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First responders

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First responders

Offering support to customers in need of first aid is something that pharmacy teams are well-versed in, but as with many areas of health and wellbeing, the pandemic has changed public behaviour. Anecdotal reports suggest that more people have been attending pharmacies when they would previously have sought assistance from minor injury clinics or even A&E. Consequently, pharmacy staff are being called upon to have up-to-date knowledge of first aid. 

Chief executive of the Company Chemists’ Association Malcolm Harrison believes that community pharmacy has gone above and beyond throughout the pandemic. He says: “Many people sought advice for first aid and injuries from community pharmacies during the early stages of lockdown rather than visiting A&E or their GP. Overall, this past year has demonstrated the vital role that community pharmacies play in providing urgent services.” 

Mr Harrison suggests that NHS England needs to do more to encourage referrals to community pharmacies, “so that the sector can start to make an impact on the estimated 20 million appointments every year that can be safely moved from general practice to pharmacy.”

Mentholatum senior brand manager Elvy Mardjono believes community pharmacy has always been ideally placed to be the first stop for first aid and minor injury advice. “However,” she says, “history and A&E figures have shown us that it has not always been used in this way.”

Ms Mardjono believes that the pandemic has particularly raised awareness of the role of community pharmacy in pain relief first aid. “Since the pandemic started, pharmacies have been visited more, especially by consumers needing pain relief while waiting for a GP appointment,” she says. “With nearly 90 per cent of people within a 20-minute walk of a pharmacy, stock choices should be based around high traffic categories and distress purchases.”

Elaine Walker, senior brand manager for Deep Relief, recommends that pharmacies create an enhanced first aid feature, including topical painkillers. “A selection of topical analgesic products is essential in every household’s self care toolkit,” she says. “There are a variety of applications, alongside topical triple action analgesic gels, that can also be discussed – to suit the site of the pain, or the customer’s preferences – such as patches, sprays, creams, glide-ons and roll-ons with cold and hot therapy options.”

stock choices should be based around high traffic categories and distress purchases

Nelson’s global head of professional education Sofia Rizzo suggests taking a holistic approach and being sure to stock natural remedies. “Two out of three people now prefer natural options, so ensure that you have a range of natural products for customers to choose from, including products with herbal extracts, that are paraben/perfume free and suitable to cover all bases,” she says.

Keeping Nelsons Arnica Cream in a first aid kit could help heal bruising and aid muscular aches, tension or sprains, she adds. “And Rescue Remedy, known as the ‘emergency remedy’ can support in times of emotional demand.” 

Aside from the usual first aid situations, new exercise habits induced by lockdowns over the past year have contributed further to demands for first aid care. According to Kaye Mackay, senior brand manager for Deep Heat & Deep Freeze, recent research suggests that more people are suffering from minor injuries like pulled muscles because they have a new found love for exercise, but are failing to warm up properly. 

“For instance,” she says, “our research found that a scary 44 per cent of people have had to specifically deal with exercise-related pains born out of poor warm-up preparation. These included knee pain, elbow pain, pulled muscles and groin strain.”

It’s important therefore to advise customers to spend time priming their body for exercise. “Recommending a dynamic warm up is essential prior to exercise,” she says. “If customers know they have muscles or joints which always ache after exercise, they need to focus on these areas during their warm up. They can use a classic heat rub or a heat muscle massage roll-on to massage the area, allowing warmth to penetrate and start working to relax and ready muscles and joints before starting warm-up exercises.”

Ms Mackay adds that it’s equally important to cool down the body properly after exercise. “There is a temptation to just stop once you have finished exercising,” she says, “but taking the time to do a proper cool down is beneficial. Gentle stretches will help release any build-up of lactic acid and increase flexibility. Over time, regular stretching will increase strength, mobility and balance. Plus, it’s a great way to release muscle tension, and there are even studies showing that stretching increases metabolism and burns calories.”

In 2018, a study evaluated the effects of using an aerosol plastic dressing as a protective barrier before applying a compressive adhesive dressing, focusing on skin damage, pain, and itching. Researchers found that applying the aerosol dressing first led to a reduction in skin damage incidence, with reduced rates of blister, irritation, and erythema. 

A useful addition to the first aid kit could therefore be Cuxson Gerrard’s Carnation Spray Plaster, which is said to offer immediate protection and form a breathable, flexible film that helps stop dirt and bacteria getting into minor cuts and grazes.

First aid at work: the legal requirements

The Health and Safety (First-Aid) Regulations 1981 sets out essential aspects of first aid that employers must address. Full details are available on the Health and Safety Executive website here, but in essence, an employer must provide or make available adequate equipment and facilities to enable first aid to be administered to employees if they are injured or become ill at work.

Things that need to be considered include:

  • Hazards and risks in the workplace
  • Previous history of accidents
  • The size of your organisation
  • Working patterns
  • Distribution of workforce
  • Remoteness of site from emergency medical services
  • Annual leave and other absences of first aiders or appointed persons
  • First aid provision for non-employees, customers and visitors.

As a minimum, first aid provision should include:

  • A suitably stocked first aid kit
  • An appointed person to take charge of first aid arrangements
  • Information for employees.

The Health and Safety Executive recommends that companies with between five and 50 employees should have at least one first aid trained person, and for low risk workplaces with 25 to 50 people, there should be at least one first aider with an Emergency First Aid at Work certificate.

Call for recognition

A 2020 survey carried out by PAGB indicated that attitudes to accessing health services are changing. Almost a third of people (31 per cent) said they were more likely to consult a pharmacist as their first option for a self-treatable condition, while 77 per cent of those who had previously considered A&E as an option for self treatable conditions said it was less likely to be their first port of call.

PAGB chief executive Michelle Riddalls believes pharmacy teams are well placed to advise on over the counter products to help treat injuries such as minor cuts, bruises and burns, and to suggest remedies for aches and pains caused by sport or exercise. “We believe pharmacists’ expertise should be better recognised and utilised so that they can support self care more effectively,” she says. “They should have appropriate access to individuals’ medical records to ensure that any advice they give is based on the best available information, and they should be able to refer people to another healthcare professional, such as a GP or a physiotherapist, if they believe that’s necessary.’

PAGB would also like to see more online triage systems signposting people towards local pharmacies for self treatable conditions. “These are measures that would encourage people to visit their pharmacy as a first option where self care is appropriate, freeing up resources in urgent care centres and A&E departments – as well as GP appointments.”

after a year of lockdowns, 64 per cent of 18 to 29-year-olds are starting to experience back problems

Any increase in treating patients as a result of the pandemic should be met with additional funding, believes the Royal Pharmaceutical Society (RPS). “There are already well established community pharmacy services providing support for minor ailments,” says RPS director of pharmacy Robbie Turner. “It’s vital that these services are maintained and strengthened to meet demand and utilise the accessibility, expert clinical knowledge and growing prescribing capacity of community pharmacists.”

Upskilling your team

The two qualifications recommended by the Health and Safety Executive (HSE) for first aiders are Emergency First Aid at Work (EFAW), and First Aid at Work (FAW). 

EFAW is a one day course that teaches trainees how to respond to a range of accidents and first aid emergencies, including how to assist someone who is:

  • Unresponsive and not breathing, including how to use an automated external defibrillator (AED)
  • Unresponsive and breathing
  • Having a seizure
  • Choking
  • Bleeding heavily
  • Suffering from shock
  • Suffering from a burn or burns.

The course also includes information on:

  • Assessing and monitoring casualties
  • Where to get help
  • Electrical incidents
  • Accident recording and reporting
  • Control of substances hazardous to health (COSHH).

The First Aid at Work (FAW) qualification is a three-day course covering a wider range of topics. Both qualifications are valid for three years, but annual refresher courses are recommended to ensure staff stay up to date with their knowledge.

The Red Cross offers EFAW courses from £126 per person, and FWAW from £279. See here for details or check the HSE website for other providers across the UK.

A range of helpful first aid resources can be downloaded from the St John Ambulance website, including free posters for pharmacies and two pocket-sized guides, Essential Baby First Aid and This Guide Saves Lives.

Backs need extra care

According to Mentholatum, before 2020, back pain was already costing the UK £10 billion a year, and it accounted for four out of every 10 sick days. But a recent survey revealed that after a year of lockdowns, 64 per cent of 18 to 29-year-olds are starting to experience back problems too. 

Ms Mardjono believes that appropriate pain relief should be a priority for community pharmacy. “Pain relief is consistently the largest consumer health category and sales have increased 2.7 per cent on the previous year,” she says. “Lockdowns, with their accompanying home working, home schooling and the new ‘normal’, have led to an increase in the number of people experiencing musculoskeletal and back pain. Topical analgesics are particularly important in the pharmacy collection for this type of pain and are also vital for people looking to avoid taking oral painkillers.”

Pharmacy staff can direct customers to Mentholatum’s Mind Your Back campaign, which is designed to help manage back health and general wellbeing via five simple STEPS – Stretch, Therapy, Exercise, Posture, and Strengthen.

Child’s play

Children are prone to scrapes and minor injuries, and in recent years, the choice of branded plasters and brightly coloured dressings designed to take the sting out of a sore knee has been growing. 

However, Lorna Smith, founder of Baby Aid, suggests that while appropriate first aid products are important, character branded products are not a big issue for very young children. She says: “Parents of babies are more concerned with choking, high temperatures and burns – and are looking for a comprehensive first aid solution. When the babies become toddlers and pre-schoolers, branding becomes more important to help cheer up young children with less serious first aid needs.”

Views from the P3pharmacy category panel

“This is a really important sector for us. We don’t sell first aid kits as these can be expensive, but we do stock all the components. Plasters, especially hypo-allergenic and eco-friendly, are year-round great sellers as we are in a popular tourist location. Silver healing and waterproof are also popular, as are dressings for surgical wounds; we offer customers advice on the best type to choose. Customers like options. It’s important to keep a large display of first aid products in your pharmacy.”

Sarina Mughal, Day Lewis, Knightsbridge

“This is a huge category in our pharmacy, and we’ve had many more people coming for advice in the last year; Covid has opened the public’s eyes to what they can get from their local pharmacy. The school sometimes sends children to us to decide on a course of action. In lockdown, we saw lots of people who’d had DIY accidents as the nearest hospital is 30 miles away. We do some first aid kits, but most prefer to make up their own as it’s cheaper. Elastoplast is our best seller.”

Fiona McElrea, Whithorn Pharmacy, Dumfries & Galloway

“I would be surprised if a day goes by when I don’t advise someone about a burn, cut or graze. Burn plasters with a cooling gel element, like HypaPlast, are great for minor burns. For more severe burns, we recommend Jelonet alongside an adherent dressing. Variety is important. Include burn plasters, spray on plasters, antiseptic creams, adherent and non-adherent dressings, bandages, micropore tape and plasters. Create a shelf edger advising the must haves in a first aid kit for home or for travel.”

Ellis Nugent, Well Pharmacy, Llantwit Major, South Wales

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Common conditions