Choking: Prioritising Proven First Aid Techniques
Recent guidance from Irish regulatory bodies, including Tusla, the Pre-Hospital Emergency Care Council (PHECC), and the Health Service Executive (HSE), has underscored the critical importance of evidence-based first aid techniques for choking incidents, particularly in paediatric settings. This guidance specifically advises against the use of anti-choking suction devices in early years services due to insufficient clinical evidence to confirm their safety or effectiveness. Instead, these bodies continue to recommend standard choking first aid methods as the safest and most evidence-based approach.
In the UK, the Office for National Statistics (ONS) reported 276 deaths due to choking in 2021. While choking can affect anyone, young children are at a higher risk. A St John Ambulance study revealed that 40% of parents have witnessed their own child choke, yet a concerning 80% were unsure how to respond. This highlights a significant knowledge gap that effective first aid training can address. The HSE in Ireland provides clear steps for choking in children aged one year or older, including encouraging coughing, delivering back blows, and performing abdominal thrusts. For babies, specific guidance involves supporting them in a forward-leaning position and administering back blows, followed by chest thrusts if necessary.
Preventative measures are also crucial, especially for children. The HSE advises cutting food into very small pieces, pureeing or blending foods for infants, and supervising children during mealtimes. High-risk foods like grapes and cherry tomatoes should be cut lengthways and into quarters, and whole nuts should not be given to children under five.
Anaphylaxis: Prompt Recognition and Adrenaline Administration
Anaphylaxis is a severe and potentially life-threatening allergic reaction requiring immediate action. The Resuscitation Council UK (RCUK) provides comprehensive guidelines for healthcare providers on managing anaphylaxis, emphasising the ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) for recognition and early administration of intramuscular adrenaline. The National Institute for Health and Care Excellence (NICE) also offers essential guidance to improve the care and management of individuals at risk of or experiencing anaphylaxis.
In the UK, individuals at risk are often prescribed adrenaline auto-injectors (AAIs) such as EpiPen, Jext, or Emerade. It is crucial for individuals to carry two AAIs at all times, regularly check expiry dates, and practice using trainer devices. Family, friends, and carers should also be taught how and when to use these devices. If anaphylaxis is suspected, the NHS advises using an AAI immediately, calling 999 for an ambulance, and lying down with legs raised, or sitting up if struggling to breathe.
In Ireland, allergies are common, affecting approximately 29% of the population, with IgE-mediated food allergy found in 5% of young children and 2% of older children and adults. Deaths due to anaphylaxis are rare, estimated at 1 in 1-3 million people per year, and are more commonly triggered by medications, blood transfusions, or insect stings rather than food allergy. The Anaphylaxis Registry, which collects data across Europe, noted that by March 2024, 16,988 cases had been registered, with food being an increasing trigger in children.
Related training: If you are looking to qualify as a trainer in this area, see first aid trainer qualifications or explore online first aid training courses for nationally recognised UK and Ireland qualifications.
Bleeding Control: Essential Workplace and Public First Aid
Effective bleeding control is a fundamental first aid skill, vital in both workplace emergencies and public incidents. In the UK, the Health and Safety (First-Aid) Regulations 1981 mandate that every employer must provide adequate and appropriate first aid equipment, facilities, and personnel. This provision is determined by a risk assessment of the workplace, considering factors such as the number of employees, hazards, and the nature of the work.
Similarly, in Ireland, the Safety, Health and Welfare at Work (General Application) Regulations 2007 require employers to provide adequate first aid equipment and facilities, ensure trained first aiders are available, and conduct risk assessments. For instance, a low-risk office with up to 50 employees may require one trained first aider, while higher-risk environments will need more.
For severe bleeding, both the British Red Cross and Resuscitation Council UK (RCUK) emphasise immediate and continuous direct pressure on the wound with available material, followed by calling emergency services (999 or 112). If bleeding is life-threatening and not controlled by direct pressure, a tourniquet can be applied to a limb, 5-7cm above the injury, and tightened until bleeding stops. It is crucial not to remove embedded objects, but instead apply pressure around them.
These guidelines highlight the ongoing commitment of health and safety authorities to ensure that individuals and workplaces are equipped with the knowledge and skills to respond effectively to medical emergencies. Comprehensive and up-to-date first aid training is paramount in achieving this goal.
For more information on first aid training and to ensure your workplace meets regulatory requirements, visit Abertay Training at https://www.abertaytraining.co.uk.