Excerpt
ii
Dedication
To our parents
Anura, Nilmini
and sister
Nima
iii
Acknowledgement
The negligence: the paucity of pre-medical knowledge is a small step to uncover a
highly overlooked yet important aspect of our priorities. Disclosure of this area will
pave the way to keep people informed. Therefore, assessing the knowledge of pre-
medical care and its related fields is the prime objective of this book.
In this regard, individuals and communities were considered. Furthermore, experts
were consulted. The authors would like to pay sincere gratitude for those who have
participated in the survey and consultation. The contributions of students, teachers, and
parents are central in this work and our heartfelt gratitude is owed to all of them.
We have consulted various studies and predecessors' ideas for this work. Different
principles, guides, manuals, and publications produced by British Red Cross, Saint John
Ambulance, Saint Andrew's First Aid, American Safety & Health Institute, and
Queensland First Aid Manuals of Australia are a few of the works that were consulted
and cited. We highly recognize their outstanding contributions in the form of
publications, training, and services in due course.
Knowledge of first aid is needed for the protection of the society in terms of pre-
medical care. This knowledge is important, however, little attention is paid to acquire
formal education and training. We appreciate first aid agencies, trainers, and volunteers
all over the world for providing first aid education and services.
Converting our knowledge of pre-medical care into this book was proposed by our
parents. Our deepest gratitude is owed to our beloved mother Nilmini, father Anura and
sister Nima for their continuous support and encouragement.
iv
Forward
The negligence of pre-medical knowledge is one hidden aspect of the society. Also
known as a pre-medical care or emergency health care, first aid is the immediate
attention given to a sick or injured individual until proper medical treatment arrives.
This special treatment can be provided by any skilled bystander, commonly known as a
first aider, prior to consultations with health professional.
It is assumed that the community as a whole neglects acquiring such vital
knowledge. This book presents an overview of actual thoughts, feelings and attitudes of
the society towards this knowledge. Here we present the information discovered from
the public, regarding how far "the negligence" affected their daily lives. An individual
at any stage of his or her life might have faced situations where the needs of primary
care to a victim or the need of such assistant to oneself has occurred in their daily lives.
Some may have no knowledge, while some may have limited skills to face such
situations. Every individual must rely on their own life-saving skills
until the arrival of
medical assistance to the scene. It is assumed that many individuals do not possess
adequate knowledge of standard pre-medical care in terms of "first aid".
We attended many events where people overlooked the need for pre-medical
knowledge. Many life-threatening situations that could have been easily treated were
neglected due to the lack of knowledge on pre-medical care. Though there are
voluminous publications and courses on pre-medical care, we thought to disclose our
knowledge of pre-medical care to the public. We compared several root causes and
alternatives by practical observations.
This book is intended to drag the attention of the public towards the negligence of
pre-medical care. It is highly recommended that this booklet is not to be considered as a
complete guide or textbook on first aid treatments. This book covers a few selected pre-
medical skills based on the needs and demands of the investigated grounds.
For the full medical treatments and management of such situations, it is
recommended to refer standard first aid textbooks. This book merely considers the
concept of negligence alone. The information for the treatment of the discussed
incidents should not be applied without formal first aid training from a recognized
organization or a certified trainer. Readers are strongly advised to use the contents of
the book as supportive information for research needs only and not for treatment.
v
Contents
Acknowledgement ... iii
Forward ... iv
1. Introduction ... 1
1.1 Overview ... 1
1.2 First Aid or Pre-Medical Care ... 3
1.3 The Three Ps of First Aid ... 4
1.4 The Focus ... 6
1.5 Significance ... 7
1.6 Summary ... 7
2. Methodology ... 9
2.1 Introduction ... 9
2.2 Investigated Grounds ... 9
2.3 Assessment Tools ... 11
2.4 Observed Sample and Response ... 12
2.5 Evidence ... 12
2.6 Summary ... 14
3. The Depth of Negligence ... 15
3.1 Introduction ... 15
3.2 Basic Knowledge of the Human Body System ... 15
3.3 Paucity of Knowledge - Negligence over Human Body System... 21
3.4 Knowledge of Pre-Medical Care ... 34
3.5 Possession of Basic Formal Pre-Medical Knowledge ... 38
3.6 Summary ... 38
4. Knowledge of Pre-Medical Care ... 40
4.1 Introduction ... 40
4.2 Primary Survey ... 40
4.3 Secondary Survey ... 48
4.4. Cardiopulmonary Resuscitation (CPR) ... 50
4.5 Recovery Position ... 51
4.6 Dressing and Bandages ... 52
4.7 Summary ... 53
5. Conclusion ... 54
Bibliography ... 56
1
1. Introduction
1.1 Overview
"The Negligence", the title of this book provides an insight of the content and aim of
the writing. What is the meaning of negligence? Negligence is an act of neglect or
ignorance. The word "negligence" can apply to an individual or to a society as a whole.
This writing encompasses the negligence of an entire society. To do so, analysis of the
individual factors of the society in study has been carried out.
The focus of this book is to study and analyse the negligence of the society.
However, what is this negligence? The negligence focused on this book is that of pre-
medical care. The knowledge of pre-medical care is a commonly neglected factor in the
daily life of each individual. The opinion of the majority of individuals represents the
opinion of the particular society. Hence, the negligence of most individuals is the
negligence of that society. Therefore an individual is representative of that society.
Moreover, the secondary title of the book: "The paucity of pre-medical knowledge"
also refers to this great negligence. The key of this explanatory title is the word paucity.
Paucity can be defined as the lack of or insufficiency of a particular aspect. Being the
subtitle of this book, it refers to the insufficiency of pre-medical knowledge as a cause
for this negligence. As mentioned, the lack of knowledge in other words ignorance is a
cause of negligence.
To sum up, the prime purpose of this book is to provide us insight into the problem
of negligence. This book is focused on this single issue. The society in the study is a
clear example of this negligence. Although the depth of the negligence may vary among
different societies, it remains a consistent problem. The degree of this issue may vary
due to the cultural, economic and social values of each society. However, it is an
accepted fact that the negligence is a serious issue.
The objective of this book is to analyse the negligence and to present the results of
this analysis clearly. The analysis of the negligence is step by step procedure. Over the
cause of the book, these steps will be discussed in the due procedure. The analysis of the
problem required analysing the knowledge of pre-medical care. For an individual's
knowledge on a topic shows the care shown towards it. The opposite shows the
2
negligence of an individual. Furthermore, the analysis involves the effects of the
negligence. The combination of these two aspects forms the content of this book.
An experiment was carried out to test the depth of the negligence. Therefore, this
book is based primarily on the findings of this survey. All opinions formed on the cause
of negligence and its effects are all due results of this experiment. As a result of this
experiment, this book was written to highlight the problem of negligence, by focusing
on the negligence of one society.
Although the experiment focuses on a few grounds of society, it is considered to be
representative of the society. The surveyed ground though of a small sample size is a
distinct representative of its entire community. The experiment provided an overview of
the situation of the negligence and the degree of the paucity of knowledge. Furthermore,
the root causes of this issue were revealed. However, it must be noted that the survey
was focused on the last two years.
In the process of experimentation, the possession of pre-medical knowledge has been
clearly outlined. Despite its importance, the study shows that this has been greatly
neglected. The findings of the survey depend upon individual opinions; however, the
majority of the data is reliable. Thus the overall result is not affected.
Apart from the experiment and the study of the negligence, this book provides a
general overview of a few basic pre-medical skills. These skills are essential for the
application of pre-medical care. However, it must be noted that since the general focus
of this book is the negligence, the pre-medical skills are a surface discussion. The in-
depth discussions of this book only focus on the negligence.
As mentioned the prime purpose of this book is to provide an insight of the
negligence as a whole, not in providing information of pre-medical knowledge and
skills. The surface discussion may not cover certain important information. Only a few
selected pre-medical skills are taken into focus based on the needs of the surveyed
grounds. Therefore this book must not be considered as a complete manual of pre-
medical care.
It highly recommended that this book is not taken as a reference for pre-medical care,
but merely for research purposes. For the application of pre-medical care, it is
recommended to refer to a complete guide. In addition, it is required that the knowledge
3
of pre-medical care be obtained from a more reliable source, such as a formal first aid
course. The scope of this book is merely restricted to experiment and the insight of the
negligence. Therefore, the application of pre-medical care requires professional training.
This book contains five chapters. Each chapter focuses on the significant aspect of
the negligence and its solutions. Chapter one outlines the negligence in different
grounds: home, school, workplace, events, and others. In addition, it also focuses the
negligence of responsible parties: family members, teachers, students, workers, and
individuals. Chapter two focuses on the experiment or survey. Thus, being the most
crucial section of the book, chapter three presents the finding with a brief discussion.
Chapter four summarises the vital knowledge needed for pre-medical care. Chapter five
concludes the negligence for possible solutions.
1.2 First Aid or Pre-Medical Care
First aid is a pre-medical attention paid to the sick or injured individual until meeting
the proper medical treatment. It can be named as primary medical care or pre-
emergency care given by any skill bystander commonly known as a first aider before
consulting a health professional. Though there are many different terms used from far
back of the history, the term "first aid" comes to light in the nineteenth century
onwards. The term itself appeared on the document of "Erste Hilfe" (Esmarch, 1882)
for a situation where pre-medical attention is needed. Such situation is further known as
different ways. Here we selected a simple and complete definition provided by Queens
First Aid in Australia which is more aligned with the scope of our study.
"First aid is the initial care provided to someone who has suddenly fallen ill, or who
have been injured until more advanced care is provided or the person recovers.
Immediate and effective first aid may reduce the severity of the injury or illness and
promote recovery. Knowledge of first aid is important for everyday life at home, work
or in the community. Not every incident requiring first aid will be life-threatening,
however, the more people with basic first aid knowledge, the better the chances are of
saving a life" (First Aid, 2014)
Since the everyday life of people is to be faced with emergency situations, all
individuals must have high responsibilities of possessing knowledge of first aids. It is a
compulsory to all despite their any social status or dignities.
4
1.3 The Three Ps of First Aid
Application of first aid circles around three simple principles known as the "three
Ps". These three principles are the most basic roles and responsibilities of every first
aider. The keywords of the three Ps are: Preserve, Prevent, and Promote. The three Ps
are necessary for guiding the first aiders towards the more important responsibility. To
have a clear understanding of one's duty as a first aider one must have a clear
understanding of the nature of the three Ps.
1.3.1 Preserve
The key word: "Preserve", comes from one of the most basic, yet important roles of a
first aider. Meaning is the role of preserving life. Preserving life is more important than
treating a victim's wounds. For instance, in situations such as obstruction of the airway,
it is important to clear the airway than tending to the wounds of the patient. No matter
the seriousness of the injury life must be the primary focus of the first aider.
Hence, preserving a person's life is more important than treating his or her wounds.
Therefore, of all the three P's, preservation of life is the most important. A first aider
must be able to recognize any threats to the patient's life. This is a very important ability
to possess as a first aider, for it will guide your decision making and enabling you to
carry out the best approach.
The type of wound and the situation of the incident may alter the necessity of the
application of this principle. Situations vary drastically and so does the situation of the
patient. If the victim is not in a life threating situation the focus of the first aider must
shift towards his or her other responsibilities. Should the situation be the contrary, the
utmost attention must be focused on saving the victims life.
The word preserves means to keep something safe or to keep something going.
Therefore, one must keep the victim going; in other words, keep him or her safe from
death. In some emergency situations, the first aider will be incapable of performing any
treatment to promote the victim's present situation. Thus the first aider's only option is
to preserve the life of the victim.
1.3.2 Prevent
Preserving the life of the casualty is the most important duty of a first aider.
However, it is also important to stop the situation from becoming worse. The word
5
"Prevent" comes from the nest duty of a first aider: to prevent the situation from
worsening.
To prevent the situation from worsening is as important as preserving life. For these
two principles are linked and correlated. If the situation should worsen, the difficulty of
preserving life decreases, as the chances of survival will diminish.
In most cases, a first aider with an intention of curing the casualty or preserving his
or her life may carry out certain procedures that would pose a threat to the life of the
casualty. To worsen a situation means to carry out a treatment unsuited for that
particular incident. Such treatments will increase the danger of the situation. For
example in a case of spinal injury, an unsuspecting first aider may try to move the
person to recovery position. In such situations including fractures, the movement of the
casualty is forbidden.
The most common cause of a worsened situation is the lack of awareness and
understanding of the situation. Such weakness of the attendee may cause serious side
effects. The slightest mistake may cause irrevocable damage to the health of the
casualty, and increase the critical level of the emergency. Therefore, as a first aider, it is
your responsibility to prevent any situation from worsening.
1.3.3 Promote
Promote is derived from the phrase: Promote recovery. It is the first aider's third and
final key principle. The first and most important duty of a first aider is to preserve life,
followed by preventing the situation from worsening. The last duty of the first aider is to
promote recovery. Although the order of a first aider's duty is such, each of his or her
duties is of equal importance. The order of the duties is due to the limited time duration
of treatment in any situation.
To promote recovery means to carry out the necessary treating procedures, to ensure
the long-term cure of the casualty's injury. This is very important because this ensures
that the casualty will be free from any side effects of his or her injury. It must be noted
that promoting recovery is often associated with emergency situations where the first
aider can do more than management of the situation. For managing a situation requires
the first aider to place his or her attention merely on the preservation of life. However,
these situations may require the first aider to take certain steps to help in the recovery of
the casualty. The first aider must have a clear understanding of the emergency situation
6
to promote recovery. By doing so, the first aider will be able to fulfil his or her duties
without any disturbances.
Figure 01 - Three Ps (Preserve, Promote and Prevent): the cycle of pre-medical care
1.4 The Focus
Understanding whether the responsible parties including students, teachers and
parents do possess fair knowledge of emergency care is taken to discuss. This book
mainly focuses the actual ability of above three parties in relation to minor, mild, critical
or deadly emergency situations in day to day life. Then practical solution will be
suggested to overcome the negligence at hand with due potential knowledge which can
be used as extra knowledge to the situation. The prime focus of this study highly
concentrates on the negligence as the central issue. And it is suggested to take proper
first aid knowledge for every individual. As well as refresh the knowledge regular basis.
Though such incidents are often in any place and cannot be predicted, home, school,
and workplaces are the most obvious grounds for reported incidents daily. Therefore,
understanding the possible grounds is vital to make a clear path to eliminate the
negligence.
With this focus in central, this study determined to disclose some hidden aspects,
attributes, attitudes and opinion in this regard. The study also focused some key areas
such as basic knowledge of human body and structure, common incidents or injuries
7
that may occur in daily life, knowledge of pre-medical care and effects of formal
knowledge of pre-medical care for making a picture of negligence at hand.
In this attempt, the above focusses further connected with parents, teachers, and
students as the responsible parties involved. They might have to play individual roles at
school or home or need to bear a collaborative responsibility in collective events like
games or disasters situation. Society is open to fatal incidents of accidents (road
collision, riots,) or hazards (fire, shooting, and explosion). Also, is suffering from
natural disasters (flood, wildfire, hurricane, cyclone or earth slides) to a greater extent
where the facility of professional medical cannot be reached immediately.
1.5 Significance
A study by Metin & Mutlu 2010 found that many people die due to lack of proper
attention of first aids. The study found that a time frame for death occurrences. Around
35% of these deaths are found within 5 minutes after the incidents and remaining 54%
might die within 30 minutes. Though the death amount cannot be prevented completely
by first aid care, the study found that at least 20% of such death average could be
prevented by on-site first aid assistance.
First, this study provides sufficient information to understand how far the scope of
knowledge of first aid is recognized in the society. Secondly, home, school, and
workplace are found as the common grounds for unexpected illness, injuries, and other
health-related issues. Such incidents can be treated at the initial stage. Then the high-
risk factor could be minimized and due protection can be granted. Thirdly, it is assumed
that many incidents are treated by non-professional or untrained personnel and
subjected to receive fatal outcomes. Many people do not have even the basic knowledge
to face such incidents except a few incidents like minor cuts and similar. People react
quickly with minimum knowledge or no knowledge which results in more vulnerable
outcomes. Whatever the treatment they use is not meeting the adequately enough
standards as per the criteria. Acquiring fair knowledge of first aid certification provided
by recognized institutes is a must for every individual.
1.6 Summary
Knowledge of first aid is vital for every single individual despite age, gender or any
other discrepancies. This study assumed that majority of peoples does not possess such
vital knowledge and simply overlooked the needs in their life. Until they meet a sudden
8
incident, they do not pay attention or care for such need. Once they recover, peoples just
overlooked the needs of this knowledge. This book intended to address this omitted
aspect and basically presented why this vital need is neglected.
References
1. Esmarch, F., (1882). First aid to the injured. Five ambulance lectures (translated by
HRH Princess Christian), 1st ed., London: Smith, Elder, and Co.
2. First Aid: Pre-Course workbook, (2014). ed 2.0, Department of Health, Queens
Ambulance Service. Queensland Government, Australia.
3. First aid headquarters, departments of the army, the navy, and the air force (2002),
Washington D.C.
4. Metin, I. & Mutlu, C., (2010).Level of knowledge about first aid of the university
students. Turkia Journal of Sciences,8(2),pp.262-265
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- Arjun Karunanayake (Author)Apoorwa Karunanayake (Author), 2018, The Negligence. The paucity of pre-medical knowledge, Munich, GRIN Verlag, https://www.grin.com/document/387496
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