First aid - assessing danger

Staying safe

The instinct for most nurses is to help anyone who needs their help in any situation. The Nursing and Midwifery Council (NMC, 2017) recognise that not all nurses are first aid trained and may therefore not feel they have the skills necessary to delivery emergency aid away from their usual clinical setting. The NMC (2018) also promote the fact that nurses should not put themselves in danger in order to provide first aid as becoming injured themselves only means that the emergency services have to deal with an additional casualty.

Being safe yourself is the first thing anyone will learn on a first aid course, which means when appraising a situation the nurse must consider:

• is it safe?
• what happened to the casualty and could that affect me?
• are other people in attendance able to offer better care than me?
• can I be of assistance in another way,

The initial first aid assessment of a potential casualty uses the acronym, DRABC (Doctor ABC), where DRABC stands for:

• D – Danger
• R – Response
• A – Airway
• B – Breathing
• C – Circulation (St John’s Ambulance, 2021)

RABC is covered elsewhere in this series (see: First aid: assessing a casualty)

Questions about whether the nurses assessing a situation is in danger include:

• who might be in danger here, me, the casualty or other people?
• if after assessing the situation the nurse decides it is not safe, they should:
  • stand back from the situation and take stock
  • where possible make the situation safer, e.g. get someone to direct traffic, turn off electricity
  • ensure they call for additional help where needed, e.g. call the emergency services, if bystanders not already helping
  • if the situation is now safe approach

The nurse should use all of their senses to judge if the situation is

Is there a need for first aid?

Whether in the workplace or externally, the nurse should ascertain if there is a likely need for first aid but observing what is in front of them.  What level and type of aid is determined by undertaking a primary survey – which is described in First aid: assessing a casualty.

It is likely that an individual needs first aid under a variety of circumstances which, as the examples illustrate, can be in a variety of places and according to the situation, may mean a variety of things.  First aid may be required when:

• finding a patient in the hospital setting whose life appears to be in immediate danger or where someone risks an issue becoming life limiting if first aid is not performed, i.e. if the nurse were to wait to summon other help. In hospital this usually applies to people experiencing a

References

Nursing and Midwifery Council. Information for nurses and midwives on responding to unexpected incidents or emergencies. 2017.  https://www.nmc.org.uk/news/news-and-updates/information-for-nurses-and-midwives-on-responding-to-unexpected-incidents-or-emergencies/ (accessed 08 March 2022)

Nursing and Midwifery Council. The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates.  2018. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf (accessed 08 March 2022)

St John’s Ambulance. How to do the primary survey (DR ABC). 2021.  https://www.sja.org.uk/get-advice/first-aid-advice/how-to/how-to-do-the-primary-survey/ (accessed 09 March 2022)