First Aid After Terrorist Attack

First aid instructor explains how to help other people right after a catastrophe or terrorist attack and not to imperil your own life. Start to act is the best way to cope with fear and panic and get rescued.

Iwrote this guide after the tragedy in Paris that happened in November 2015. On March 22, 2016 ISIS launched a new strike — this time in Brussels. More than 30 people are dead, and 200+ injured.

First reaction is to close your eyes and murmur a mantra “Never-never-never with me or my dearest” like a child. But let’s be realistic: if not a terrorist attack — a natural disaster, train crash, fire, vehicle accident — anything can happen to us. Injured people can be rescued if someone around knows the basics of first aid. It is very easy to learn little things that can save lives. Just enroll to a first aid training course — there are such trainings in every city. Learn how to stop the bleeding or restart a heart. And may this knowledge will never be of any use to you.

Artem Kharchikov, first aid instructor, founder of “+1” project Training in first aid

A 3-STEP METHOD

  • What should you do if you found yourself in the middle of a catastrophe, like the one in Brussels? We start to ask ourselves a lot of (seemingly) unresolvable questions.
    What should I do: run for my life or stay and help others?
    If I should stay — how can I help them? What problems to deal first?
    If there are many injured — whom should I help first?
    All these questions come upon you and you may feel stamped.
  • Let’s see how to deal with it and start with your goals. You always have only one compulsive goal — to survive and not to get injured. The other two — call the emergency and give first aid to others — are optional.
  • Remember: if you don’t know what to do, forget how to call the ambulance, can’t give first aid — then save your own life. It means a lot itself.  By surviving you make the death toll smaller. And if you want to make something bigger, than you’ll have to master a couple of techniques and tricks.
  • To get through panic and brain freeze that come with any emergency event — start acting. You should keep it simple and effective, that’s why there is a simple three-step algorithm. During our training courses we teach people to follow it with their brains on autopilot.
    First step: Stop, look around and check if you are in danger.
    Second step: If your life is not at risk, check the consciousness of an injured person.
    Third step: If the person is unconscious, check their breath.
  • When people know this action sequence, they do not have brain freeze. They simply follow the algorithm and make decisions according to the situation.
  • For example, you see an injured person and follow the first step — stop, check the danger­ — beside them. Assume that there is danger. What’s next? That’s simple – you choose from three options: don’t touch anything/run away, eliminate the danger or take the injured person away from danger.
  • Important: do not start an action if you don’t understand how to accomplish it. For example, don’t try to move an injured person out of danger if you don’t know where to take them, where to retreat, etc.
  • The first step “Stop! Check the danger” is the most important and the most difficult one. Your brain shouts panicking “Why are you standing, run, rescue yourself!” But what you really need to do is the opposite – you should stop and don’t run anywhere before you understand what is going on.
  • Remember, rescuing another person shouldn’t cause your death. Otherwise, it contradicts simple logic: if you die in process, how are you going to help the injured person?
  • The algorithm should be practiced before the emergency case; otherwise all of this is just talky talk.

EVACUATION

  •  If you checked the threat and decided that you can escape along with the injured person – that’s great.
  •  Remember the first principle of evacuation – do it fast! It doesn’t matter which traumas and wounds the injured person has, the most important thing is to leave dangerous area. The way of evacuation is not important, the faster the better.
  • In the video of Le Mond you can see an appropriate way of evacuation of the injured. The rescuer goes backwards, holds an injured man by his hands and drags him faceup.
  • If the ground is flat and there are no obstacles, dragging by hands is the fastest and the easiest for the rescuer. The head of an injured person remains above the ground and doesn’t bump much. However, in an extreme situation when you can be shot or a bomb is about to explode, even dragging by one leg facedown is better than nothing.

THREE PROBLEMS TO RESOLVE

  • On the scene of a catastrophe, there are three problems that kill people faster than others.
    External threat. You have handled it as you have evacuated the injured person away from the danger.
    Heavy bleeding.
    Breathing problems.
    You should deal with them in the same order as we have listed. Focus only on these three things and you’ll maximize the number of survivors. Broken hands, legs, and other scary things won’t kill anyone as fast as bleeding or breathing problems will. Broken spines and heavily wounded heads are out of your span of control as well. You cannot do anything right here and right now even if you are world’s best neurosurgeon or resuscitator.
  • First, check the injured people using the algorithm (steps 2 and 3).
    Check if they are conscious. If not,
    Check if they are breathing.
  • Now you have three groups of people:
    1.Conscious
    2. 
    Unconscious, breathing
    3. 
    Unconscious, not breathing
  • You need to kind of sort the injured people to get the answer to the question “how can I help them?” There is a set of rules for each category of the injured.
    1. Conscious: stop the bleeding, if any, help them assume a comfortable position, and wait for help.
    2. Unconscious, breathing: turn them sidelong, to prevent breathing problems due to falling back of tongue or vomiting, stop the bleeding, and wait for help.
    3. Unconscious, not breathing: start cardiopulmonary resuscitation and wait for help.

  • Here is the best video about hands-only CPR from British Heart Foundation.
  • The main question to solve in the middle of a catastrophe — whom to help first. Assume you have 3-4 people around. You can’t help everybody at a time, obviously, so use the triage system. Its goal is to save as much people as possible, and not to save all of them, as it is frequently said.
  • First we save the ones who can breathe, but is heavily injured: multiple traumas, vast blood loss, unconsciousness. Then we move to the conscious people with similar injures. And the last to receive our help are the ones who can move around by themselves.
  • Don’t try to rescue those who is unconscious and don’t breathe. You don’t have enough resources to help them.
  • Inspect all the injured — conscious and not — for presence of bleedings. By bleedings we mean heavy bleedings, when blood is obviously running or even gushes with pressure. Find the source of the bleeding. Simply plug it with a hand or, which is better, a piece of cloth. Literally, plug the wound. If it is a leg, push on the inner thigh near the pelvic area, there is an artery and you can feel the pulse. Push the artery with your fist to the bone until the bleeding stops. Then dress a wound, if you have anything suitable for that. But first of all stop the bleeding quickly. Right now.
  • If you have a first aid kit with you of something similar, stop the bleeding with a pressure dressing or a tourniquet, if dressing is not an option.
  • It doesn’t matter if it is a gunshot wound, knife one or from a piece of glass. The only thing that is important is if is bleeding or not.
  • What is the main result of your battle? The place where you are staying should be safe. If situation changes, evacuate alone or take someone with you. All the unconscious people who are breathing should lie sidelong. All the bleedings should be stopped.
  • Skinburns here are the last thing to be worried about. Breathing problems and bleedings are much worse — they kill very fast.
  • Only if you and the injured are in safe place and the bleeding is stopped, you can move along to the skinburns. You need to cool it down. As you, probably, don’t have a special gel with you, use room temperature water. Pour it on the skinburn during 2-3 minutes. If there are a lot of people — put wet pieces of cloth on each skinburn. To protect the damaged area from ambient impact, reel it loosely with a plastic bag or a PE foil. That is all you can do, now wait for the ambulance.

Illustration: Alena Lavdovskaya

 

 

 

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