D.R.S.A.B.C.D. – The Emergency Action Plan
The Australian Resuscitation Council state any attempt at CPR is better than no attempt at all. If a casualty is in cardiac arrest you cannot do any further harm in your attempt to revive them.
Primary Survey
The D.R.S.A.B.C.D. or the emergency action plan is the protocol to follow in all emergency situations and allows a first aider to work through an emergency safely and systematically.
If the casualty is unconscious the first aider need only follow the D.R.S.A.B.C.D. emergency action plan and perform CPR if the breathing is abnormal.
If a casualty is conscious and able to communicate then the first aider should obtain a history of the incident from the casualty and bystanders by using S.A.M.P.L.E. and begin the secondary survey.
(D) Danger
In any emergency situation, it is important to initially confirm it is safe to approach a casualty. Is there any danger to you, bystanders or casualties? This initial survey of checking the scene for dangers should only take several seconds but can be life-saving. At the scene of a serious incident, the experienced first aider is the most important person and must ensure they are not injured as well.
Determining whether the scene is safe
After identifying an emergency situation, prior to making direct contact with the casualty, it is important to assess the scene for danger to yourself, bystanders and the casualties. If it is safe to do so, remove the danger. If not, remove the casualty and bystanders away from the danger. If it is essential to move a casualty before an ambulance arrives, take extreme care and use good manual handling techniques.
First aiders must consider the setting in which first aid is to be provided including situational risks.
Potential hazards include but are not limited to:
Potential personal violence
Smoke, fire, fumes
Traffic dangers, on-coming traffic
Confined spaces, unstable structures
Electricity, electrical cords, fallen power lines
Sharps (needles or broken glass), sharp metal edges
Weather conditions, slippery/wet surfaces, fast-flowing or deep water
Chemicals, flammable liquids, leaking fuel, risk of explosion, biological hazards
Leave dangerous situations to the emergency personnel who are trained and equipped to manage these situations. You do not want to become a casualty!
(D.R.) Response
Check the casualty’s level of consciousness (or response) by using ‘touch and talk’. On your approach, if the casualty is a stranger first ask “Can I help you?”. You must attempt to establish consent for your legal protection, remember the injured casualty has a right to refuse your assistance. If the casualty is unconscious and a stranger; approach from behind and squeeze the shoulders or hold their feet to check for a response for your safety. DO NOT shake infants and children, and be gentle with all casualties. If you feel it is safe, kneel beside the casualty, take both hands in yours to check for paralysis, and speak to them in a loud voice.
When asking the casualty questions use the C.O.W.S. acronym, this is a method of “Touch & Talk”:
Can you hear me?
Open your eyes.
What’s your name?
Squeeze my hands.
Ask the casualty to squeeze both hands, as this can determine if there’s paralysis on either side of the body.
Responsive?
If the casualty responds by answering and appears conscious, leave them in the position in which you have found them, unless they are in danger or their airway is blocked by fluid and begin the secondary survey using the S.A.M.P.L.E assessment. ( See basic emergency flow chart)
S.A.M.P.L.E.
Signs are what can be observed and may include bleeding, bruising, swelling, skin colour, sweating. Symptoms are what the casualty can feel and may include nausea, dizziness, headache, confusion.
Allergies – Allergic reactions can range from mild-moderate or severe. If there is a known allergy this could be why the casualty is unwell.
Medications – Names, doses, timing and last dose taken. A casualty may take a regular medication that may assist in their first aid management, for example, ventolin puffer for asthma.
Past medical history – Previous illness or injury, some conditions like asthma or heart conditions can reoccur, likewise, soft tissue injuries such as sprains and strains may happen more than once.
Last time they ate or drank – This is relevant for dehydration, blood sugar levels and cases of anaphylaxis. Important to handover to medical personnel if the casualty requires surgery.
Events leading to the incident– Understanding the events leading to the injury or illness. For example, understanding how a casualty has fallen could help you to locate further injuries.
- Check the casualty’s condition and send or go for help, or call 000 for an ambulance if required.
- If you are on your own, leave the casualty and go for help if you cannot call 000.
- Observe and reassess the casualty regularly for breathing and the feeling of warmth in their hands for circulation.
No Response?
- If the casualty does not respond or gives a poor response, such as a confused verbal response:
- Shout for help or call 000.
(D.R.S.) Send for Help
If there are no clear signs of a response to your touch and talk, stop and call for emergency assistance. If there are bystanders instruct them to make the call to allow the experienced persons to remain with the casualty.
Calling for HELP:
1. Call 000 for Ambulance, Police or Fire Service.
2. Call 112 if you are using a mobile phone and you are out or range of your telecommunications provider (a black spot).
3. When the emergency operator answers, state clearly which service is required.
4. Stay calm and speak clearly. Be ready to answer questions.
5. State the location (your location is identified through a GPS method on your mobile phone), describe the emergency, number of casualties involved, condition of casualties, hazards – fire, fumes, chemical spill and telephone number where the caller can be contacted for further information.
6. Do not hang up until told to do so by the operator.
