Munich - Many motorists are uncomfortable with the subject of first aid. The first-aid course they took to obtain their driving licence is often long past, and they feel unsure of themselves, unqualified, and fearful of making mistakes, noted the Munich-based German automobile association ADAC.

For these people, a nightmare scenario is suddenly having to administer first aid following an accident. Emergency physicians say such fears are groundless, however, because there is little a first aider can do wrong - quite the contrary.

A study by Munich University Hospital's Institute for Emergency Medicine and Management in Medicine (INM) found that first aid was "on the whole sufficient" in only 59.1 per cent of all emergencies. In 24.8 per cent of the cases, first aiders acted insufficiently, and 16.1 per cent of the time they did nothing at all.

The INM said that willingness to help depended largely on a person's self-assessment of competence. There are circumstantial factors too, it noted. People who are not professional first responders are more likely to help if they have witnessed the entire accident.

And the greater the number of people present at the scene of an accident, the less likely someone would provide assistance. Everyone shifts responsibility to the others, said Karin Burghofer, an INM psychologist.

Almut Schoenermarck, director of ADAC's traffic medicine department, said that while she understood first aiders' nervousness and agitation, inaction was not justified.

"Any help is better than none at all," she remarked.

Schoenermarck pointed to studies showing that even incorrect cardiopulmonary resuscitation improved the chances of survival. In cases of cardiac arrest, time is of the essence. "After seven minutes, permanent brain damage can be expected," she said.

Considering that the average interval between an emergency call and the arrival of an ambulance is about eight minutes in Germany, first aiders are clearly important.

According to the Berlin-based German Red Cross, first aiders should secure the scene of the accident, rescue injured persons from the danger zone, make an emergency call, and position the injured.

An injured person who is unconscious but breathing normally should be placed securely on his or her side. After this, wounds should be covered cleanly, and bleeding should be staunched with a tourniquet.

If no breathing can be detected, the injured person should be placed on his or her back for cardiopulmonary resuscitation. Schoenermarck described the steps: Expose the person's chest and place both hands in its centre, between the nipples. Then, with elbows kept straight, push down four or five centimetres. After 30 compressions, pinch the person's nose shut and breathe into the mouth twice.

"The compressions should have priority," she said.

The psychological effect is important apart from the procedure itself, Schoenermarck noted. Simply knowing that someone is there is a huge help to an injured person. (dpa)