First aid must be administered immediately to: restore breathing and heart-beat, control bleeding, remove poisons, prevent further injury to the patient (for instance, his removal from a room containing carbon monoxide or smoke).
A rapid, emergency evaluation of the patient should be made immediately at the scene of the injury to determine the type and extent of the trauma. Because every second may count, only the essential pieces of the patient's clothing should be removed.
In the case of an injured limb, get the sound limb out of the clothing first, and then peel the clothes off the injured limb. If necessary, cut clothes to expose the injured part.
Keep workers from crowding round.
The patient's pulse should be taken. If it cannot be felt at the wrist, it should be felt at the carotid artery at the side of the neck. If there is no pulse, heart compression and artificial respiration must be started. The patient should be treated for shock if the pulse is weak and rapid, or the skin pale, cold, and possibly moist, with an increased rate of shallow, irregular breathing. Remember that shock can be a great danger to life, and its prevention is one of the main objectives of first aid.
The patient should be kept in the position that best provides relief from his injuries. Usually this is a lying-down position, which increases circulation of the blood to the head.
The patient should be observed for type of breathing and possible bleeding. If he is not breathing, mouth-to-mouth or mouth-to-nose artificial respiration must be given.
Severe bleeding must be controlled.
During this time, the patient, if conscious, should be reassured and told that all possible help is being given. The rescuer should ask about the location of any painful areas.
The patient should be kept in a lying-down position and moved only when absolutely necessary. The general appearance of the patient should be observed, including any signs and symptoms that may indicate a specific injury or illness.
The patient should not be moved if injuries of the neck or spine are suspected. Fractures should be splinted before moving a patient. No attempt should be made to set a fracture.
Wounds and most burns should be covered to prevent infection.
Once life-saving measures have been started or deemed not necessary, the patient should be examined more thoroughly for other injuries. The patient should be covered to prevent loss of body heat. If necessary, protect him also from heat, remembering that in the tropics, the open steel deck on which he may be lying will usually be very hot. The patient should not be given alcohol in any form. Never underestimate and do not treat as minor injuries: unconsciousness; suspected internal bleeding; stab or puncture wounds; wounds near joints; possible fractures; eye injuries.
Note. Never consider anyone to be dead, until you and others agree that: no pulse can be felt, and no sounds are heard when the examiner's ear is put to the chest; breathing has stopped; the eyes are glazed and sunken; there is progressive cooling of the body (this may not apply if the surrounding air temperature is close to normal body temperature).