DR ABCD in first aid is an action plan detailing key steps for giving assistance. It stands for danger, response, airways, breathing, circulation and defibrillator.
The plan includes a set of steps every first aider should follow when they spot an injured person. They should do so in the order of the letters in the mnemonic. This is because it will protect personal safety, and the health of the injured victim.
Danger and Response (DR)
The first two steps, danger and response, include steps that occur before a person has even got to the patient.
A person should survey the area of the incident before treating someone. Whether they be a first aider at work, walking down the street or at an event, they need to remove any dangers. When coming across a health and safety incident, ask yourself a few key questions like:
- Are there any hazards around the area?
- Is it safe to approach the victim(s)?
- What was the nature of the incident?
- How badly are people hurt?
- How many people are hurt?
- Is there anyone else around to help?
If there are hazards like workplace machinery, then you need to control them. They are a threat to your own personal safety and ability to give first aid.
Secondly, a first aider needs to assess whether a victim is responsive or not. This will determine how serious the accident was, and how soon the emergency services are needed.
To do this, verbally and physically inspect the subject. See if they respond to calls to them, as well as the use of their name (if known). If not, firmly shake the body from the shoulder area. Failing this, see if they respond to pain. Lightly pinch arms or legs and wait for a response.
If a patient is totally unresponsive, you will need to check some vital signs before giving aid.
Airways, Breathing, CPR and Defibrillator (ABCD)
Once you have figured out that a person is unresponsive, you must check for signs of breathing and clear airways. In certain circumstances, checking these things may also be required if a person is conscious.
In the event of a casualty, open airways allow an unconscious person to keep breathing.
According to the NHS, to open an airway you must “place 1 hand on the casualty’s forehead and gently tilt their head back, lifting the tip of the chin with 2 fingers”. Once you complete this, breathing can be checked.
To check breathing, visually assess whether a person’s chest is moving up and down as normal.
If this cannot be done or isn’t obvious, hold your hand up to their nose and mouth. When a person exhales, you should feel air flowing out, or moisture from breath. If not, the airway may be partially or totally blocked by a foreign object.
If there are absolutely no signs of breathing, a first aider must perform CPR. Under absolutely no circumstance should it be performed on someone that is breathing.
A first aider at work may have to deal with adults in an office, or young infants in a hospital. Therefore, it is important to know the differences in procedure between the age groups. They include:
- Less compression force on the chest for children
- Compressions with two fingers for infants, instead of two hands for adults
- For adults, you should always call 999 and then start CPR – for infants it’s the opposite
- For young infants, you shouldn’t exhale as much air in a rescue breath than for an adult
When all else fails, use an Automated External Defibrillator (AED). This will send an electrical signal to the heart, restarting it.
To learn how to properly use one, you must complete a course of first aid training. You will learn about DR ABCD in first aid, procedures, and good practice.