Help!

There are plenty of horror stories about well-meaning attempts at first aid. Take the old lady who recently tried to stuff her handbag into the mouth of someone having an epileptic fit, so he wouldn't bite his tongue. Or another would-be Samaritan who stuck a safety pin with string through the tongue of another epileptic sufferer to pull the tongue away from the airway. While clear airways are necessary, the possibility that the sufferer could have bitten his tongue in half didn't occur to the rescuer.

Caterers are not much better, however. Some chefs still use butter or oil on burns, or believe that a second burn will remove the first. Another old remedy is to urinate on a burn, which, at the very least, has unpleasant hygiene connotations.

These examples of incorrect first aid come from Dave Smith, training and operations director of LEV Training and Supplies, a charity organisation which does much of the first-aid training for the hospitality industry. Set up in 1991, LEV has such clients as Compass, Conran Restaurants, Hilton, Belgo Restaurants, the Dorchester, Number One Aldwych, Thistle and Choice Hotels Europe.

LEV offers two levels of first-aid training. There's a one-day course which will get someone through an emergency until an ambulance arrives, and the four-day registered First Aid at Work course required by the Health and Safety Executive. All first aiders must recertify every three years, although Smith says that research shows they begin to lose their skills after 90 days. "We do yearly follow-ups for many of our regular clients," he says, "just to keep them on their toes."

St John Ambulance is the training provider which most people will know best, and its manuals are fairly standard for most training courses. Actual courses vary in price depending on location but, as with LEV, the First Aid at Work course lasts a standard four days.

"Everyone in the catering industry is prone to cuts, burns and scalds, and needs to know how to deal with their injuries," says Carol Lock, training officer for St John Ambulance. "People organising events and working with the public should know how to deal with someone who becomes unwell. Companies should ensure that their staff have this knowledge, rather than rely on the venue or group to provide this expertise."

One organisation planning to provide a comprehensive health service, including first-aid courses, is SOS Doctors Direct. The organisation currently offers private general practitioner care in London and its clients include the Sanderson, Thistle, Holiday Inn and Blakes hotel. From February, it will offer a programme incorporating health and safety, first-aid training, and GP services.

"We've found that many people tell us there are too many different bodies providing information on these types of issues, and we're hoping to co-ordinate the various professionals from different fields for our clients," says Andrew Rae McCance, chief executive of SOS Doctors Direct.

The driving force for increased first-aid training, according to LEV chairman Phil Ryan, is the increasing pressure on staff and management. "If you're a duty manager in a hotel, you've got enough on your plate already without having to worry about that," he says. "Hotels are businesses. We can't expect them to be totally safety conscious to the point of ridiculousness, because members of the public are capable of doing daft things. How can you factor for guests who carry too much heavy luggage and don't want help, then fall over and say, ‘What kind of a hotel are you running?'."

However, providing first aid for customers in restaurants and hotels is not, in fact, required by law.

According to Phil Phillips, the British Hospitality Association's technical services director, companies are required to have one qualified first aider for every 50 employees, but there are no requirements for providing first aid to guests. And he says, because of today's litigiously minded society, many hotels no longer provide any type of medication for guests.

"You must be careful providing medication and first aid to a guest or member of the public," warns Phillips. "It is possible to make the situation worse if you do not already know of an existing condition. I'm not saying do nothing, just proceed with caution."

The "no win, no fee" advertisements currently in vogue may well encourage people to try their luck with the law, but the LEV's Smith says that, as long as a first aider is qualified and follows the procedures necessary for the situation, the law has been tested and is pretty much on their side.

In the future, though, as well as giving basic first aid, trained hotel and restaurant staff could be reviving heart attack victims. The Government's White Paper, A Healthier Nation, outlines plans for defibrillators to revive heart attack sufferers to be located in public places. There are 400 already sited around the country in railway and bus stations, and Smith estimates that, in five to seven years' time, hotels will need them too.

He adds: "As an American pointed out to me, he'd be safer in a bus station than a £300-a-night hotel, and he's got a point."

Basic first-aid advice from LEV Training and Supplies

Burns

1 Run burned area under cold water for minimum of 10minutes

2 If still hot, continue to run under cold water

3 Wrap in clingfilm or plastic bag and go to hospital

Serious cuts

1 Take dressing from first-aid kit, or any material, and wrap the cut

2 If blood soaks through, wrap with second dressing

3 Repeat

4 Do not apply tourniquet, but apply direct pressure above the wound to stem the blood flow

5 Do not press directly on the wound if there is glass in it

Food allergy

1 Remove sufferer from what has upset them, if possible

2 They may be red, blotchy and may have a swelling of the airways

3 Sit them forward, leaning on the table - this makes it easier for the lungs to work and keeps the throat open

4 They may have an Epi-pen with adrenaline which they can inject themselves with

Unconscious person

Follow the standard first-aid rules (DR ABC):

D, Danger - make sure you aren't in any danger

R, Response - call the patient, to make sure they aren't just asleep

A, Airway - check their mouth to make sure the tongue isn't blocking the airway, and clear their mouth of any food

B, Breathing - check to see if they are breathing

C, Circulation - check to see if they have a pulse

Food poisoning

Except in restaurants where glutamate is used, such as Chinese restaurants, you will not see the immediate effects of food poisoning. It is characterised by vomiting and diarrhoea occurring four to 48 hours after ingestion, depending on the bug. It lasts for 24 to 48 hours.

Andrew Rae McCance, chief executive of SOS Doctors Direct, says: "When a customer complains, 99.9% of your complainants will be suffering from a non-specific gastro-enteritis. We actually find very few cases of food poisoning."

For £70-£100 a doctor will attend the complainant within a few hours, administer treatment and take a faecal sample to exclude food poisoning. A sample of the food from the restaurant is sent to the company's laboratory for confirmation of a match in the bacterial infection, which costs £30.

This, Rae McCance points out, can be much cheaper than refunding the price of the meal, dealing with a solicitor and settling out of court, if the guest decides to take action against the business.

In six years, the company has found only one case of food poisoning. However, as people are becoming more aware of the possible compensation they might get, Rae McCance advises restaurateurs to be particularly careful.

Food-related injuries

Number of people injured by different items of food in a leisure capacity. This includes all leisure activities, not just dining out.

Fish 2,851

Meat and poultry 1,387

Other bones 605

Fruit 2,129

Vegetables 1,387

Sweets 976

Alcoholic drinks *70,894

Hot coffee 801

Hot tea 781

*Can include accidents that occurred while drunk

Source: DTI home accidents and leisure accident surveillance system, provided by the Royal Society for the Prevention of Accidents - 1998 estimates.

FIRST AID ADVICE FROM SOS DOCTORS DIRECT

Chest pain - could be angina or heart attack

1. Have someone call 999

2. Loosen their clothing and help the sufferer half sit up , bend their knees

3. Stay calm and be reassuring

4. Ask about medication and, if they have some, help them to administer it, if necessary

5. If the victim is unconscious, not breathing and you cannot find a pulse, a qualified first aider should administer cardiopulmonary resuscitation

6. If they are unconscious and breathing easily, place them in the recovery position - this means rolling them on their side, bending their knees to support the body and ensuring the head is leaning forward

Stroke victim

If the guest is suffering severe head pain, has poor mobility or paralysis, and difficulty in speaking, they may have suffered a stroke:

1. Call 999

2. Loosen their clothing, help them to half sit up or place them in the recovery position

Choking

If the patient cannot breathe and cannot talk

1. Proceed with the Heimlich Manoeuvre

• Place yourself behind the patient, standing up

• Put your palms in the upper stomach area and move them quickly and firmly upward under the rib cage - this should create air movement and shift the obstruction

• The same manoeuvre applies to children but instead of your whole hand, use three or four fingers

1. If there is no movement of the obstruction, call 999

Fainting

1. Lay the patient in the recovery position

2. Loosen clothing

3. Check for normal breathing, and put legs higher than head

4. Stay calm and be reassuring

5. If there is no trauma while falling down, wait until consciousness is regained

6. Leave lying down until fully recovered

Nose bleed

Advise patient to:

1. Sit down

2. Hold head forward

3. Press nose with thumb to the nostril - hold for as long as 15 minutes

4. Apply ice to the front of the head

FIRST AID TRAINING ORGANISATIONS

SOS Doctors Direct

020 7603 3332

Twenty-four hour callout service for a doctor. Charges to the guest, for central London, range from £70 to £90 depending on day and time.

LEV Training and Supplies

08700 119990

www.lev.uk.com

LEV will come to your premises and run a four-day course for 15 people for £1,400, or a hotel can send a single member of staff on one of LEV's four-day courses at its training centre for £225.

St John Ambulance

020 7235 5231 for information on courses nearest you

www.sja.org.uk

Source: Caterer & Hotelkeeper magazine, 4-10 January 2001