Module 1: First Aid Principles and the Law PDF

RESTRICTED TO AUTHORISED AND ENROLLED STUDENTS EXCLUSIVELY Our course materials are the intellectual property of Turtle Life Support cc and are protected by the Copyright Act of South Africa. By accessing the course materials, you agree to not share, copy,...

RESTRICTED TO AUTHORISED AND ENROLLED STUDENTS EXCLUSIVELY Our course materials are the intellectual property of Turtle Life Support cc and are protected by the Copyright Act of South Africa. By accessing the course materials, you agree to not share, copy, distribute or plagiarise the contents thereof in any manner whatsoever. MODULE 1: FIRST AID PRINCIPLES AND THE LAW 1.1 INTRODUCTION Saving a life is among the highest and most noble acts a person can perform, as it embodies selflessness and compassion. First aid is a life-saving skill set that empowers individuals to provide immediate care in the event of an injury or medical emergency. A first aid emergency can happen at any time to anyone, anywhere. The role of the first aider is to identify the emergency, call for help and stabilise the casualty until emergency medical services (EMS) arrives. However, bystanders often hesitate to respond to a first aid emergency due to fear of making mistakes, uncertainty about helping a casualty from another culture and concerns about potential legal consequences. This module addresses these issues by discussing first aid and the law, cultural sensitivities in administering first aid and the principles that guide first responders. By equipping yourself with this knowledge, you can act confidently and effectively when it matters most, ensuring you are prepared to make a critical difference in an emergency. 1.2 CAN YOU GET INTO TROUBLE ADMINISTERING FIRST AID? The law is on your side to protect you for administering first aid. In English case law (South Africa is part of the common law tradition), Lord Denning stated that: “whoever comes to the rescue, the law should see that he does not suffer for it”. However, a first aider who possesses some skill or expertise, such as first aid training, will be required to act within the bounds of their skills and knowledge. 1.3 RESPONSIBILITY Under the common law, there is no duty on the ordinary citizen to rescue another citizen. There might be a moral duty but there is no legal duty. While you are shopping you notice a person who collapses, or while driving you witness a car crash. You are not compelled to stop and help the injured casualty. There is no legal obligation to render first aid outside your workplace. Administering first aid is voluntary. It demonstrates selflessness and compassion for individuals who are in need. This voluntary act of service reflects a sense of community where individuals step forward to provide immediate care during first aid emergencies. In this sense a community could include: school mates, friends, family, or complete strangers. However, if administering first aid is part of your job, then you are required to respond to first aid emergencies during working hours. As an employer appointed first aider you are governed by the Occupational Health and Safety Act 85 of 1993 (OHSA).  Working hours are defined as time spent either on your employer’s premises or when you are off campus and assembled with staff or learners. Examples: company conferences or meetings, school camps and ‘away’ sport activities, etc. You have a legal obligation to carry out first aid treatment in the same way a reasonable person with your level of training would act. You should not attempt to provide first aid treatment beyond your ability unless specifically directed, guided and coached by professional emergency personnel (i.e. emergency call centres). The OHSA states that all employers who employ more than 10 employees are required to have at least one trained first aider on duty (General Safety Regulations, 1986, of the OHSA) to administer first aid promptly. As a first aider you are legally required to write a report of the incident and first aid treatment administered to the casualty (Section 38 Compensation for Occupational Injuries and Diseases Act). The incident report only documents details concerning the actual first aid emergency and is only shared with the emergency medical services and the health and safety committee in the workplace. Example of an Incident Report: Scenario: You are the teacher on break duty. On Tuesday 12 November 2009 at 12h30pm. Cindy Davies (aged 10) was observed falling down the stairs next to the hall during second break. Cindy was found sitting at the bottom of the stairs. She was alert and tells you she felt dizzy and fell down the stairs. Cindy says she still feels dizzy and her left ankle hurts. A cold pack was applied to her ankle. Her parents and the emergency services were contacted. Emergency services arrived 10 minutes later and took Cindy to the hospital. INCIDENT REPORT Date: 12/11/2009 Time 12h30 12h45 13h00 Casualty’s name: Cindy Breathing rate 30/min 20/min 20/min Casualty’s surname: Davies Pulse rate 110 90 80 Casualty’s contact no: Skin colour Pale Pale Pale Parent’s cell number Pupil reaction Equal Equal Equal Address where incident happened: Injuries (detailed) Swollen left ankle. Bartholomew Primary School What happened: Cindy Davies (aged 10) was observed falling down the stairs next to the hall. Cindy was found sitting at the bottom of the stairs. She was alert and stated that she had felt dizzy and then fell down the stairs. Treatment given: Ambulance company: A cold pack was applied to her ankle. Netcare 911 First aider’s name: Teacher’s name Paramedic’s name: Tshepo Mashaba Contact no: Teacher’s cell number Contact no: 082 911 1.4 CONFIDENTIALITY As a first aider you may become aware of sensitive (or even embarrassing) information about the casualty. The South African constitution provides for everyone to the right of privacy (section 14). When communicating the casualty’s first aid emergency condition with a parent/guardian or professional emergency personnel, utmost discretion is paramount. In other words, communicate relevant first aid information only. 1.5 CULTURAL SENSITIVITY Cultural sensitivity in an emergency refers to the awareness, understanding and respect for cultural differences and preferences when administering first aid. It recognises individuals from diverse cultural backgrounds may have unique beliefs, practices and preferences related to health and illness. If possible, to reassure the casualty in keeping with their culture, have a family member or friend help explain the reasons for administering first aid. Communication styles: different cultures may have distinct communication styles. Respecting these differences is crucial for effective communication during an emergency. Some individuals may prefer direct communication, while others may value a more indirect or collaborative approach. Modesty and privacy: respect for individual privacy and modesty is important. Some cultures may have specific requirements or preferences regarding how individuals are treated, especially when it comes to exposing certain parts of the body or engaging in physical contact. Religious considerations: awareness of religious practices is essential. For example, some religions may have specific dietary restrictions or rituals that need to be considered when providing first aid, such as accommodating fasting during certain hours. Gender sensitivity: in some cultures, individuals may have strong preferences for the gender of the person providing medical assistance. Being sensitive to these preferences can help ensure the comfort and cooperation of the casualty in need. Language barriers: cultural sensitivity also involves addressing language barriers appropriately. Providing information and instructions in a language the casualty understands, helps ensure effective communication and understanding. Respecting diverse perspectives: recognise that cultural diversity extends beyond ethnicity and nationality. Individuals may belong to various subcultures based on factors such as age, socioeconomic status, or sexual orientation. Being attuned to these differences fosters a more inclusive and respectful approach. Cultural sensitivity in a first aid emergency is crucial for providing equitable and effective care. Respecting cultural nuances contributes to building trust, ensuring better communication and ultimately improving the overall experience and outcomes for casualties in need of emergency medical assistance. 1.6 CONSENT TO ADMINISTER FIRST AID When approaching a casualty, always introduce yourself as a first aider and ask if you may help. All conscious casualties 12 years and older have the capacity to consent to first aid treatment (Children’s Act (Section 129). Implied consent: casualties who are incapacitated due to shock, unconscious, or any other reason preventing understanding cannot provide informed consent; in this case consent is implied. Substitute consent: section 7(1) of the National Health Act 61 of 2003 allows for substitute consent when a casualty cannot speak for themselves. This means an adult may give consent on behalf of a friend or family member for first aid treatment. Refusing help: according to common law, a competent person cannot be given emergency medical treatment if they refuse it, such as with a "do not resuscitate" order. However, if a person is unconscious, their consent cannot be known, so implied consent is assumed to provide necessary treatment. Minor's consent: the Children’s Act outlines the legal requirements for a minor's consent to medical treatment. A minor as young as 12 years old may consent to their own medical treatment, provided they have the maturity and capacity to understand the benefits, risks, and implications of the treatment. For children younger than 12 years, consent must be obtained from a parent or guardian before administering first aid, as stipulated in the Children’s Amendment Act 41 of 2007, Section 129(2)(a). In loco parentis: in an educational environment, employed staff act in loco parentis (whether in a school or sports coaching setting) and legally assume the functions and responsibilities of a parent. In such cases, parental consent is not required when treating a child casualty as they have already entrusted custodianship to the educational institution (South African Schools Act, 1996). 1.7 NEGLIGENCE The standard of care expected from a first aider will depend on his/her training or skills. Medical negligence is defined as: § If a casualty is deprived of advanced treatment. That is not calling for an ambulance, when necessary, thus preventing the administration of advanced life support. § Not administering first aid if you are an appointed first aider in the workplace. § Administering first aid that is above your level of training, unless you are guided by a professional over the phone. 1.8 ABANDONMENT Abandonment is failing to continue first aid before handing the casualty over to someone with the same or a higher level of training. Example 1: a 7-year-old child falls off the jungle gym and hurts her arm. You, a staff member, respond to the first aid emergency. After deciding it’s not broken, you ask her friend to take her to the sickbay. Example 2: you stop at a roadside accident and identify a casualty who has whiplash. You call for an ambulance. It takes too long for EMS to arrive, so you decide to leave the accident scene because it appears the casualty is okay. In both examples you have abandoned your casualty. You did not hand over the casualty to someone with the same or a higher level of training. 1.9 PRINCIPLES OF FIRST AID These principles of first aid guide the first aider to deliver effective and timely care during emergencies. The principles of first aid focus on preserving life, preventing further injury and promoting recovery. To preserve life, ensure the scene is safe, check responsiveness, manage the airway, ensure breathing and control bleeding. Prevent further injury by immobilising fractures, positioning the casualty appropriately, avoiding unnecessary movement and continuously monitoring vital signs. Promote recovery by providing care that supports the casualty’s condition, offering reassurance and calling emergency medical services. Preserve life The primary goal of first aid is to preserve life. Attend to any life-threatening conditions first, such as airway obstruction, severe bleeding, or cardiac arrest. Prevent further injury Prioritise actions that will prevent the casualty's condition from deteriorating. Immobilise injured limbs to prevent further damage, stabilise fractures and support the casualty in a comfortable position. Promote Recovery Provide appropriate care to promote the casualty's recovery. This may include administering basic first aid, such as applying bandages to wounds. Remain calm and provide reassurance to the casualty to help alleviate anxiety and distress, which positively impacts the casualty's recovery. 1.10 CONCLUSION Understanding the intersection of first aid and the law, cultural sensitivity and the core principles of first aid is essential for all individuals involved in emergency response. By adhering to the legal considerations, respecting cultural differences and applying the principles of assessment, first aiders can provide effective and compassionate care.