A new article published in Resuscitation reported on the first aid guidelines by the European Resuscitation Council based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. For medical emergencies the following content was reported to be covered – recovery position; optimal positioning for shock; bronchodilator administration for asthma; recognition of stroke; early aspirin for chest pain; second dose of adrenaline for anaphylaxis; management of hypoglycemia; oral rehydration solutions for treating exertion-related dehydration; management of heat stroke by cooling; supplemental oxygen in acute stroke; and presyncope.

For trauma related emergencies the topics include – control of life-threatening bleeding; management of open chest wounds; cervical spine motion restriction and stabilization; recognition of concussion; cooling of thermal burns; dental avulsion; compression wrap for closed extremity joint injuries; straightening an angulated fracture; and eye injury from chemical exposure.

It was reported thatalkali injury to the cornea has shown to cause severe corneal injury and risk of blindness. On the other hand, acidic substances cause protein coagulation in the epithelium, a process that limits further penetration into the eye. While irrigation with large volumes of water is more effective at improving the corneal pH than low volumes or saline. The use of solutions such as lactated ringers (LR) or balanced salt solution (BSS) or, in industrial settings, amphoteric-hypertonic solutions were proposed as the preferred option for emergency neutralization.

Moreover, the timing of treatment is of most prognostic importance, and any delay in irrigation should be avoided. Owing to the increase in the number of violent acid assaults on the face, apart from accidental exposures, more extensive first aid training and the wider provision of specific neutralization measures are necessary.

Source: Resuscitation. 2021 Apr;161:270-290. doi: 10.1016/j.resuscitation.2021.02.013.