First Aid Trainers all know how to teach the first aid basics and anyone with a hint of common sense would be able to adapt their treatment according to the casualty and the situation. After all, that is exactly what First Aid is, the absolute first treatment that a casualty receives, generally before they are handed over to a medical professional for full and specialised treatment.
Practising First Aider Trainers will most likely agree that first aid treatments are prioritised in order of breathing, bleeding, breaks, burns; however, in the situation of dealing with a chemical spill incident, the burns treatment will most likely be prioritised, with a high risk of breathing failure to follow.
Chemicals are generically categorised into acids and alkalis. Alkalis burn deeper than acids, however, the severity of a chemical spill burn is related to a number of factors such as the pH, concentration, length of contact time, volume and physical form of the chemical.
Prompt burns irrigation is absolutely essential. However, it is the safe approach to a spill site that must remain the absolute priority to a First Aider. The safe approach should be in conjunction with permission or handover of the casualty from a Scene Manager. The site of the incident and the nature of the chemical spillage may influence a First Aider’s pre-treatment actions. These may include decontaminating the casualty, wearing PPE or even that the First Aider can only guide the casualty to a clean area where they can instruct them on how to self-treat.
With a safe, efficient and effective on-site Spill Team alongside a competent Incident Controller and Scene Manager, the First Aider should be able to commence irrigation of both acid and alkali exposures within several minutes. Such swift action will lead to an immediate decrease in the chemical pH, consequently it will begin to cool the skin and significantly reduce the extent of injury. It has been previously been documented that burns irrigated within ten minutes have a five-fold decrease in full-thickness injury and a two-fold decrease in length of hospital stay.
In addition to burns injuries, casualties of chemical spill injuries may experience difficulties breathing. Such difficulties may be displayed through inhalation and choking problems. Competent and skilled First Aiders are usually trained to follow a DRAB or similar procedure. Once they have checked the scene for Danger, they will proceed to evaluate the Response, Airway and Breathing of a casualty. This four-part procedure can become second nature to the point that a First Aider feels compelled to commence checks straight away.
In the event of a chemical spill, a First Aider must be aware that their casualty may be highly contaminated. It is imperative that they do not begin treatment until they have received permission to do so, or, that the casualty has been handed over by a Scene Manager. At this time, even if dealing with a decontaminated casualty, the First Aider may choose to make a number of safe adaptations such as omitting CPR breaths or only moving the casualty when wearing non-corrosive PPE. If PPE is not available to the First Aider, they may choose to adapt a make-shift recovery position without using the hands.
With all of the information and training in the world, it remains a fact that perfect practice makes perfect. A First Aider who has the possibility of dealing with casualties involved in chemical spills should be practising their skills and procedures in context. First Aiders should be practising accessing and using site treatment areas, equipment; regularly practising using emergency communication methods and regularly practising working within the emergency response team with formal roles and responsibilities. It is only with regular practice that an action can become near perfect and it is only with perfect practice that an action can become perfect.
Source by Becki Coombe