This article is intended to give you introductory guidance about First Aid in the context of applying henna to a variety of clients and is not meant to be followed in isolation to specific legal and medical advice. In order to feel fully confident about hennaing, and what to do if it goes wrong there is no substitute for attending a first aid course given by an appropriate body. A neat way to do this is through your normal employer, they are often on the lookout for first aiders.
Appropriate bodies in the US are:
American Red Cross http://www.redcross.org
Appropriate bodies in the UK are:
St John’s Ambulance http://www.sja.org.uk/
British Red Cross http://www.redcross.org.uk/
Appropriate bodies in Canada are:
Canadian Red Cross: http://www.redcross.ca
St John Ambulance Canada: http://www.sja.ca/english/links/canada.asp
You can also contact your local Occupational Health Service or local schools and colleges for courses which they might be hosting.
First Aid is the care which you administer to another person in order to save their life. This includes (but is not limited to):
1. Chest compressions
2. Mouth to mouth resuscitation
3. Immobilising fractured limbs
4. Making strains and sprains more comfortable
5. Assisting people with chronic conditions in emergency situations
6. Stopping or reducing bleeding
7. Dealing with burns and scalds
8. Dealing with poisoning
9. Dealing with chemical burns
10. Dealing with allergic reactions
First Aid is about preventing a bad situation from getting worse whilst the patient is transferred to someone who really knows what they are doing! It is not about prescribing treatment – no matter how innocuous or effective you believe that treatment to be.
With henna, the most likely situations will involve poisoning, chemical burns, and allergic reactions. Remember though that you will also be equipped to deal with any First Aid Incident occurring in the future!
The following information is adapted from the 'First Aid at Work Manual' ISBN 0954190807, by A. Sumpner. However any up to the minute first aid book written by an official organisation (St John's ambulance, Red Cross etc) will contain the same info. If you follow the recommendations given in such a manual you will not do anything you shouldn't!
The principles of first aid are to:
1. Assess - what has happened? ask questions - are you allergic to anything?, are you on medication?, is there any pain? Remember that not only could your client be allergic to henna itself (check out the black henna warning pages on this website for info about henna reactions to real henna), any of the ingredients you use or a reaction between what you apply and something else they have already applied to their skin that day. It may even be a reaction to something else which has just become apparent because of your clients heightened awareness during the application of henna.
Check the ingredients in your oils. Many oils are adulterated with unexpected ingredients. Another thing to watch is nut oils. Almond and other nut oils could cause problems for people with nut allergies and are often used as carrier oils for other oils.
2. Diagnose – This is the point at which you give your best guess at what has happened. If you suspect that it could be something to do with your henna then tell your client that. ‘It looks like you MIGHT have had a reaction to one of the ingredients, or something else you have used on your skin today’ is all you need to say. Go through your ingredients again and check for allergies and previous reactions.
3. Treat ONLY to save life - or prevent the condition from worsening. All you need to do (or ask your client to do) is to remove the henna with clean running water for at least 10 minutes. Do not suggest any treatments. In the context of first aid you will be deemed to have prescribed a medicine and could make matters worse than they already are.
4. Dispose - This is the point at which you pass on the patient to someone who really knows what they are doing! You have four options:
1. Return the patient to whatever they were doing
2. Advise them to see their GP,
3. Take them or have them taken to hospital (non-emergency)
4. Call an ambulance if it is an emergency.
5. Record the incident. This is really important. Write down as much information about the incident as possible. Names, dates, times, what happened, what was said, what can be done in the future to prevent the same occurring in the future. Get details of any witnesses as well. YOU WILL FORGET! Keep this somewhere safe.
The Legal context
It is important to be aware of the law and regulations governing first aid, and the most questions which are asked in first aid training are 'how do I avoid getting sued when all I am trying to do is help?'
The relevant legislation you might want to check up on is:
COSHH : Control of Substances Hazardous to Health
You can check out the website at: http://www.hse.gov.uk/hthdir/noframes/coshh/coshh2.htm
COSHH is basically the information that you see on the label of any household chemical such as bleach. The information includes what ingredients are in the product and what to do in the event of ingestion, getting into eyes, etc.
You will be able to obtain COSHH information from your supplier. COSHH sheets contain all the relevant information including specific, up to date medical treatment information. If you follow their guidance you just can't go wrong at all.
Criminal and Civil Law
Sexual assault – A critical element of first aid is that dignity and confidentiality are maintained at all times. Your patient might not be that concerned with the reaction but does get cross when you accidentally touch them in a sensitive place. Similarly they might not want to announce, in front of your queue that they are receiving treatment for a STD!! It is important to realise that this applies whenever you apply henna. It is really easy to get lost in applying henna (especially at an event when you are under pressure) and suddenly realise that you have been resting or leaning in a sensitive or inappropriate place. Try to keep aware of what you are doing and avoid unnecessary or inappropriate physical contact or ask your client permission if you really can’t avoid it. Maintaining dignity extends to making sure that your client does not need to expose their body beyond what is comfortable to them so make to clear what will be expected of them.
Common assault - Just the physical act of touching someone else without consent or permission can technically be interpreted as common assault. You have to ask permission to look and touch and if this is refused immediately refer the person onto the St John's ambulance or first aid tent (if at a festival), their GP or the hospital. You should also make note of this.
Trespass or theft – This is especially important if you need to lay your casualty down, they faint or otherwise lose consciousness (for example just standing up on a baking hot summers day is enough to cause someone to faint!). You must make sure that their possessions are OK. If you need to remove anything (e.g. jewellery) you must make sure you have a witness and make an inventory of the things you remove.
Negligence - Negligence exists where you:
a) Have a duty of care
b) There is a breach of that duty
c) Harm results
For example you henna someone, they come to you 5 minutes later and show you a great big red blister where you hennaed and you ignore them. You hennaed them, you are the expert, and you therefore have a duty of care. You breached that duty by not advising them to wash off the henna with water, harm resulted because they decided the best thing to do, in the absence of your advice was to leave the henna on and the blistering got even worse.
What you can do to help yourself
1. Attend a First Aid course
2. Make sure you have an up to date First Aid book to hand which you can refer to if in doubt
3. Find out all of the ingredients in your ingredients and assess the hazard they may present and the appropriate treatment or get hold of the appropriate COSHH sheets for them (COSHH : Control of Substances Hazardous to Health). Make sure you have copies of this handy ‘just in case’. If your patient takes this info to hospital with them they will receive fast, appropriate treatment. I actually have little leaflets for the event of someone having a problem which they can take with them to hospital
4. Have fresh clean water available for washing away henna that causes a reaction
5. Publicise your ingredients and make sure your clients understand the risk they are taking
6. Make sure that you are familiar with the henna application guidelines available on this website (links to the guidelines about not hennaing over broken skin etc)
7. Do not offer any treatment to your client – that is prescribing medicine and you are not trained for that
8. Get insured!
We are in the business of wanting to make people happy and beautiful and on the whole we achieve this! However it is unfortunate that we live in a day and age where problems are often someone else’s fault and you need to protect yourself from this. You also need to make sure that your protect yourself from allegations of misconduct, sexual assault and common assault. The best way to protect yourself is to spend a few hours preparing for your worst henna disaster and make sure that you are ready to cope with it – it could save you lots of time, money and heartache in the future!
What marks a professional is not how they behave when things go right but what happens when things go wrong!
12th August 2004
First Aid Resources on the Web: