This is a continuation of last week’s post so if you missed it get caught up here : https://sites.stedwards.edu/comm2399-amillerf/?p=60

**Disclaimer**
This is by no means qualifies you to do anything. This post is merely for education, knowledge and the hopes that you will pursue further training.  If you do something incorrectly you risk further injury to the person or killing them. As an untrained person the best thing you can do for someone is call 911 and explicitly follow their instructions only.
**Disclaimer**

Now that you have an idea of an injured person’s responsiveness you want to quickly assess any injuries they may have. The best way to do this is to take a systematic inventory of the entire body as best you can without causing further harm to the patient. Really Bad Boys Should Find Better Habits. This is a moniker that is taught in combat life savers courses to remember what things to look for, and the order of severity to treat first.

R
The first is Really- this is our responsiveness (AVPU) which in the case of the woman in the car accident I determined to be only pain responsive.

B
The next thing is “Bad” for Breathing; you want to take note of their breathing to ensure they are in fact breathing and listen for any indications of further problems such as obstructed airway or fluid build up in the lungs. If you cannot see a chest rise and fall you can put something such as the glass face of your watch under their nose to see if it fogs up from their breathing. If they are not breathing you will want to immediately find a way to get them breathing again. After 3 minutes the likeliness of death or extreme brain damage skyrocket.

B
“Boys” is for bleeding. You will want find where bleeding is coming from and stop it. Arterial bleeding  will be a dark (almost black) blood that will come out in large large quantities while venous bleeding will be lighter and more ooze out. The woman in the vehicle had arterial bleeding in her left arm from a large piece of glass that had gone into it. DO NOT EVER REMOVE THINGS; doing so could tear more flesh and cause further damage. I had a tourniquet handy which I applied to her arm to stop the bleeding. She also had blood coming from her nose and shoulder but it was not life threatening so I left it alone.

Remember the goal of first aid is to stabilize a patient long enough to get them to the next level of care, while preventing further harm. 

S
“Should” is for shock. If you have stabilized breathing and bleeding you will then want to look for signs and symptoms of shock. Symptoms include shallow breathing, clammy skin, rapid weak pulse, and confusion or weakness. The best thing you can do for someone is to loosen restrictive clothing and if possible elevate the feet above the head. In the car accident situation I could not because I did not want to move her in case she had a spinal injury. I used my knife to cut away the seat belt and make breathing easier.

FBH

“Find Better Habits” is for fractures, burns, and head injuries. At this point the patient should be stable and you should further look for other injuries. Fractures come in two varieties, simple and compound or open and closed. A simple or closed fracture is one in which the bone is broken but has not pierced the skin. A complex or open fracture has bone protruding from the skin. Burns can come in 4 varieties these are chemical, laser, electrical and thermal. The most common are thermal caused by either fire or friction. These should be dressed with sterile gauze, anything attached to the burn (melted clothing or matter) should be left there for surgeons to remove. Head injuries are hard to detect, the best thing you can look for or rather smell for is a sour, pungent clear fluid in the ears or nose. This is spinal fluid and is a bad sign.

Of course the entire time I was doing this I had EMS personnel on the phone with me and ensuring that she was receiving proper care and that I did not cause further harm.

In the end the paramedics arrived and were able to save her life in part due to the life saving measures I had taken in preparation to their arrival. I encourage everyone to take any available medical training, not for their sake but for those around them.