Communication, communication, communication!

As a student of public relations I spend a lot of my time trying to extol the virtues of effective communication and getting people to talk to one another.  Effective communication being a good thing may sound pretty obvious but reality doesn't always have much to do with common sense.  Anyway, the importance of communication is no less when it comes to delivering first aid.

During a recent training exercise, I had the fun of being strapped into a Kendrick Extrication Device (KED). The KED is a jacket normally used to immobilise a casualty's upper body, enabling them to be removed from a confined space while reducing the risk of further damage. Another use for the KED however, is to immobilise the lower body in the event of a pelvic injury, as I was using my fairly dismal acting skills to demonstrate on this occasion.

I actually found that being immobilised in such a way was quite an unnerving experience. Maybe it was just the exercise artificiality, but there seemed to be a lot of people getting intimately close while repeatedly pulling, shoving, lifting and tugging. I could only imagine what it would be like for a real casualty with a real injury, someone already likely to be suffering both physical and mental stress.

Communication is therefore essential on the part of the first aider who must talk to the casualty at all times. If moving them, let them know first so nothing comes as a surprise. They will already be distressed so the last thing they need is more pain inflicted on them, especially if it seems unnecessary.

Talking to them does not just mean telling them what you are doing, but explaining why. If you fully discuss your actions and the reasoning behind them, then your apparent confidence will help provide reassurance. The psychological value of reassurance can be just as important as the physical treatment. Perhaps keep in mind that if you don’t tell them what you’re doing, they’ll try to find out themselves, any movement potentially aggravating a spinal or neck injury.

Communication is not just a one-way information flow. It is not just the first aider who should talk to the casualty, the casualty should do likewise with the first aider. Arguably this is still the responsibility of the latter who needs to ask the right questions in order to obtain the relevant answers. This interaction will give the first aider a better idea of the extent of the injury and what needs to be done to prevent further pain or damage. By ensuring that communications are symmetrical, the first aider and casualty can discuss a suitable way forward and agree on a treatment that is designed to suit the situation.

Models of Public Relations (Adapted from Grunig & Hunt, 1984, pp. 22).

Communication is not just verbal, even an unconscious casualty can tell you a lot. Observations can all help build a picture of the condition of the casualty. It is not only the casualty you need communicate with, but their friends and family who may need reassurance as well, or could provide some vital information about the casualty.

So the next time you treat a casualty, don’t just switch to auto pilot and treat them as though they were a dummy. Remember you’re dealing with a fellow human who is probably quite scared. Talk to them. Listen to them. Make sure there is a mutual understanding between you. Then treat them.