First Aid Saves lives! part one Airways

Just got back from a mandatory first aid course at work, being a medical student and having done first aid courses before, it was easy to think I already knew it all. I was surprised at how much I learnt from the experience. 
The first thing I learnt was some shocking statistics;

• Two thirds of people in the British public couldn't save a life in the event of an emergency.
• over a quarter of people who said they knew first aid would of done the wrong thing in an emergency (for example if someone was choking they would put their fingers in the persons throat to relieve the obstruction (pushing the obstruction further down))
• In the UK, less than one in ten will survive a heart attack while in Norway over 25% will, most likely due to the fact most people in Norway are able to perform CPR (First aid training being mandatory in Norwegian schools). 

I'll try an give a concise summary here about what was covered. also big thanks to Actual First Aid for the excellently run course. 

When approaching an emergency or an unconscious individual the mnemonic to use is:

DR ABC

D is for Danger. 

First, make sure its safe to approach, we dont want to generate another casualty for the ambulance to deal with. A classic example would be a car crash situation and oncoming traffic, a second crash?

R is for Response

You need to determine if the casualty is conscious, check this by asking a simple question."are you ok", perhaps they cannot respond verbally, so ask "can you open your eyes". if there is no response, you should call for help and contact the emergency services and move onto ABC. 

A is for Airway

The tongue is an incredible muscle, unlike the muscles in your arms and legs, the tongue is only attached at one point. The picture below highlights the tongue (purple) and its singular attachment at the bottom of the mouth in a cadaver. When someone loses consciousness the tongue relaxes completely and falls back slightly covering up the airway (not the thin route to the airway in the cadaver).(By the way its impossible to swallow your tongue, just try it).

The airway can be opened by gently tilting the head back by applying pressure to the forehead with your hand. HOWEVER, its possible in many situations that the casualty may have sustained a spinal or cervical spinal neck injury. In this case movements of the head and neck are to be avoided if there is any suspicion of neck injury. So how do you open the airway?
The best way to open the airway in this case would be by dislocating the jaw and bringing the jaw forward the so called 'jaw thrust' maneuver.
This is performed by placing three fingers behind the angle of the jaw close to the ear and with your thumbs applying pressure to the cheek bones below the eye, you pull the jaw forward and out so that the head doesn't move. (the movement of the jaw, pulls the attached tongue forward as well, allowing air to pass).

B is for Breathing
not breathing? you should consider CPR see part two...

C is for Circulation
no pulse? you should consider CPR see part two...