Recovery Position

When do you put someone into the Recovery Position?

If no serious bleeding, shock or spinal injury is found or suspected, you place your unconscious, breathing patient in the recovery position.

You place an unconscious, breathing patient in the recovery position to decrease the risk of airway obstruction by the tongue or aspiration of body fluids.

How do you put someone into the Recovery Position?

Step 1

Kneel at the patients’ side and place the arm nearest to you out at a right angle to the patients’ body with the elbow bent and the palm upward

Step 2

Bring the casualties far arm across the chest and hold the back of the hand against the patient’s cheek nearest to you – keep hand in place

Step 3

With your other hand, grasp the far leg underneath the knee and raise so it is bent the ankle should be in line or higher than the other legs knee, keeping the foot on the ground

Step 4

Place your hand on the outer edge of the casualty knee, keeping your other hand holding the casualties hand to their face and press down on the knee towards you.

Press, do not pull as you are using the leg as a pivot

Step 5

Continue pressing on the knee

Until the casualty knee is on the floor, with the leg at a very firm right angle against your outer leg.

Step 6

You can now start to move back from the casualty keeping hold of the head. As the casualty gentle moves forward of their own accord, gently let the head lower.

The casualty arm will rest on the lower arm

Step 7

If need be, gently pull back on the patient’s head to assure an open airway

And if the mouth is not open – open

Step 7

Stay with your casualty and continually monitor their breathing, until an ambulance arrives.

Additional Points

If the patient has to be kept in the recovery position for more than 30 minutes, the recommendation is to turn the patient to the opposite side to relieve the pressure on the lower arm and casualties side.

It is strongly advised that you attend one of our courses to understand what to do in a medical emergency. 

Rutland First Aid Training provides this information for guidance and it is not in any way a substitute for medical advice. Rutland First Aid Training is not responsible or liable for any diagnosis made, or actions taken based on this information.

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What happens when I call 999?

Please remember YOU DO NOT GET SEEN ANY FASTER AT A&E IF YOU ARRIVE BY AMBULANCE but NEVER be afraid to ring them if emergency help is required.

The decision to call 999

Having to call 999 is not the call that any of us want to make as it means there is an emergency and help is needed urgently. The decision will vary, but some examples include

  • a person appears not to be breathing
  • a person is unconscious and unresponsive
  • is having chest pain, difficulty breathing or experiencing weakness or numbness
  • experiencing severe bleeding that you are unable to stop with direct pressure
  • a person has had a fit for the first time, even if they seem to recover
  • a person is having a severe allergic reaction to something which is accompanied by severe difficulty in breating
  • a child is severely burnt
  • a person has fallen from a height and there is a possibility of a spinal injury

What happens when you dial 999 (or 112)

When you call 999 you will speak to a BT Operator who will ask “Emergency, which service“? Fire, police, ambulance, coastguard or mountain rescue are all appropriate answers. For the purpose of this blog ambulance, however if you want Fire, police and ambulance still say ambulance and the ambulance service will contact Fire and Police if required.

Once you are transferred to Ambulance the call taker will say…

  1. Ambulance, is the patient breathing?
  2. Is the patient awake?

If the answer to any of these two questions is No, then it triggers a Category 1 call and an Ambulance will be dispatched at this point before they have an address

Then you will be asked for the address of the emergency, from there the call taker will talk you through hands only CPR (if you have been taught CPR and Rescue Breathing AND are happy to do, then do both – but remember your training and that priority is to good quality CPR)

If you answer YES to the two questions, the call handler will ask the caller “Tell me exactly what’s happened?”

The call handler will listen to you very carefully as they have a list of automatic Category 1 triggers, such as Allergic Reaction, Major Trauma, Choking, etc. if any of these are clicked then a Category 1 again will be generated

If no Category 1 triggers are heard then the call taker will type in the chief complaint for example “Chest Pain” which will automatically be allocated a call category. The system will then generate questions to ask you the caller and depending on what is wrong, it will reassess the call category to determine your priority.

What should you do whilst waiting for an ambulance?

If doing CPR and Rescue Breaths then continue doing so and stay on the line to the ambulance call handler

If not doing CPR then

  • Stay with the patient until the ambulance crew or community first responder arrives and call back if the patient condition or location changes
  • If your house name and / or number is not clearly visible from the roadside, ask someone to open the door and signal to the emergency team where they are required AND if possible switch on outside lights and car lights
  • If it is dark, turn on house lights and pull back curtains
  • Lock away family pets
  • If possible, collect any medication being taken by the patient
  • Stay calm

When the ambulance arrives

If you are undertaking CPR and / or Rescue Breathing DO NOT STOP until the emergency crew asks you to! They will assess the patient’s clinical condition and treatment given prior to taking over the scene.

About Us

Rutland First Aid training provides a full suite of first aid training all tailored to your needs. We strongly recommend that everyone has some basic first aid skills, so why not attend one of our CPR and AED courses and know how to do CPR.. you could be the difference between your family member or even work colleagues survival

Rutland First Aid Training provides this information for guidance and it is not in any way a substitute for medical advice. Rutland First Aid Training is not responsible or liable for any diagnosis made, or actions taken based on this information

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COVID Training Standards

Along with great training, the safety of our staff and our students is our highest priority. All our first aid courses are undertaken using the latest scientific advice, training guidelines and government recommendations. All our course attendees are asked to listen carefully and follow the advice of our instructor team who will be present throughout your training with us.

First and foremost, if you are displaying any COVID-19 symptoms then we insist that you follow the government guidelines to stay at home and self-isolate.  In this instance, please DO NOT ATTEND our courses.  Failure to do so will mean that you will be removed from the course.

All of our staff will have undertaken a Lateral Flow Test on the first day of your course. In the unfortunate circumstance that all staff need to isolate we will contact you to rearrange your training as per our terms and conditions.

During your Course

On arrival, you will be asked to use the hand sanitiser provided and / or wash your hands.

We recommend that you check-in to our location with the NHS COVID-19 Test & Trace app QR code

We will ask everyone to cleanse their hands before, during and after all the practical sessions as well as when they return to the training room following breaks.

Regular hand washing is better than hand sanitiser – do you know how to correctly wash your hands? Are you sure about that? 

On our longer courses, this is one of the exercises we run and, so far, we have only had ONE class that ALL correctly washed their hands. How do we do this? – join us to find out!

Throughout your course, you will be reminded of the need to regularly wash/sanitise your hands and the importance of barriers.

Each student will be provided with their own manikin for their sole use throughout the course, plus a full set of personal barrier materials..

Tea and coffee making facilities are available throughout our courses. Students should only make their own drink and ensure there is only one person at a time in the refreshment area. Hand sanitiser is available, and we ask you to use it before making your drink.

If someone develops COVID-19 symptoms while on one of our courses, we will ask you to self-isolate. All delegates will be asked at the end of their course to tell us if they develop symptoms.  This enables us to identify all other course attendees and contact them to let them know if they should self-isolate.

Classrooms

We undertake training on behalf of businesses, schools, gyms and others in their preferred location. It is your responsibility to have undertaken a risk assessment to ensure that it is suitable for the agreed number of attendees to maintain a safe distance from each other whilst undertaking the various elements of the course. If you are not sure then we are happy to come out and work with you to achieve the requirements for the course.

Our numbers have always been low when training in our own classroom. This provides a better environment for interaction with plenty of time for the practical elements of the course.  Our course attendees have told us that they really like this approach and it works really well.  These measures are particularly appropriate during these COVID-aware times.

Our classroom has a dehumidifier running with the indoor humidity level keeping the relative humidity value at 40% and 60%.

Where appropriate, doors and windows will be opened to circulate the classroom air and for added ventilation.

Laerdal Manikins

The manikins we use are all from the well-known and highly respected manufacturer Laerdal.

All have one-way valves. These stop air coming back out of the manikin’s mouth and direct expired air out of the back of the head via a filter.

If manikins are used for a two-person training skill, additional procedures are in place that include using sanitising wipes to clean and disinfect all surfaces.

Our Laerdal manikins also provide real-time feedback. This gives students a chance to get competitive and to see who is the most effective at performing the skills they’ve learned. We guarantee you that by the end of the course EVERYONE will be extremely effective and very competent at delivering the skills they’ve been taught.

HSE requirements

For our workplace courses, the HSE requires all students to demonstrate Rescue Breathing and CPR skills. Our training procedures and cleaning regimes follow all the official guidance and recommendations, allowing us to confidently teach these specific skills in our training courses.

After the Course

Manikins

After each first aid course, our manikin t-shirts are removed, along with their faces, and are all washed in the washing machine or dishwasher and properly dried. We do get some funny looks from the neighbours when the washing line is full of faces, but we think they’ve got used to us now!

All manikin lungs are removed and thrown away at the end of the course. Each manikin body is carefully washed and fully disinfected.

Other Training Aids

All training aids are throughly disinfected prior to being packed away.

The Classroom is cleaned and isolated for 48 hours before our next course starts.

General

If anyone needs to isolate after the course, we will contact all attendees to let them know.

About Rutland First Aid Training

We specialise in running high quality first aid training in small groups. We concentrate on providing everyone with the skills and confidence needed in a real emergency.  This will ensure that you are prepared to undertake the various first aid skills needed to improve the casualty’s chance of survival.

We run a variety of courses including the Airborne Pathogen Awareness course, click the button below to find out more.

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How to be overtaken by a 999 vehicle

Am I legally obliged to move over for emergency vehicles?

The Highway Code states that you should ‘consider the route of such a vehicle and take appropriate action to let it pass, while complying with all traffic signs’.

Rule 219 of the Highway Code states that drivers should “look and listen for ambulances, fire engines, police, doctors or other emergency vehicles using flashing blue, red or green lights and sirens or flashing headlights, or traffic officer and incident support vehicles using flashing amber lights.”

What counts as an emergency vehicle?

An emergency vehicle is classed as a vehicle used:

  • for police purposes (but not necessarily a police vehicle, e.g. search and rescue)
  • for firefighting purposes (but not necessarily a fire brigade vehicle) including local councils and the Forestry Commission as well as fire salvage work
  • for ambulance purposes (but not necessarily an ambulance vehicle, e.g. cave rescue) including the movement of sick, injured or disabled people and for moving human organs
  • for bomb disposal
  • for nuclear accidents
  • for mountain rescue
  • by the Royal Air Force Armament Support Unit
  • by the National Blood Service
  • by HM Coastguard
  • for mine rescue
  • by the RNLI for launching lifeboats
  • by HM Revenue and Customs for serious crime
  • by the military special forces (e.g. the SAS) for a national security emergency

How to be overtaken safely

When you spot an emergency vehicle approaching with its lights flashing you should consider the route it is likely to take, then take an appropriate action to let it pass.

You can pull to the side of the road and stop but you must avoid doing this on a bend, narrow section of the road or before the brow of a hill, which could put the emergency vehicle into the path of oncoming traffic.

Even when you are in the process of letting an emergency vehicle pass, it is important to continue obeying nearby traffic signs, because you will still be liable to prosecution if you break any motoring laws, while allowing an emergency vehicle to pass by.

Also, avoid mounting the kerb, braking harshly on the approach to a junction or roundabout. Using your driving awareness, avoid any action that could put pedestrians or other road users in danger.

No driver should move into a bus lane or run a red light move out of the way for an emergency vehicle – this could land you a fine if you do. The 999 crews know that motorists are not allowed to ‘jump’ a red light. The only exception would be if a uniformed police officer directed a motorist through a red traffic signal.

It is advised that drivers do not overtake emergency vehicles while on pursuit and, if one has passed them to wait and follow at a safe distance.

If you are on a road with solid white lines then keep driving at the speed limit as the emergency vehicle will wait until you’re past the white lines. Usually the vehicle’s sirens will come back on and it will overtake.

Drivers should also keep going on an approach to a bend or brow of a hill, until the road ahead is clear.

Always check your mirrors to see what signals the emergency response vehicle might be making. If it is a police car, look carefully, as it may be signalling you to stop.

Are you Blue Light Aware?

Do Emergency Vehicles have to follow any rules?

With ambulances now expected to reach the most seriously ill patients in an average time of seven minutes, there is more pressure to reach destinations faster. 

But drivers of emergency vehicles have laws and rules they must follow, even in an emergency. These rules are in place so as not to force other road users into illegal manoeuvres.

For example, emergency vehicles should turn their sirens off at junctions while traffic lights are on red, to avoid encouraging other drivers to jump a red light.

Most drivers of emergency vehicles undergo advanced driving courses and official training is required if that driver wants exemption from speed limits, where necessary.

They are granted certain exemptions from the law in emergency circumstances, including:

  • They can disobey the speed limit.
  • Pass on the wrong side of a keep left bollard.
  • Treat red traffic lights as a give way sign.
  • Drive on a motorway hard shoulder, even against the direction of traffic.
  • They can use bus lanes, even if in use to reduce the effect of congestion on public transport.

However, there are also many laws emergency vehicles cannot ignore, even when answering a 999 call. They should not:

  • Ignore ‘stop’ or ‘give way’ signs.
  • Ignore ‘no entry’ signs.
  • Drive through a one-way street in the wrong direction.
  • Ignore flashing signs at level crossings or fire stations.
  • Fail to stop if involved in a Road Traffic Accident
  • Cross a solid white line down the middle of the road. That is unless, like for other road users, it is done to pass a stationary vehicle, slow-moving cyclist or horse, or a road maintenance vehicle.
  • Fail to obey traffic lights controlling a Railway Level crossing or Fire station
  • Drive without a seat belt
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Burns

Burns and scalds are damage to the skin usually caused by heat. Both are treated in the same way. A burn is caused by dry heat – by an iron or fire, for example. A scald is caused by something wet, such as hot water or steam.

Burns Categorisation

First-degree burns affect only the outer skin layer. The skin is red, slightly swollen and painful to touch. Sunburn usually falls into this category

Second-degree burns go into the second skin layer and appear as blisters on red, splotchy skin

Third-degree burns involve all layers of the skin – even underlying tissue. These serious burns are often painless due to nerve destruction. They appear as charred black or dry and white areas.

Treating Burns

What NOT to do

  • Put ice, butter, grease, ointments, creams or oils on a burn
  • Peel of any clothes, or break any blisters
  • Burst any blisters
  • Use fluffy materials – example: cotton wool, which will stick to the burned area

Patient Care – Major Burns

  1. Help the patient lie down ensuring the burnt area does not come into contact with the ground;
  2. Douse the burnt area with cool liquid for at least 20 minutes;
  3. Carefully remove clothing from around the burnt area and remove any constricting items such as watches, belts etc. before swelling begins;
  4. Cover burns with a sterile dressing – Cling film applied lengthways works great;
  5. For burns to the airway, loosen clothing around the neck, offer ice or small sips of cold water;
  6. Continue to monitor the patients’s medical status using the Cycle of Care until Emergency Services arrives;
  7. Monitor and record vital signs whilst managing the patient for shock

Patient Care – Minor Burns (first degree and small second-degree)

  1. Flush or soak the burn in cool water for at least 20 minutes and where possible, remove any jewellery, watches, belts or constricting items from the injured area before it begins to swell
  2. Cover with cling film, a burns dressing or if the burn is on a hand or inserted into a sterile plastic bag.
  3. Never rush to dress a burn as the most important treatment is to cool the burn under cool running water.
  4. Check burn daily for signs of infection – redness, tenderness or presence of pus (yellowish or greenish fluid at wound site)
  5. Have all burns assessed by a medical professional.

Rutland First Aid Training provides this information for guidance and it is not in any way a substitute for medical advice. Rutland First Aid Training is not responsible or liable for any diagnosis made, or actions taken based on this information.

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Fire Extinguisher in Car

Fire Extinguishers are they required in Company Vehicles?

Background to Post

When running our Scene Assessments as part of our First Aid Courses we often discuss what we would do in a Road Traffic accident that involved fire. Yes of course we would ring 999 and ask for all the relevant services but just how would you help those poor individuals trapped.

Well with a Fire Extinguisher, but just where do you get one of those from? Do you have one in your car or work vehicle? What are the rules about business vehicles and fire extinguishers?

We set out to answer those questions in one definitive post.

Work place legislation that covers Business Vehicles

So, with more and more business being conducted on our roads; be it transporting goods, a mobile workplace that brings the business to a customer (anyone from dog groomer, plumber, mobile hairdresser, electrician, shop fitters so on and so forth as the list is endless), or simply travelling from place to place on business

Employers have a number of legal requirements to satisfy, procedures to implement and documentation to record and keep. It can be a minefield knowing what your legal requirements are and tough to find the answers. One such struggle is knowing just what your responsibilities are when it comes to Health and Safety in business vehicles.

FSO2005 Regulations

As we have found there is plenty of contradicting information out there from different sources, many claiming that your business vehicle is classed as a ‘workplace’ and therefore must follow FSO2005 and the requirements set out in it. We have to say until we carried out the formal research on this – that is what we also thought! But it seems that in most cases, claiming that company vehicles are a ‘workplace’ and therefore require fire extinguishers is incorrect.

A business vehicle is NOT required by law to have a fire extinguisher installed under FSO2005 as that act does not apply to vehicles that are licensed under Vehicle Excise and Registration Act 1994 or exempt from duty. Most road vehicles fall into this category.

However there is a requirement for businesses to conduct a Health and Safety assessment and this should include a fire risk assessment and quite often your health and safety risk assessment will highlight the need for a fire extinguisher and adequate training in its use.

Fire extinguisher character saying "Nothing to worry about here I have got this"

The requirements for which kind of fire extinguishers to use in a business vehicle will vary depending on the type of vehicle, use, content and size. e.g. a car used for travelling between premises may only need a small 1kg Dry Powder Extinguisher, or may not even need one at all if your risk assessment doesn’t see the need. But, a larger van or truck being used to transfer goods or chemicals will have very different requirements, and will need one or more larger extinguishers.

The HSE sets out these requirements but we would recommend you contact a Fire Safety company who will assist you with your requirements.

Dangerous Goods

Carriage of dangerous goods by road in the United Kingdom is carefully regulated by two pieces of legislation:

  • The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment Regulations 2009 (CDG regs); and
  • The ADR which is the European agreement concerning the international transport of Dangerous Goods by Road (ADR). It sets provisions for the safe transport of dangerous goods by road. If your products are classified as dangerous goods and would like to transport them by road, you must comply with the provisions in the ADR

The regulations set out a set of guidelines for all vehicles carrying substances or goods classified as hazardous, including guidelines on providing adequate fire protection equipment such fire extinguishers.

So what is meant by a ‘hazardous’ load?

 Hazardous substances are classified as any of the following:

  • Class 1 Explosive substances and articles
  • Class 2 Gases
  • Class 3 Flammable liquids
  • Class 4.1 Flammable solids, self-reactive substances, polymerizing substances and solid desensitized explosives
  • Class 4.2 Substances liable to spontaneous combustion
  • Class 4.3 Substances which, in contact with water, emit flammable gases
  • Class 5.1 Oxidizing substances
  • Class 5.2 Organic peroxides
  • Class 6.1 Toxic substances
  • Class 6.2 Infectious substances
  • Class 7 Radioactive material
  • Class 8 Corrosive substances
  • Class 9 Miscellaneous dangerous substances and articles

Each entry in the list has been assigned a specific UN number.

Where vehicles are carrying, or are sometimes required to carry, any hazardous material, fire extinguishing equipment must be provided.  The size and number of fire extinguishers required varies according to the vehicle’s maximum gross weight, but is summarised in the following table: 

Transport Unit
Maximum Permissible
Mass
Minimum
Number of
Fire Extinguishers
Minimum
total capacity
per transport unit
Extinguisher suitable
for engine or cab fire
At least one with a minimum
capacity of
Additional extinguisher(s)
requirement. At least
one should have a min
capacity of
Up to 3.5 Tonnes24Kg2Kg2Kg
3.5 to 7.5 Tonnes28KG2KG6KG
Over 7.5 Tonnes212KG2KG6KG

The capacities in the table are for dry power devices (or an equivalent capacity for any other suitable extinguishing agent)

Examples

  • A 3.5t Mercedes Sprinter carrying a hazardous substance must carry 2 fire extinguishers totalling a minimum of 4kg weight, including one with at least 2kg Dry Powder dedicated for a cab or engine fire.  In this instance, 2 x 2kg Dry Powder fire extinguishers would be an acceptable minimum.
  • A 44 ton curtain sided articulated truck must also have 2 extinguishers on board, with a minimum total capacity of 12kg of Dry Powder.  One must be specifically for a cab or engine fire, and must hold at least 2kg of Dry Powder.  You must then provide an additional 10kg of Dry Powder, with no extinguisher containing less than 6kg of Dry Powder.  An common setup is a 3kg Dry Powder in the cab, with 1 x 9kg Dry Powder unit mounted on the trailer.  If the tractor unit (cab) is sometimes used with other trailers, you must fit an additional 9kg unit to the cab, to ensure even if the trailer has no extinguisher fitted the whole vehicle complies.  The additional 9kg Dry Powder is normally mounted in a Single Extinguisher Cabinet on the back of the cab.

General Points

Note that Dry Powder fire extinguishers are specifically referenced.  This is due to their multi-class fire rating – their ability to tackle nearly every classification of fire, including Class A (flammable solids such as wood, paper and textiles), Class B (flammable liquids) and Class C (flammable gases), as well as being completely safe for use on live electrical equipment.  Other types of extinguisher can be used, but they must have similar or better fire fighting capabilities, both in respect of the types of fires they can tackle, and their overall fire ratings.

Another key point is that the fire extinguishers should be subject to a system of regular inspection in accordance with authorised national standards in order to guarantee their functional safety.  Here in the UK the standard that they must be inspected to is BS5306 Part 3.

The final notable point on the ADR Regulations which must be considered stipulates that fire extinguishers must be installed in such a way so as to prevent the effects of the weather compromising the operational performance of the fire extinguishers.  The extinguisher for the cab is generally mounted inside the cab, covering this point perfectly.  However, fire extinguishers too big for in-cab mounting, or extinguishers mounted on the trailer, must be adequately protected.  This is normally done by mounting inside a weather-sealed fire extinguisher cabinet. 

A range of sizes and styles is available, from traditional ‘front loading’ cabinets, to the ‘top loaders’ that have been specifically designed for mounting on vehicles.  These ‘top loaders’ offer the very best protection for fire extinguishers on vehicles.

Our Recommendation

Of course, your vehicle doesn’t have to carry dangerous goods for it to be a good idea to carry a fire extinguisher!  Fire can strike without warning, and a vehicle fire quickly turns to a complete loss of the vehicle if not tackled fast and early.  If you rely on your vehicle, don’t take the chance – make sure you have an adequate and operational fire extinguisher handy at all times.  You never know when you might need it, even to help someone else!

In our opinion it seems to us a good idea to always carry a fire extinguisher

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