Afterword

Most emergencies in care do not begin with sirens. They begin quietly: a cup that falls, a word that comes out wrong, a person who walks more slowly than usual on a hot afternoon. The care worker who notices, stops and acts is very often the person who makes the biggest difference, long before an ambulance arrives. This book was written for that moment, and for you, the person most likely to be there.

I have tried to put the general content of first aid courses into plain steps, and to set those steps in the places where your work really happens: the bathroom, the kitchen table, the bus stop, the pavement in the summer heat, the side of a busy road. None of it asks you to do more than first aid. It asks you to keep yourself safe, to call for help early, to do the next right thing and to stay with the person.

Nobody is calm by nature in an emergency. Calm comes from knowing what to do, and knowing comes from practice. That is why this book keeps returning to the same advice: take a practical first aid course, go back for refresher courses, and practise the steps with your team. Each time you practise, the steps move a little further from the page and a little closer to your hands.

Please remember, too, that care includes caring for yourself. After an emergency, rest, talk to someone you trust and accept the support your workplace offers. Thank you for the attention you give every day to the people you support. Ready hands are not only skilled hands; they are kind hands, and yours can be both.

Using This Book at Work

This book works well in a team. A short team meeting can begin with one chapter: read the moment at the start aloud, ask each person what they would do, and then read the step-by-step sections together. Afterwards, walk through the steps in the real place. Find the first aid kit, the nearest automated external defibrillator, the coolest room in the building and the safest place to stop on the route you use most often with the people you support.

The things to check at the end of each chapter can be shared out in the team: one colleague checks the first aid kits, another checks the room temperatures on hot days, another checks the emergency information kept with each care plan. Practice drills, such as a practice emergency call or a practice collapse in the dining room, help everyone learn their part in calm conditions. When the team next goes to a practical first aid course or a refresher course, bring the questions from these meetings to the trainer.

The Steps at a Glance

Chapter 1: Make the scene safe, check the person, call for help, give first aid and stay with the person until help takes over. Learn the emergency number from official information, know your workplace's procedures and each care plan, and book a practical first aid course.

Chapter 2: Decide who calls, call the emergency number with the phone's speaker on, say where you are and what has happened, answer the operator's questions and follow the instructions without ending the call first. On a road, describe the road, the direction, what you can see and the location shown on your phone, and send someone to meet the ambulance.

Chapter 3: Check for danger, check for a response with your voice and a gentle tap on the shoulders, shout for help, open the airway and check breathing for no more than 10 seconds. If the person is breathing normally, place them in the recovery position, make sure the emergency number has been called and keep watching the breathing.

Chapter 4: If the person is not breathing normally, call, send for a defibrillator and start chest compressions in the centre of the chest at 100 to 120 per minute and about 5 to 6 centimetres deep, with 30 compressions and 2 rescue breaths if you are trained, or hands-only CPR otherwise. Switch on the defibrillator, follow its voice and keep going until help takes over or the person starts breathing normally.

Chapter 5: Encourage a person with mild choking to keep coughing. For severe choking, call for help, give back blows and then abdominal thrusts or chest thrusts as the course where you live teaches, and start CPR if the person becomes unresponsive.

Chapter 6: For heat exhaustion, move the person to a cool place, help them lie down, loosen their clothes, cool the skin and give sips of water if they are awake and can swallow safely. Call the emergency number if they do not improve quickly or show any sign of heatstroke, and prevent heat illness by offering drinks often and keeping rooms cool.

Chapter 7: For heatstroke, call the emergency number at once, move the person somewhere cool, remove extra clothing and cool them fast with water, fanning, wet cloths and cold packs wrapped in cloth. Keep cooling until help arrives, give nothing to drink if the person is confused or drowsy, and be ready for the recovery position or CPR.

Chapter 8: On a hot outing, stop at once if the person feels unwell, find shade, help them sit or lie down, call when needed, cool them and stay with them. If someone is trapped in a hot parked car, call the emergency number and follow the operator's instructions.

Chapter 9: At a road accident, stop only where it is safe, turn on your hazard lights, put on a high-visibility vest and warn the traffic coming towards the scene. Call the emergency number, count the people involved, keep injured people still and do not move them unless there is danger.

Chapter 10: For severe bleeding, put on gloves, press firmly on the wound with a clean pad, call and add more pads on top without removing the first. For shock, help the person lie down, keep them warm, give nothing to eat or drink and stay with them; for a nosebleed, help the person lean forward and pinch the soft part of the nose.

Chapter 11: After a fall, do not rush to lift the person; check for danger, response and breathing, ask where it hurts and look for a head injury or a broken bone. Call when there are worrying signs, support a suspected broken bone in the position you found it, and follow your workplace's procedure for getting up safely.

Chapter 12: Stop the burning, cool the burn under cool running water for about 20 minutes, remove rings and tight clothing near the burn, and cover it loosely with clean plastic food wrap or a clean cloth that will not leave fluff. Never use ice, butter or creams, and call the emergency number for large, deep or serious burns.

Chapter 13: For chest pain or the signs of a stroke, call at once, help the person rest, note the time the signs started and follow the operator's instructions. During a seizure, protect the person from injury without holding them down or putting anything in their mouth, and in a diabetes emergency give a sugary drink or food only if the person is awake and can swallow safely.

Chapter 14: For a person who is too cold, find shelter, remove wet clothes, cover them with dry blankets including the head and warm them gradually, with warm drinks only if they are fully awake and can swallow safely. Plan outings by the weather forecast, with the right footwear, layers of clothing and extra time.

Chapter 15: Hand over to the paramedics by saying what happened, when it happened and what you did, then record and report the event, clean up with gloves and refill the first aid kit. Look after your own feelings, and keep your skills fresh with refresher courses and team practice.