Emergency action plan

Many variables exist when dealing with emergencies. Knowing when to do what in a first aid situation, despite the number of possible variables, is the key to giving the casualty or casualties the best chance of a full recovery. In any first aid situation the first aider must have an action plan. The plan of action for first aiders is known as the emergency action plan (EAP). The steps in the EAP are listed below:

1. pause and plan
2. call for emergency assistance
3. primary assessment
4. secondary assessment
   
   • management of injuries
   • vital signs survey
   • history
   • body check
   • treatment
5. Ongoing management

Pause and plan

The aim of pause and plan is to remind the first aider to remain calm, and to stop and think. Any time you are called to an incident, consider the following questions:

• is the area safe?
• do you have the appropriate first aid kit and equipment to manage the incident?
• how long could you be out in the elements?
• do you have a radio or mobile phone?
• are you likely to need assistance?
• do you need to call Triple Zero (000) before you attend to the incident?

Through an understanding of your environment and the injuries you are likely to encounter you should already have answered most of these questions.  However the couple of seconds it takes to pause and plan will save you minutes down the track.

Call for emergency assistance

It is essential that emergency services are contacted as soon as possible. This should not be delayed until the primary assessment has been completed, but can happen at any stage during the primary assessment.

Ask a bystander or relative who is present to call for an ambulance. This enables you to remain with the casualty. When sending another person for assistance, always make sure that they report back to you.

The person calling needs to remain calm and will be asked a number of questions by the emergency services operator. The four P’s, Position, Problem, People and Progress can be used to remember the information that will need to be supplied to the emergency services operator.

Position   
What is the exact location of the emergency??The caller should be ready to give the street address and suburb, or a description of the location such as the nearest intersection or landmark. It is also useful to pass on the telephone number they are calling from.

Problem   
What is the problem? ?The caller should be ready to explain what has happened.

People   
How many (other) people are hurt (sick)? The caller must be prepared to list the number of people involved in the incident including their gender, ages and signs of life.

Progress   
What has been done (progress) to assist the casualty?  ?The caller may be asked if he or she is with the casualty at the time and what treatment has been provided so far.
The caller should never hang up until told to do so by the operator. They may be given instructions on how best to treat the casualty until emergency services personnel arrive.

Primary assessment

A primary assessment is the initial survey of an emergency situation, and the actions that need to be carried out.

Danger
Check for danger to Yourself, the Patient and Bystanders

Response
Check for response by talk and touch

Send
If unresponsive, send for help by calling Triple Zero (000)

Airway
Open airway and ensure it is clear. If not, roll patient onto their side and clear the airway

Breathing
Look, listen and feel for breathing

CPR
If there is no breathing or response, give 30 chest compressions followed by 2 rescue breaths. If unwilling or unable to perform rescue breaths, continue chest compressions only

Defibrillation
Attach an Automated External Defibrillator (AED) as soon as it is available and follow its prompts

Secondary assessment

The secondary assessment is a systematic means of finding other conditions that were not apparent during the primary assessment. This further assessment should not be undertaken if life-threatening conditions are still present.

Before conducting a secondary assessment, always:

• introduce yourself to the casualty and ask their name
• explain your intentions to the casualty
• seek consent to treat the casualty
• consider and respect the casualty’s privacy

Management of injuries
After completing the primary assessment and having identified that the casualty is breathing, the first aider can begin managing other injuries. It is important to remember that CPR must not be interrupted to treat other injuries.

Order of treatment
The control of major bleeding is seen as the first priority after the completion of the primary assessment.  Then manage any major burns, treat the casualty for shock, stabilise any fractures and treat any other injuries.

Casualty position
The casualty should be moved or assisted into the most comfortable position for their condition.  Does the casualty require protection from the sun, wind or rain?

Call for further assistance if required
The first aider should now consider what further assistance or equipment may be needed to treat the casualty, and call Triple Zero (000) if necessary and if not already done.