In the realm of first aid, the ability to swiftly and accurately assess injuries is paramount, especially when encountering an injured individual lying on the ground. A well-trained occupational first aid attendant, or anyone with first aid knowledge, plays a critical role in determining whether immediate life-saving interventions are necessary.
In the world of first aid protocols, two widely recognized approaches are the Priority Action Approach, often used in WorkSafeBC training, and the Check/Call/Care method, prevalent in Canadian Red Cross training. These methods guide responders in assessing the situation, understanding the incident’s cause, and conducting a thorough evaluation of the person’s airway, breathing, and circulation—collectively referred to as ABCs.
The most optimal position for evaluating an individual’s ABCs is when they are lying flat on their back, known as the Supine position. It is also the best position to perform most critical interventions. Therefore, certain situations demand the repositioning of the injured person to this posture. Repositioning may also be necessary if the individual is at risk of airway blockage due to substances like vomit or other fluids.
In this discussion, we will focus on two essential repositioning techniques covered in basic first aid courses such as Emergency First Aid or OFA 1:
Rolling a Person from a Face-Down to a Face-Up Position
Sometimes, a person may collapse in a position that hinders assessment or obstructs their airway. In such cases, immediate action is imperative. You should only move an ill or injured person if:
- Their position prevents you from providing care for a life-threatening injury or illness.
- They block access to someone with a more serious injury or illness.
- The scene becomes unsafe.
To roll a person from a face-down to a face-up position, follow these steps:
- Kneel beside the worker, on the side opposite of where they are facing, if possible
- Cradle the person’s head and neck with the hand closest to the their head
- Grasp the clothing at their far hip, or the hip itself, with your other hand
- Pull the person’s hip to roll them over to their back
Attempt to roll the person as one unit, including the head, back, and legs. - Open the airway with a head-tilt/chin-lift once the person is facing upward.
- Reassess the person’s ABCs.
Recovery Position
For an unresponsive or partially responsive individual, it is unsafe to leave them in a face-up position, as the airway can become blocked by the tongue or bodily fluids. Rolling the person onto their side and into the recovery position is essential to protect the airway if you have to leave them for any reason.
The recovery position is generally safest for an ill or injured person, except when it interferes with providing care. However, if the person is fully responsive and capable of safeguarding their own airway, the recovery position is unnecessary.
To safely roll a person into the recovery position, follow these guidelines:
- Raise the person’s arm closest to you.
- Place the far arm across the person’s chest, palm against the cheek.
- Raise the knee of the far leg.
- Roll the person as one unit, pulling the raised knee and supporting the head and neck.
- Position the person on their side, ensuring the bent knee prevents them from rolling onto their face.
- Place the other arm in a comfortable position in front of the body.
- Reassess the person’s ABCs.
While these steps are recommended, various effective methods can achieve the same outcome. What matters most is safeguarding the person’s head, rolling them as one unit, ensuring their body remains securely on its side, keeping the airway open, and rechecking the ABCs after completing the repositioning.
Conclusion
Repositioning an injured person is a crucial skill for any first aid expert. Prioritizing the assessment of the individual’s airway, breathing, and circulation is the foundation of sound first aid practice. Whether it involves rolling from a face-down to a face-up position or transitioning to the recovery position, the safety and well-being of the injured person should always be the primary concern. Timely and appropriate repositioning can make a significant difference in the outcome of a medical emergency, underscoring the importance of thorough first aid training and the ability to adapt to various situations.