Background
Methods
Setting
Materials
Development of the checklist
Optimal position for a shock patient:
“Place individuals with shock into the supine (lying on back) position. Where there is no evidence of trauma use passive leg raising to provide a further transient (<7 min) improvement in vital signs.”
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Oxygen administration:
There are no direct indications for the use of supplemental oxygen by first aid providers.
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Bronchodilator administration:
“Assist individuals with asthma who are experiencing difficulty in breathing with their bronchodilator administration. First aid providers must be trained in the various methods of administering a bronchodilator.”
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Stroke recognition:
“Use a stroke assessment system to decrease the time to recognition and definitive treatment for individuals with suspected acute stroke. First Aid providers must be trained in the use of FAST (Face, Arm, Speech Tool) or CPSS (Cincinnati Pre-hospital Stroke Scale) to assist in the early recognition of stroke.”
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Administration of aspirin for chest pain:
“In the pre-hospital environment, administer 150–300 mg chew- able aspirin early to adults with chest pain due to suspected myocardial infarction (ACS/AMI).”
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Second dosage of adrenaline for anaphylaxis:
“Administer a second intramuscular dose of adrenaline to individuals in the pre-hospital environment with anaphylaxis that has not been relieved within 5 to 15 min by an initial intramuscular auto-injector dose of adrenaline.”
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Hypoglycaemia treatment:
“Treat conscious patients with symptomatic hypoglycaemia with glucose tablets equating to glucose 15–20g. If glucose tablets are not available, use other dietary forms of sugar.”
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Exertion-related dehydration and rehydration therapy:
“Use 3–8% oral carbohydrate–electrolyte beverages for rehydration of individuals with simple exercise-induced dehydration.”
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Exertion-related dehydration and rehydration therapy:
“Use 3–8% oral carbohydrate–electrolyte beverages for rehydration of individuals with simple exercise-induced dehydration.”
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Control of bleeding:
“Apply direct pressure, with or without a dressing, to control external bleeding where possible. Do not try to control major external bleeding by the use of proximal pressure points or elevation of an extremity. However it may be beneficial to apply localized cold therapy, with or without pressure, for minor or closed extremity bleeding.”
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Use of a tourniquet:
“ Use a tourniquet when direct wound pressure cannot control severe external bleeding in a limb. Training is required to ensure the safe and effective application of a tourniquet.”
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Straightening an angulated fracture
Do not straighten an angulated long bone fracture. Protect the injured limb by splinting the fracture. Realignment of fractures should only be undertaken by those specifically trained to perform this procedure.
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First aid treatment for an open chest wound:
“Leave an open chest wound exposed to freely communicate with the external environment without applying a dressing, or cover the wound with a non-occlusive dressing if necessary. Control localised bleeding with direct pressure.”
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Spinal motion restriction:
“The routine application of a cervical collar by a first aid provider is not recommended. In suspected cervical spine injury, manually support the head in position limiting angular movement until experienced healthcare provision is available.”
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Recognition of concussion:
“Although a concussion scoring system would greatly assist first aid providers in the recognition of concussion, there is no simple validated scoring system in use in current practice. An individual with a suspected concussion should be evaluated by a healthcare professional.”
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Cooling of burns:
“Actively cool thermal burns as soon as possible for a minimum of 10 min duration using water.”
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Burn dressings:
“Subsequent to cooling, burns should be dressed with a loose sterile dressing.”
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Dental avulsion:
“If a tooth cannot be immediately re-implanted, store it in Hank’s Balanced Salt Solution. If this is not available use propolis, egg white, coconut water, ricetral, whole milk, saline or phosphate-buffered saline (in order of preference) and refer the individual to a dentist as soon as possible.”
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Rating the books
Results
Book | Publication year | Pages | CPR instructions | Anatomy section |
---|---|---|---|---|
1 | 2009/2015 | 144 | + | + |
2 | 2011 | 128 | + | + |
3 | 2011 | 62 | + | + |
4 | 2011 | 127 | + | + |
5 | 2012 | 84 | + | + |
6 | 2012 | 109 | + | – |
7 | 2013 | 112 | + | – |
8 | 2015 | 170 | + | + |
9 | 2015 | 68 | + | + |
10 | 2015 | 142 | + | + |
Items with more than 50% compliance | Items with less than 50% compliance |
---|---|
Definition of shock as a condition with failing circulation. | Passive leg rise for shock victims with no sign of trauma. |
Placement in the supine position for victims with shock. | Instructions on how to use inhalators or other bronchodilators. |
Assist individuals with asthma with inhalators/bronchodilators. | Aspirin administration for chest pain. |
System for the recognition of stroke. | Second dose of adrenaline for anaphylaxis. |
Hypoglycaemia treatment. | Exertion-related dehydration and rehydration therapy. |
Eye injury from chemical exposure. | Advised against the use of proximal pressure points to control bleeding. |
Direct pressure to control external bleeding. | Advising against the elevation of extremities to control bleeding. |
Immobilized of fractures in finding position. | Tourniquet use. |
Dressing an open chest wound only with non-occlusive dressings. | Not straightening an angulated long bone fracture. |
Manually support the head in position limiting movement. Placing avulsed teeth should in Milk. | Leaving open chest wound exposed to freely communicate with the external environment. |
Contacting a dentist at dental avulsion. | Stopping localized bleeding on the chest with direct pressure. |
Spinal motion restriction | |
Cooling of burns | |
Avulsed teeth should be placed in; balanced salt solution, propolis, egg white, coconut water, phosphate buffered saline. |
Category | Item | Book a | Book b | Book c | Book d | Book e | Book f | Book g | Book h | Book i | Book j | +/- |
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1. Optimal position for a shock victim | 1.a Is shock defined as a condition with failing circulation? | + | - | + | + | + | + | - | + | - | + | 7/3 |
1.b Is it mentioned that persons with shock should be placed in the supine position? | + | + | + | + | + | + | + | + | + | + | 10/0 | |
1.c Is it mentioned that leg should be raised by “passive leg rise”, if there is no sign of trauma? | - | - | - | - | - | - | + | - | - | - | 1/9 | |
2. Bronchodilator administration | 2.a Is it mentioned that one should assist individuals with asthma in taking their inhalators/bronchodilators if they have difficulty breathing? | + | + | + | + | - | - | + | + | + | + | 8/2 |
2.b Is there an explanation on how to use an inhalator or other bronchodilators? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
3. Stroke recognition | 3. Is there an explained system for the recognition of stroke? | + | + | + | + | + | - | + | + | - | + | 8/2 |
4. Aspirin administration for chest pain | 4. Does the book instruct in the use of acetylsalicylic acid/aspirin (ASA) for chest pain due to suspected myocardial infarction (ACS/AMI)? | - | - | - | - | - | - | - | - | - | - | 0/10 |
5. Second dose of adrenaline for anaphylaxis | 5. Is it recommended giving a second (repeated) intramuscular dose of adrenaline to persons with anaphylaxis? | - | - | - | - | - | - | - | - | - | - | 0/10 |
6. Hypoglycaemia treatment | 6. Does the book instruct readers to give glucose tablets of 15–20 g or equal glucose containing substance to persons with symptomatic hypoglycemia? | + | - | + | + | + | - | + | + | + | + | 8/2 |
7. Exertion-related dehydration and rehydration therapy | 7. Is it recommended to a se 3–8% oral carbohydrate–electrolyte beverages for rehydration of individuals with simple exercise-induced dehydration? | - | - | + | - | - | - | - | - | - | - | 1/9 |
8. Eye injury from chemical exposure | 8. Is it recommended irrigating eye injuries due to exposure to a chemical substance, with water? | + | - | + | + | + | + | + | + | + | + | 9/1 |
9. Control of bleeding | 9.a Is it recommended to apply direct pressure, (with or without a dressing) to control external bleeding? | + | + | + | + | + | + | + | + | + | + | 10/0 |
9.b Is it advised against the use of proximal pressure points, that is pressure applied centrally relative to the wound? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
9.c Is it advised against the elevation of extremities? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
10. Use of a tourniquet | 10. Does the book instruct readers to use a tourniquet when direct wound pressure cannot control severe external bleeding in a limb? | - | - | + | - | + | + | - | + | - | - | 4/6 |
11. Straightening an angulated fracture | 11.a Does the books state that on should not straighten an angulated long bone fracture? | - | - | - | - | - | - | + | - | - | - | 1/9 |
11.b Is the reader instructed to leave angulated fractures immobilized in the position in which it was found (possibly with a splint)? | + | + | + | + | + | + | + | + | + | + | 10/0 | |
12. First aid treatment for an open chest wound | 12.a Is it clear that one should leave an open chest wound exposed to freely communicate with the external environment without applying a dressing, or cover the wound? | - | - | - | - | - | - | - | - | - | - | 0/10 |
12.b Is it described that one should stop localized bleeding on the chest with direct pressure? | + | - | - | - | - | - | - | - | - | - | 1/9 | |
12.c Is it clear that dressing an open chest wound should only be done with a non-occlusive dressing (e.g. with a valve)? | + | + | + | + | + | - | + | + | + | - | 8/2 | |
13. Spinal motion restriction | 13.a Does the book advise against the use of a cervical collar (e.g. Stiffneck)? | - | - | - | - | - | - | - | - | - | - | 0/10 |
13.b Is it recommended to manually support the head in position limiting angular movement? | + | - | + | + | + | + | + | + | + | + | 9/1 | |
14. Cooling of burns | 14. Is it clear one should actively cool thermal burns as soon as possible and for a minimum of 10 minutes duration, using water? | - | - | - | + | + | + | + | - | - | - | 4/6 |
15. Burn dressings | 15. Is it clear that subsequent to cooling, burns should be dressed with a loose sterile dressing? | - | - | - | - | - | - | - | - | - | - | 0/10 |
16. Dental avulsion | 16.a Does the text state avulsed teeth should be placed in one of the following solutions if not able to immediately re-implanted? | + | - | - | - | - | - | + | - | - | + | 3/7 |
1). Balanced salt solution? | - | - | - | - | + | - | + | + | - | + | 4/6 | |
2). Propolis? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
3). Eggwhite? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
4). Coconut water? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
5). Phosphate buffered Saline? | - | - | - | - | - | - | - | - | - | - | 0/10 | |
6). Milk? | + | - | + | + | + | + | + | + | + | + | 9/10 | |
16.b Does the book state that one should contact a dentist at dental avulsion? | + | + | + | + | + | - | - | + | - | + | 7/3 | |
Total compliant answers (number of “Yes” answer of 32 possible): | 14 | 7 | 14 | 13 | 14 | 9 | 15 | 14 | 9 | 13 |