Air Canada Flight Attendant Manual: First Aid and Universal Precautions
General Definitions and Objectives of First Aid
First aid is defined as the emergency care provided to a casualty who has been injured or suddenly becomes ill. This care utilizes readily available materials and is administered while awaiting the arrival of medical help or during the preparation for transportation to medical facilities. While Cabin Crew are explicitly not permitted to diagnose or treat injuries and illnesses beyond those of a minor nature, they are recognized as trained first responders who are required to administer first aid to any person with suspected injuries or illnesses.
The primary objectives of providing first aid are tripartite: to preserve life, to prevent the specific injury or illness from becoming worse, and to promote the recovery of the individual. In the context of these procedures, medical help is defined as the specific treatment provided by or under the direct supervision of a qualified medical professional. This treatment may occur at the scene of the incident, while the casualty is being transported, or once they have arrived at a medical facility.
Age Guidelines for First Aid Techniques
To ensure the application of appropriate first aid techniques, casualties are categorized into three distinct age groups. An Adult is defined as any individual years of age and over. A Child is categorized as an individual between the ages of and years. An Infant is defined as any individual under the age of year ().
Safety Protocols While Providing First Aid
Safety is the paramount concern during any first aid intervention. Cabin Crew must maintain a rigorous focus on three safety pillars: their own safety, the safety of other passengers, and the safety of the sick or injured passenger. To ensure this safety, crew members must use all protective equipment available onboard and assess the scene to remove any risks before approaching the casualty.
Caution must be exercised to prevent injury to oneself or others. For example, a casualty situated in a passenger seat may need to be moved into the aisle or a galley area if they require Cardiopulmonary Resuscitation (CPR) or the use of an Automated External Defibrillator (AED). If the galley area is utilized, crew must stow all applicable items, including carts, carriers, and coffee pots. Despite a medical emergency, casualties must be properly secured for landing, and Cabin Crew are required to sit in their assigned jump seats during take-off and landing.
Universal Precautions in First Aid
Universal precautions are standardized safety measures applied to protect the caregiver, the casualty, and any bystanders from infection. These measures are common in health care professions and are mandatory for Cabin Crew. Hand washing is the primary defense; crew must use soap and running water for approximately immediately after any contact with a casualty and must strictly avoid touching their eyes, mouth, ears, and nose.
Gloves must be worn whenever there is a possibility of contact with a casualty's blood, body fluids, open wounds, or sores. Sharp objects must be handled with extreme care. To minimize the risk of disease transmission during rescue breathing, a face mask designed for this purpose should be used to avoid mouth-to-mouth contact. Crew members should cover their mouths when coughing, ask others at the scene to do the same, or step back. The Universal Precaution Kit (UPK) must be employed when handling potentially infectious spills, such as blood, urine, vomit, or feces.
Protective Equipment and Supply Management
Health authorities generally do not recommend the arbitrary use of masks, gloves, or other personal protective equipment for healthy Cabin Crew or passengers, as regular hand washing remains the most effective defense against disease transmission. However, protective equipment is provided in each flight satchel and kit, including glycerin soap bars, antiseptic towelettes, gloves, and masks. This equipment must be used responsibly and according to guidelines if health and safety are threatened.
Masks specifically must be changed if they become moist, physically damaged, visibly soiled, or if they make breathing difficult. If a passenger's mask becomes soiled, they may be directed to place it in an airsickness bag. In the event of cabin depressurization, Cabin Crew are required to make an announcement instructing passengers to remove their protective masks before donning oxygen masks. Furthermore, crew members must remove their masks to deliver oral shouted commands clearly.
Antiseptic towelettes or wipes are provided to aid in preventing the spread of disease and can be used on any equipment handled during first aid. Gloves are provided in two types: Nitrile (blue) and Vinyl (clear). Gloves found in First Aid and Medication kits are reserved strictly for medical emergencies. Clear vinyl gloves from the flight satchel are permitted for use during pick-up tasks in the Premium Rouge and Economy cabins.
Step-by-Step Procedure for Glove Removal and Disposal
Used gloves are considered contaminated and a source of infection. They must be removed without touching the outer surface. The procedure begins by grasping the cuff of one glove and pulling it toward the fingers, turning it inside out as it is removed. This glove should then be held in the palm of the remaining gloved hand. The wearer then slides their fingers under the cuff of the second glove and pulls it toward the fingers, turning it inside out over the first glove. A knot is tied in the top of the combined gloves before disposal.
If gloves are torn during first aid, they must be removed immediately, hands should be washed if possible, and a new pair must be donned. Proper disposal involves placing used gloves into the red bio-hazard bag found in the Universal Precaution Kit. Following disposal, hands must be washed with soap and running water as soon as possible.
The Universal Precaution Kit (UPK)
The Universal Precaution Kit is mandatory for handling potentially infectious spilled body fluids. The kit contains several specialized items: a Red-Z fluid control pouch, Sanizide Plus germicidal disinfectant, P.A.W.S (Personal Antimicrobial Wipe), a disposable impermeable mask, disposable impermeable gloves, a disposable impermeable gown, a large absorbent wiper towel, a pick-up scoop with a scraper, a red bio-hazard disposal waste bag, and an instruction sheet.
Red-Z is a dry powder used to treat liquid spills. When sprinkled onto liquids, it converts them into a harmless granulated gel, which can then be easily collected using the scoop and scraper. Red-Z also functions to immediately eliminate most odors associated with vomit, urine, or feces spills.
Cleanup and Disposal Procedures for Infectious Spills
When managing infectious spills, Cabin Crew must disinfect the affected surface area using Sanizide Plus germicidal disinfectant wipes. Heavily soiled items such as seat covers, blankets, or pillows must be placed directly into the red bio-hazard bag. Any soiled floor surfaces require an entry in the Cabin Defect Log. All contaminated materials, including the gloves used during the cleanup, must be placed in the red bio-hazard disposable plastic bag.
This bag is then disposed of in the garbage. To conclude the process, crew members must wipe their hands with a P.A.W.S antimicrobial hand wipe and then wash thoroughly with soap and running water as soon as possible.
First Response and Emergency Scene Management (ESM)
To ensure proper care and the well-being of a sick or injured person, Cabin Crew must be prepared and respond rapidly but safely using the principles of Emergency Scene Management (ESM). Verbal or implied consent must be obtained before touching a casualty. Crew members must use reasonable skills and care consistent with their level of training. Additionally, they must protect the casualty's personal belongings and keep unnecessary people away from the scene.
The Pilot-in-Command (PIC) must be kept informed of the situation, including the condition of the casualty and the care being provided. Crew members are responsible for reassuring the family or friends of the casualty and completing all required documentation. A crew member must remain with the casualty until they can be handed over to medical help.