Copyright © Geoff Thompson 2004
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In the execution of self-defence it is quite likely that you, even if you defend yourself successfully, may pick up minor or serious injuries. You may be with a friend or friends who are injured or you may even wish to treat an attacker who you have injured in the process of defending yourself. The latter is unlikely and not recommended. If your adversary has been neutralised, it is highly dangerous to hang around, though of course the prerogative is entirely yours.
THE PRINCIPLE OF FIRST AID
First aid is the skilled application of accepted methods of treatment on the occurrence of an injury or in the case of sudden illness, using facilities or materials available at the time. It is the approved method of treating a casualty until placed, if necessary, in the care of a doctor or removed to hospital.
First aid treatment is given to sustain life
To prevent a condition from becoming worse
To promote recovery
So, basically, if the injuries are bad, you are looking to do a patch-up job that will suffice until somebody skilled, i.e. a doctor or hospital, can take over. Of course, injuries sustained in physical attacks can be very varied, so we will try to aim at the obvious and potentially life-threatening injuries.
THE SCOPE OF FIRST AID
This consists of four parts:
- Assessing the situation.
- Diagnosing what is wrong.
- Giving immediate and appropriate treatment.
- Disposing of the casualty to a doctor, hospital or home, according to the seriousness of the situation.
In the attack scenario, from my experience the most common injuries are unconsciousness, face and head wounds and stab wounds to the body.
Unconscious casualty
If the casualty is unconscious, the task of ascertaining his/her injuries is a difficult one because you cannot ask the person where they hurt (well you can, but they are unlikely to answer!). So, a thorough detailed examination of the person is necessary. Note if breathing is present. If absent, immediately commence artificial respiration. Examine over and under the casualty for dampness which might indicate bleeding or incontinence. Stop any serious bleeding before proceeding further with the examination. Bear in mind the possibilities of internal bleeding. Once everything is in order, place the casualty in the recovery position.
The recovery position
If the casualty is lying on his/her back:
1) Kneel beside him/her and place both arms close to the body. Cross the far leg over the near leg. Protect the face with one of your hands. Gently turn the casualty onto their side. This may be done by grasping the casualty’s attire at the hip.
2) Draw up the upper arm until it makes a right angle to the body and bend at the elbow.
3) Draw up the upper leg until the thigh makes a right angle to the body and bend the knee.
4) Draw the underneath arm gently backward to extend it slightly behind the back.
5) Bend the undermost knee slightly. The reason for the limbs being placed in this manner is that it provides the necessary stability to keep the casualty comfortable in the recovery position, and stop the casualty from rolling onto his or her back, where there is a danger of choking. If the casualty is very heavy, two hands should be used to grip the clothing. In this instance, you should kneel at the side of the casualty so that when he/she is turned, the face will rest against your knees.
If bystanders are present, get them to help with the turning. Gently tilt the casualty’s head slightly back so as to ensure an open airway.
Artificial respiration
There are many methods of artificial respiration. The most effective is mouth to mouth (mouth to nose), and this method can be used by almost all age groups and in almost all circumstances except when there is severe injury to the face and mouth or when the casualty is vomiting.
1 Ensure the casualty has a good airway by tilting back the head. Support the back of the neck and press the top of the head so that it is tilted backward, simultaneously pressing the chin upward. This will extend the head/neck and lift the tongue forward clear of the airway. This is particularly vital if the casualty is on his/her back, because the tongue may fall to the back of the throat and cause the tongue to be swallowed.
2 Loosen the casualty’s clothing at the neck and waist. If the casualty is not breathing, keep the head tilted backward and begin mouth to mouth (mouth to nose) breathing.
3 Open you mouth wide and take a deep breath. Pinch the casualty’s nose together using your thumb and forefinger. Seal your lips around the casualty’s mouth. Blow into the lungs until the chest rises then remove your mouth and watch the chest fall. Continue these inflations at the natural rate of breathing. Continue until the casualty begins breathing on their own.
If you can’t make a seal around the casualty’s mouth, you may try mouth to nose. You may wish to place a handkerchief over the casualty’s mouth for hygiene reasons. If the casualty’s heart is not beating and his/her colour becomes blue/ grey, the pupils are widely dilated and you cannot feel a pulse, put the casualty on their back on a flat surface and strike the chest sharply on the lower part of the breastbone with the edge of the hand. Hopefully this will restart the heart. If not, start external heart compressions whilst at the same time continuing to give artificial respiration.
1) Take up position at the side of the casualty.
2) Find the lower half of the breastbone.
3) Place the heel of your hand on this part of the bone, keeping the palm and the fingers off the chest.
4) Cover this hand with the heel of the other.
5) With the arms straight, rock forward pressing down on the lower half of the breastbone (about one to one and a half inches in). Adult casualty – repeat the pressure once per second. Make sure the pressure you push with is controlled, as too much pressure may cause damage to the casualty’s ribs or internal organs.
6) Check your effectiveness by watching for an improvement in the casualty’s colour, noticing the size of the pupils (which should become smaller with effective treatment) and feeling for a progressively stronger pulse.
7) In extreme cases, this method should be continued until help arrives. The rate of lung inflation (mouth to mouth) and heart compressions should be fifteen heart compressions followed by two quick lung inflations, and then repeat until the casualty’s heart and breath return or help arrives.
Stab wounds
Potentially a fatal place to be stabbed, a wound in the chest may well allow direct access of air into the chest cavity. When the victim breathes in, the noise of air may be heard. On breathing out, blood or blood-stained bubbles may be expelled from the wound. If the lung is injured, the casualty may also cough up frothy bright red blood. The immediate aim is to seal up the wound and stop air entering the chest cavity. Until a dressing can be applied, place the palm of the hand firmly over the wound, lay the casualty down with head and shoulders raised and the body inclined toward the injured side. If there is first aid equipment available, plug the wound lightly with a dressing, then cover the dressing with a thick layer of cotton wool. Keep it in place by strapping or a bandage. Get hospital help urgently.
Wounds to the stomach (abdominal wall). Place the casualty so that the wound does not gape, preferably on his back with head and shoulders raised and supported with a pillow under his knees. If there are no internal organs protruding, apply a dressing to the wound (if one is available), and bandage it firmly into position. If internal organs are protruding, cover them lightly with a soft, clean towel or a large gauze dressing, secure without undue pressure. If the casualty is coughing or vomiting, be sure to support the abdomen.
Generally speaking, with profuse bleeding from miscellaneous body parts, apply firm pressure with a towel or gauze and try to elevate the body part that is bleeding – leg, arm, etc. – and keep the pressure fixed until the bleeding stops or professional help arrives. If the bleeding cannot be controlled by the application of pressure on the wound, or when it is impossible to apply direct pressure, it is sometimes possible to apply indirect pressure at the appropriate pressure point between the heart and the wound.
A pressure point is where an important artery can be compressed against an underlying bone to prevent the flow of blood beyond that point. Such pressure may be applied while dressing, pad and bandage are being prepared for application, but not for longer than 15 minutes at a time.
Brachial pressure point
The brachial artery runs along the inner side of the muscle of the upper arm, its course being roughly indicated by the inner seam of a coat sleeve. To apply pressure, pass your fingers under the casualty’s upper arm and compress the artery against the bone.
Femoral pressure point
The femoral artery passes into the lower limb at a point corresponding to the fold of the groin. To apply pressure behind the casualty’s knee, grasp his thigh with both hands and press directly and firmly downward in the centre of the groin with both thumbs, one on top of the other against the brim of the pelvis.
Bleeding from the nose
Sit the casualty down with the head slightly forward and tell him or her to breath through the mouth. Pinch the soft part of the nose firmly for about 8-10 minutes. Loosen clothing about the neck and chest and warn against trying to blow the nose.
All the former treatments you may easily apply to yourself as well as any other casualty occurring from the attack by following the instructions laid out. In serious cases, or if in doubt, always get hospital treatment.
