Essential First Aid: A Guide for Primary Care Nurses

The term ‘first aid’ covers a broad spectrum of skills, from managing minor injuries to performing cardiopulmonary resuscitation (CPR). Mastering essential first aid skills and understanding why we do things can prevent complications and even save lives.

What is First Aid?

First aid is the immediate care provided to someone in need of medical attention. This can range from minor illnesses and injuries to critical conditions. The extent of what can be done depends on the individual’s skill set, knowledge, available facilities, and the severity of the emergency.

Listed below are some common situations requiring immediate first aid. This list is not exhaustive but offers a helpful guide:

• Basic Life Support (BLS): Techniques for performing CPR and managing choking.
• Immediate Life Support (ILS): Advanced skills for managing urgent but less complex emergencies.
• Wound Care: Treatment for cuts, grazes, and bleeding.
• Shock Management: Recognising and treating shock.
• Burns and Scalds: First aid for thermal injuries.
• Fractures and Sprains: Immobilising and managing broken bones and joint injuries.
• Seizure Management: Responding to and managing seizures.
• Poisoning: Identifying and managing poisoning or allergic reactions.
• Heart Attack and Stroke Recognition: Identifying symptoms and initial management.
• Emergency Response Protocols: Knowing when and how to escalate care or seek additional help.

First Aid Skills for Primary Care Nurses

Every nurse should be proficient in key first aid skills and stay updated on them, this includes the A-E approach, CPR, AED, choking management, anaphylaxis, and the recovery position. While these skills are crucial, it’s also important to be familiar with other first aid practices. Below are some valuable resources to help professionals understand how to handle these specific emergencies:

A-E Approach: ILS courses cover the A-E systematic approach in detail. For an overview, check out the NHS guide on the basic principles of ABC and the Resuscitation Council’s comprehensive explanation of the A-E approach:

• First aid – After an incident – NHS
• The ABCDE Approach | Resuscitation Council UK

CPR and AED: Face-to-face BLS/CPR training is essential and often required by NHS Trusts. It’s also important to receive specific training on your workplace’s AEDs. The following links offer additional material and up-to-date 2021 Resus Council guidelines:

• 2021 Resuscitation Guidelines | Resuscitation Council UK
• A guide to Automated External Defibrillators (AEDs) | Resuscitation Council UK

Anaphylaxis: ILS and other first aid courses provide in-depth training on recognising and managing anaphylaxis. For a refresher or additional reading, refer to:

• Guidance: Anaphylaxis | Resuscitation Council UK
• Immediate Management of Anaphylaxis | Health Academy

Choking: Choking management is typically covered in BLS and ILS training. For further information and the algorithm from the Resuscitation Council, visit:

• Guidance: Choking | Resuscitation Council UK

Recovery Position: Refresh your knowledge on when and how to place someone in the recovery position with this guide:

• First aid – Recovery position – NHS

These links provide guidance specific to the UK, but many other resources and courses are available online and in-person to cover a wide range of first aid skills. For comprehensive learning, consider exploring sites such as the Resus Council, NHS, CQC, Department of Health England, British Heart Foundation, RCNi, and NMC.

Practical Examples in Primary Care

To illustrate how these first aid skills are applied, consider a scenario where a patient suddenly collapses in a GP’s surgery. The nurse must quickly assess the situation, initiate CPR if needed, and use an Automated External Defibrillator (AED) if available. Another example could be dealing with a patient experiencing an anaphylactic reaction, where swift administration of adrenaline can be life-saving.

Other examples such as a patient who is showing signs and symptoms of a heart attack, the nurse will need to be able to recognise these symptoms and summon emergency immediate help (999- in the UK). Or consider a patient who has a minor burn or wound, minor first aid management would be required and advice on the next steps for the patient.

Being able to carry out first aid requires the nurse to have an understanding of different conditions as well as the ability to manage them within their area of work with the resources/equipment available.

The UK’s Expectations of Nurses

Nurses working autonomously, particularly in community settings, often face the challenge of limited resources. In these situations, it’s vital to have strategies in place for managing emergencies. For example, knowing the local emergency protocols, having a well-maintained first aid kit, and staying in communication with other healthcare providers can make a significant difference.

As nurses, access to facilities and certain equipment can sometimes be limited. Therefore, the extent of care one can provide may be constrained, especially if the nurse is a lone worker in a community setting. So, the question arises, what are we expected to do in these situations? Thankfully, there are UK laws, legislations, and guidance from governing bodies to help us navigate these scenarios.

Under the Health and Safety (First-Aid) Regulations 1981, employers are required to provide adequate and appropriate equipment, facilities, and personnel to carry out first aid if required. This implies a need for staff to be appropriately trained, depending on the level of care people in their care will require.

In clinical settings like primary care, nurses are often required to respond to a variety of emergencies, from minor injuries to cardiac arrests. As such, they must be proficient in using equipment like AEDs and in administering emergency medications, as well as recognising different medical emergencies and responding to them appropriately.

The legal expectation is that nurses should be able to handle these situations competently. Failure to do so could result in legal liability for both the nurse and their employer. Therefore, maintaining up-to-date first aid skills and knowledge is crucial not only for compliance with legal standards but also for enhancing patient safety and care quality in primary care settings.

Nursing and Midwifery Council (NMC) Standards

The Nursing and Midwifery Order 2001 is secondary legislation governing the regulation of nurses and midwives in the UK. This order established the Nursing and Midwifery Council (NMC) as the regulatory body responsible for ensuring that nurses and midwives are fit to practice. This includes requirements for continued education and training as well as standards on conduct, and performance. Nurses must meet the standards set by the NMC, including continuous professional development (CPD), to remain on the NMC register.

The standard of safe care is expected to be consistent for all nurses, regardless of their level of experience. However, the skill set and knowledge that nurses possess will differ depending on their experiences and workplaces. Therefore nurses have an obligation to ensure that they continue their professional development and stay updated on safe, effective care.

There are certain parts of the NMC Code that are particularly relevant to first aid at work. Below are sections of the NMC Code of Conduct that can relate to first aid:

Prioritising People

• Act in the best interests of people at all times.
• Balance the need to act in the best interests of people with respecting a person’s right to accept or refuse treatment.
• Obtain and document informed consent before carrying out any action.
• Adhere to relevant laws regarding mental capacity, ensuring the rights and best interests of those lacking capacity are central to decision-making.

Practicing Effectively

• Always practice in line with the best available evidence.
• Ensure any advice given is evidence-based, including information related to using health and care products or services.
• Maintain the necessary knowledge and skills for safe and effective practice.

Preserving Safety

• Recognise and work within the limits of your competence.
• Accurately assess signs of normal or worsening health in the person receiving care.
• Make timely referrals or seek help for actions beyond your competence.
• Consider your own safety and that of the people in your care.
• Complete necessary training before taking on new roles.
• Offer help in emergencies within your knowledge and competence.
• Arrange prompt emergency care where possible and act without delay if there is a risk to patient safety or public protection.

Professional Development and Training Opportunities

In line with UK requirements, nurses must stay up to date with relevant training. Determining what training is required can sometimes be confusing. Several organisations, including Health Education England, the CQC, and the Resuscitation Council UK, provide guidance on the necessary skills and knowledge for different nursing specialties. Alongside this, each trust will have their own specific protocols and policies for who requires what training and how often. This will be dependent on your role, your day-to-day activities and likelihood of encountering or leading emergencies.

For primary care nurses, Basic Life Support (BLS) is the minimal requirement, while Immediate Life Support (ILS) may be appropriate depending on the role. There is no specific legal mandate for ILS, but it is recommended for those in acute care settings, support staff in critical care environments, and professionals involved in direct patient care. Many bodies strongly recommend ILS for clinicians who are expected to manage emergency situations but not lead the emergency or resuscitation. Within ILS, the course can be adapted to fit the clinicians job role, making it more beneficial and realistic to where they work.

There may also be in house training within your workplace where the trust ensures that staff are aware of how specific equipment works, where it is kept and when to use. Alongside this there are online resources and courses which can help with continuous professional development. Websites like the Resus Council offer excellent resources regarding first aid and basic life support, as well as The Royal College of Nursing providing reading and suggestions on appropriate training. Some mandatory and statutory training that your trust offers will cover elements of first aid, escalation processes and emergency protocols.

Drawing on the knowledge and expertise of our colleagues, as well as seeking additional support from senior clinicians or external services like the ambulance service, can be invaluable in challenging situations. It is both our responsibility and that of the trust we work for to ensure that we remain up-to-date and confident in managing emergencies and complex medical scenarios. However, it’s important to remember that no one is expected to know everything or handle every situation alone.

Leveraging the resources at our disposal, including the collective knowledge of our colleagues, is not just beneficial—it’s essential for providing the best possible care. Collaboration and continuous learning are key to navigating the complexities of our roles effectively.

Summary and Conclusion

First aid is a crucial skill for primary care nurses, encompassing everything from treating minor injuries to performing life-saving procedures like CPR. Practical application of these skills is vital, as nurses in primary care settings can sometimes encounter a range of emergencies. Effective management of these situations requires not only knowledge and skills but also access to the appropriate equipment and resources. Nurses must be equipped to handle emergencies, even in resource-limited settings, as part of their legal and professional responsibilities. In the UK, staying updated with first aid knowledge is not just recommended but mandated by the Nursing and Midwifery Council (NMC) to ensure patient safety and high standards of care. By staying informed, continuously improving their skills, and effectively using available resources, nurses can provide high-quality first aid.

Would You Like To Find Out About The Training We Can Offer?

Whatever training you may wish to access, Health Academy are able to offer a wide range of Basic Life Support and First Aid training solutions to meet your organisation’s training needs.

We can provide training via any delivery method from e-learning, virtual via zoom to face-to-face practical sessions. Delivered by experienced trainers these can be arranged to meet your needs. Why not get in touch to book your training today?

References

• Duty of care | Advice guides | Royal College of Nursing (rcn.org.uk)
• NHS Health Education England: Primary Care and General Practice Nursing Career and Core Capabilities Framework
• ILS (Immediate Life Support) Course | Resuscitation Council UK
• Legislation – First aid at work (hse.gov.uk)
• Quality Standards: Primary care | Resuscitation Council UK
• Read The Code online – The Nursing and Midwifery Council (nmc.org.uk)