Origins of First Aid
So, every 3 years you check your certificates and have that dread,
‘Oh no, I’ve got to do First Aid again!’
well have you ever wondered where First Aid began?
Firstly, we would ask, why are you dreading your First Aid course? Come do your course with us and we will ensure that not only do you complete the course, and get your qualification to continue as a First Aider, but also you will have some fun throughout.
First aid can be traced back a long way in history as far as the Prehistoric age, although we have no actual concrete evidence of Prehistoric Man conducting life-saving first aid skills.
Let’s consider a minute, Prehistoric Man is in a situation where his ‘friend’ has an open bleeding wound, fractured bone in his leg or is about to eat a poisonous plant. In these situations, it is reasonable to assume that due to necessity, Prehistoric Man developed methods to treat ailments and accidents that befell him. It would have probably come easy to him to realise that plugging an open wound would eventually stop the bleeding, or strapping a branch to a leg as a splint would still enable him to hobble around the place even with a fractured bone. We have to assume that he also developed ways of calculating whether a plant was a poisonous plant or not.
Without Prehistoric Man working these few things out, how would mankind have survived to where we are today?
If we look through history we can see that bandages were used in many different ways, including by the Ancient Egyptians who used bandages to mummify their dead, especially those of power who then went on to be laid to rest in the Valley of the Kings in Luxor, for example, King Tutankhamun. Not only did they have this use for bandages, but they are the first known to use bandages to treat injuries, in particular the high genius doctor Imhotep.
Who is Imhotep?
Imhotep was an Egyptian chancellor to the Pharaoh Djoser, and is the probable architect of the step pyramid. Imhotep’s name means the one who comes in peace. According to his legacy and Egyptian mythology, this meaning and therefore name is totally apt. Curiously, very little is actually known about Imhotep as an historical figure although over the 3000 years since his death he has been gradually glorified and deified (worshipped or regarded as a god). Legend shows that he was a:
However, these claims are not based on his life but on texts in the millennia after his death.
We are obviously focusing in on the claim of Imhotep being a physician, around 2000 years after his death, his status was risen to that of a god of medicine and healing. Interestingly the Greeks have equated Imhotep to their own god of medicine, Asklepios, although there is no actual evidence that Imhotep was indeed a physician.
Early History (Continued)
There are reports that many ancient Greek Doctors, travelled to Egypt to study and then returned to Greece to practice.
Bandaging as we know it, is depicted in early Greek pottery from about the year 500 BCE, these images and pottery can be witnessed and seen in museums all around the world, and are some of the first images of modern First Aid.
The Parable of the Good Samaritan, a didactic story told by Jesus in Luke 10:25-37 (The Bible), includes references to dressing wounds, and to this day the use of the phrase Good Samaritan is used. Some countries have Good Samaritan laws, although the UK doesn’t have a specific law, our laws do make provision for the action of a good samaritan.
Battles and wars over this period do seem to point to early First Aid being carried out, the first such references are from the Roman Army. Within the Roman Army there were specific roles entitled the capsarii, responsible for carrying out First Aid tasks such as bandaging the wounded.
The Roman Army is important to us as a business as we operate out of their Capital City Corinium, today’s UK Capital City London was actually Roman UK’s second city Londinium.
1000 – 1800 AD
The first recorded history of First Aid stems from 1099, which details a religious order of knights who were trained to administer medical treatment. The Order of St John specialised in the treatment of battlefield injuries during crusades, and are the first recorded people who were trained to carry out First Aid. The Order of St John can be traced back as the route for the modern-day organisation, St John Ambulance.
During the late 18th Century, a major concern of death was drowning. In 1767 a society was formed in Amsterdam entitled, Society for Prevention of Life from Accidents in Water, thus attempting to prevent drowning as it was becoming such a risk of death. Linked in to this formation of the Society, physician William Hawes in 1773, began publicising the power of artificial resuscitation as a means of resuscitating casualties who have been drowned, and helped to form in 1774 the Society for the Recovery of Persons Apparently Drowned which later became the Royal Humane Society. This society has done much to promote the benefits of resuscitation.
1800 – 1900
In 1859, Jean-Henri Dunant a Swiss businessman was on a business trip to Solferino, arriving on the evening of the 24th June, shortly after a battle had occurred nearby. There were some 23,000-wounded, dying or dead people remaining on the battlefield, with what appeared to be little attempt to provide care for them.
Dunant was so shocked that he took the initiative to organise the civilian population, especially women and girls, to provide some assistance to the war wounded soldiers. The civilian population lacked resources and materials in order to fully support the needs of the war wounded, Dunant himself organised the purchase of materials and set up makeshift hospitals. He convinced the population to look after the wounded regardless of the side of the battle they were on, using the slogan ‘Tutti Fratelli’ (All are brothers). He also managed to secure the release of Austrian doctors captured by the French.
During July 1859, Jean-Henri returned home to Switzerland, and wrote a book entitled Un Souvenir de Solferino (A Memory of Solferino) which he published at his expense in 1862. He described the battle, the costs and the chaotic circumstances that he saw after the battle. Jean-Henri, developed the idea of a neutral organisation existing to provide care for wounded soldiers. With all of these things in his book, he distributed it to leading military and political figures across Europe.
The book was acclaimed largely positively by the readership, in particular the President of the Geneva Society for Public Welfare, who made the book and its contents the topic of a meeting on the 9th February 1863, where the recommendations were assessed and positively examined. The members of the meeting created a 5-person committee to further implement these ideas; Jean Henri was one of these members. Their first meeting on the 17th February 1863 is now widely accepted as the founding date of the International Committee of the Red Cross, who have later become known as the Red Cross and are still the largest provider of worldwide First Aid and carry out Jean-Henri’s ideas today.
In 1870, a Prussian military surgeon Friedrich von Esmarch introduced formalised first aid training to the military, and he first used the phrase ‘erste hilfe’ which translates to First Aid. His formalisation included training for soldiers in the Franco-Prussian War on care for comrades enabling them to use pre-learnt bandaging and splinting skills. Esmarch invented the Esmarch bandage which is a 3-sided piece of linen or cloth, where the base measures 4 feet and the sides measure 2 feet 10 inches. It could be used open or folded and applied in 32 different ways, it answers every purpose for temporary dressing and field-work. The Esmarch bandage had diagrams printed on it to show the soldiers how to use it.
In 1872, the Order of Saint John of Jerusalem in England (as discussed under a slightly different name earlier) changed their focus from a hospice organisation to start a system of practical medical help; they started this process by making a grant towards the establishment of the UK’s first ambulance service. They continued to improve their organisation and in 1875 established their own transport and became St John Ambulance and 2 years later set up the foundations for today’s St John Ambulance, the St John Ambulance Association in order to ‘train men and women for the benefit of the sick and wounded.’
In the UK, Surgeon-Major Peter Shepherd had seen the advantages of Esmarch’s new methods around the teaching of First Aid, and he quickly developed a similar method and programme for the British Stretcher Bearers in the British Army Medical Department, and in doing so became the first user of the English term ‘First Aid for the injured’, developing a doctrine in unpublished lectures which covered a comprehensive and wide-ranging set of First Aid skills and not just of those in a battlefield.
In 1878, thanks to Surgeon-Major Peter Shepherd’s existing programme, he and Colonel Francis Duncan took advantage of St John’s new charitable focus, to establish the concept of teaching first aid skills to civilians. The first class took place in the hall of Presbyterian School in Woolwich, near the Woolwich barracks that Shepherd was based at. The class used a comprehensive first aid curriculum.
First Aid training began to spread throughout the British Empire through such organisations as St John and the Red Cross, often as they were in the UK focusing in on high risk activities such as ports and railways.
Although First Aid origins have changed very little since Shepherd’s inception of his lecture programme, the syllabus and best practice in First Aid has changed as we will look at briefly in the next section of this article.
One piece of legislation that has a minor impact on First Aid is The National Health Service Act 1946, which came into effect in 1948, which made it a statutory requirement for ambulances to be made available to be called out by anyone who needed them, laying the foundations for the NHS Ambulance Service as we know it today.
Early First Aid Courses
Some of the earliest First Aid courses would not be accepted in the world that we live in today.
For example, imagine walking into our courses and picking up the training manual that we provide and reading the words:
‘mixed classes of men and women are on no account permitted’.
How would you feel if you read this? Well that is what met learners on their training manuals in 1908. How the times have changed in just one hundred and nine years!
Further examination of the syllabus of 1908 also shows how the world has changed since then. In 1908, there were 5 lectures, lectures 1 to 4 were standard lectures for men and women, however lecture 5 was very gender specific.
Lecture 5 for men focused on:
- Dealing with stretchers,
- Carrying casualties, and
- Transporting casualties.
Lecture 5 for women focused on:
- Preparation for the arrival of casualties,
- Bed preparation,
- Removal of clothing, and
- Preparations for surgeons.
This specific lecture shows how sexist attitudes to gender existed back in the early 1900s, society in the UK has moved on largely from this preconception and you would never see this polarised view on a course today.
We thought that we would provide you with some First Aid advice given in 1908 for hysteria, the training manual would describe the casualty as a young girl, the treatment for hysteria is as follows: (according to the manual of 1908):
- Avoid sympathy with the patient, and speak firmly to her.
- Threaten her with cold water douche, and if she persists in her ‘fit’, sprinkle her with cold water.
- Apply a mustard leaf to the back of her neck.
We are not sure that this advice would go down well in this era of time, but it does highlight to us how different the world really has become in the last century, especially in the area of First Aid.
Brief note on pre-hospital care in recent years
Our main aims of First Aid are the same today as they were back in the 11th Century and of the knights who were specialising in the medical care on the battlefield.
However, over recent years pre-hospital care of the sick and wounded has advanced greatly at an unprecedented rate due to medical research and technological advances. In this day and age, you don’t have to look very far to see an Automated External Defibrillator in a public space around you, giving you the opportunity to use one and save a life.
Not only that, but as we have previously discussed on our European Resuscitation Guidelines 2015 blog, First Aid practices and best practice is today based on research and evidence to ensure the best possible outcome for as many casualties as is possible.