, apply the dressing from the first pack to the wound. Put on the second pack, unopened, and wrap it around as padding.
• This is the latest point at which you need to call emergency services on 112.

If the person has stopped breathing or is taking single gasps, it is important to begin heart compressions and artificial respiration as quickly as possible – if the brain fails to get oxygen for even a few minutes, lasting damage may be done.

Use a defibrillator if there is one nearby. There are automatic external defibrillators (AEDs) in stations, airports, some large venues, pharmacies and many other public places. These devices are recognizable from their green label, showing a heart and an electric arrow. AEDs are specifically developed so that “anyone” can use them – they are easy to use and can detect a cardiac arrest automatically. The device has an integrated voice feature to issue instructions on what to do. A small screen or graphics provide further help.

Until the defibrillator is used or if none is available, heart compressions should be applied.

• For this purpose, the patient needs to be on their back on a hard surface.
• Put the heel of your hand in the middle of their chest on the sternum (breastbone), and support it with your other hand.
• Then give 30 heart compressions, around two per second. These involve pressing the chest in around 5 to 6 centimeters.
• Follow that with two rapid lung inflations. To do this, tilt their head back slightly, pinch their nose, and breathe evenly from mouth to mouth (or mouth to nose) for about one second.
• Repeat the heart compressions and the artificial respiration until the emergency services arrive.

This Johanniter Accident Aid video explains how to do cardiopulmonary resuscitation (CPR).

When there is an accident, the site first needs to be made secure. It is important to keep yourself safe, to stay calm, and to get an overview of the situation.

To avoid endangering yourself, you should:

• put on a high-visibility jacket
• put on the vehicle’s hazard lights
• put up a warning triangle at least 100 meters away

If other people are around, ask them to help by calling the emergency services and helping you with first aid.

After making the site of the accident secure, all injured people should be removed from the danger area if possible, particularly if there is a risk of fire.

Saving someone from a vehicle that has been in an accident:

• Release their safety belt or cut through it if necessary.
• If their feet are not jammed, the person can be removed from the vehicle using the rescue maneuver.
• To do this, gently tilt the person forwards.
• From behind, put your arms beneath the person’s armpits, and grasp one of their lower arms, placing it horizontally across their chest.
• Pull the injured person onto your own thigh and drag them backwards out of the danger area.
• A second helper can take the weight of the injured person’s legs. A survival blanket, with its silver side towards the injured person, helps prevent them getting cold.

Anybody lying down can be removed from a danger area in a similar way – after talking to them and explaining your intention, approach them from behind and grip them below their neck and shoulders. The head is thus supported by the lower arms. If the person has been put into a sitting position, they can be pulled away from the danger area using the rescue maneuver.

If a motorcyclist has had an accident and is unconscious, their helmet should be very carefully removed because there is a serious risk that they could suffocate. This is best done by two people. To do so, first open the visor and chin strap, and remove any goggles. One first aider grips the head on both sides with their thumbs in front of and the other fingers behind the ears. The other first aider kneels above the injured person and carefully removes the helmet. Abrupt head movements must be avoided.

Anyone who wants to get a driving license has to attend a first aid course. But how long ago was it that you completed yours, and can you still remember what to do in case of doubt? If not, it helps to repeat what you have learned. Because someone who feels confident can respond better and stay calm more easily if something serious occurs.

But first aid cannot be learned through theory alone. To really be able to help in a crisis, you need to attend a first aid course. First aid “refresher” courses are also recommended.

It is a good idea to keep a first aid box in the car and another at home. Note that its contents will have a “best by” date, which should be checked regularly.

The organizations below are some of those that provide first aid courses and also education for workplace first responders:

• Deutsches Rotes Kreuz e.V. (DRK – German Red Cross)
• Arbeiter-Samariter-Bund e. V. (ASB – Workers’ Samaritan Federation)
• Malteser Hilfsdienst e.V.
• Johanniter