Intended for healthcare professionals

Student Education

First aid: Prehospital care

BMJ 2005; 330 doi: (Published 01 February 2005) Cite this as: BMJ 2005;330:050254
  1. Martin S Roth, first year anaesthesia resident1,
  2. Fabian J Garcia, resident instructor2,
  3. Anabella Fernandez, medical student3,
  4. Matias Garcia, medical student3,
  5. Alejo Texo, medical student3,
  6. Nicolas Roth, medical student3,
  7. Dr Samena Chaudhry, SHO in Accident and Emergency4
  1. 1Hospital Italiano de Buenos Aires, Argentina
  2. 2Isabel Pincemin clinician, Hospital Municipal de San Isidro
  3. 3Universidad de Buenos Aires
  4. 4University hospital North Staffordshire

In the first of a series about first aid, Martin S Roth and colleagues concentrate on prehospital assessment

It is Friday night. After a long, hard week of studies you think that you deserve a break and want to have a good time with friends. While walking along the road, you come across a crowd of people staring at a motorcyclist who is lying on the ground after a crash. Your friends look at you--a medical student. They are obviously under the impression that you know exactly what to do in an incident like this. Do you?

First aid is the immediate care given to an injured or ill person before they are attended to in a hospital or clinic. Traditional under-graduate teaching in management of trauma begins in the emergency department. But medical students are just as likely as anyone to come across an incident such as the one described above. Trauma is the commonest cause of death in the 1-39 age group and has a trimodal distribution (see table).

To reduce deaths in the second and third phases, early treatment must be given. This early period is known as the “golden hour” and is the time before irreversible patho-logical changes begin. The golden hour is usually from the time of injury to definitive management--for example, surgery. In prehospital management, the “platinum 10 minutes” are most important in all emergencies where the victim is not trapped (box 1). The basic principles of treatment in prehospital care are based on a systematic approach (box 2).

Box 1: The platinum 10 minutes

  • Assessment and primary survey--1 minute

  • Resuscitation and stabilisation--5 minutes

  • Immobilisation and loading for transport--4 minutes


Box 2: Basic principles

  • Personal rescuer safety

  • Scene safety

  • Patient safety

  • Primary survey with resuscitation

  • Stabilisation

  • Secondary survey

  • Packaging and transfer


Approaching with caution

The first aspect to be taken into account is without any doubt …

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