Aviation Medicine News

First Aid History

If there’s one thing that’s certain in life, it’s that life changes. We do our best to predict the future, but even so we are usually wide of the mark, particularly if politics is anything to go by! However, just sometimes, what can help is to look back at history. Are there lessons we can learn, to help us work quicker, be more innovative, and deliver immediate care more effectively and efficiently? So, with that ethos in mind, we decided to review the origins of first aid, to help us to predict what the future of first aid might look like…

The very first commercial first aid kit was manufactured by Johnson & Johnson some 130 years ago in 1888. In the late 1800’s working on the railway was a dangerous job; many workers were injured, often in remote locations. J&J co-founder Robert Wood Johnson identified this need after speaking with the Denver and Rio Grande railroad’s Chief Surgeon. He then spoke to a number of other railroad surgeons to find out the most practical contents for this ‘first of a kind’ product. After the success of the first kit, J&J began to manufacture kits for a wide variety of other contexts, including for households, cars and Scouts. In 1927 they even made the ‘Aerokit’ specifically for small passenger planes. Today, having an on-board first aid kit is mandated by IATA (the International Air Transport Association).

During this period, the Red Cross and St Andrews Ambulance service in Scotland were founded. Since then, thousands of people have become involved as professionals or volunteers. In recent years we have also seen the introduction of governing bodies, such as the UK Resuscitation Council and the formation of community-led groups (often charities) such as Community First Responders, who are a natural extension of the emergency services, with a very specific skill-set and role.

Conflict has also been an area in which first aid innovation has accelerated, historically. Marie Skłodowska Curie discovered radium and polonium and remains the only person to achieve two Nobel prizes in more than one field (Physics and Chemistry). She realised that she could apply her discoveries closer to the battlefield. She and her daughter amassed a fleet of vehicles equipped with X-ray machines and set up 200 radiological units in more permanent posts during the first two years of World War This helped doctors find the bullets and shrapnel embedded in soldiers’ bodies, as well as locate broken bones.

First Aid response in the 21st century has transformed, as the methods applied, and medicine, have advanced. Since 1960, the mannequin Resusci Annie has been the preferred CPR training tool. The mannequin gained her name from an unknown girl who drowned in the River Seine in the late 1880s. Since then, more than 500 million of people worldwide have been trained in developing these critical lifesaving skills. And Rescusci Annie has become incredibly lifelike, as simulation technology has been taken to the next level, helping a variety of first responders get ready for a wide range of medical emergencies.

First Aid training has not stopped there. It is now – thanks to a mixture of policy and proactive charities – delivered in a wide variety of contexts, including the coastguard, police, schools, workplace - almost anywhere. Indeed, the 16th of October is the UK Resuscitation Council’s ‘Restart a heart day’, where they aim to train over 200,000 people. There is no requirement to be a professional or an active member of a humanitarian organisation to attend First Aid training. In the UK, more and more people are now prepared to help to save a life if needed. An estimated 2.5 million lives have been saved since First Aid training was established.

As technology has advanced, so has first aid. Now Automatic External Defibrillators (AEDs) can help to improve the chances of survival following cardiac arrest out-of-hospital. The National Defibrillator Network is scheduled to go live in early 2019 – the goal is to link all public access defibrillators to ambulance services, so that they are much more likely to be used, and potentially make a real difference. There are now also machines that can deliver ‘high-quality automated CPR’, wrapping around the chest, minimising interruptions in chest compressions. Remote monitoring of medical emergencies is also supported by improving communications technologies (e.g. better satellites) and the word “digital” sits comfortably beside “First Aid”. Even in more remote environments, like 30,000 feet in the air, cabin crew first aid is now supported by technology, improving their confidence and bringing first aid support to life. All the above are just a few of the latest technology achievements…the list goes on.

As for the future of first aid? It seems that policy – at least in the UK, and in the near-term – will continue to push basic – but vital – first aid provision further into the voluntary sector. Just consider the rise of Community First Responder schemes, supporting ambulance services in rural AND urban locations. Then again, do we – the public – have a moral responsibility to deliver the best care we can, given that it may only take basic skills? Also, ‘first aid’ is now no longer just the provision of ambulance services; fire services up and down the UK are experimenting with having AEDs on-board, and others run their own Community First Responder schemes. But perhaps what is most fundamental is ensuring that the next generation are given regular first aid training as a matter of course, just as much as math, English and other ‘classic’ subjects are taught. Then we will have an ‘army’ of first aiders ready to confidently deliver first aid when it really counts.


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