Hurt/Comfort Month: First Aid in H/C Fic

[muccamukk]

Tony Stark selflessly preforming first aid on Steve Rogers. The Avengers v3 #70.

The structure of H/C is usually such that we have some discussion of the hurt, then later we get comforting to make the hurt better. The hurt is frequently injuries in battle, torture, illness or odd things done by aliens and/or wizards. The comfort may or may not involve wild monkey sex, or snogging at the very least. However, between the horrible torture and the wild monkey sex, there is usually some kind of scene wherein the comforter (let's call him Tony) finds the hurt person (Steve, for example) in a state of hurtness (totally a word!). At this point, Tony will probably have to do something immediately to help make Steve better, or at least to keep him from dying before Tony can cradle his seemingly lifeless from in his iron-clad arms and fly away into the sunset (or into the local hospital).

This would be first aid.

Necessary Disclaimer:
I'm not a first aid instructor, and if I were I wouldn't be allowed to randomly teach people first aid over the Internet. This post is for writing interests only, and information herein (what there is of it, as I plan to be vague) ought not to be used in meatspace. Please, if you're at all interested, go out and take a first aid course. Heck, take one if you're not interested. It's good stuff to know.

That said, I have taken first aid every two years for the last twelve years, and currently hold a marine first aid certificate. Additionally, I was raised in the bush, and my parents were into first aid to the point where, when encountering incorrect first aid when reading stories aloud, they would both stop and explain why one should never ever put butter on a burn or just go and yank out out a jagged shard of alien crystal embedded in one's leg. Which is probably why bad or completely absent first aid in stories makes me twitch to this day. It's also why running into well-used first aid makes me make little clappy motions with my hands and write good reviews.

All that out of the way, we can now move on to:

What Is It?
The main point of first aid is to keep a sick or injured person alive until actual facts medical professionals can fix the patient in a more comprehensive manner. This has secondary goals such as knowing how not to make injuries worse (like randomly carting about someone with broken bones), and knowing some things about aiding recovery once the patient gets to a hospital (so that what you do doesn't get in the way of what the doctors are likely to do). Most courses deal with taking care of an injured person for up to an hour, though you can take more involved programs such as marine or wilderness first aid which handle what to do if you're on a boat or in the back country and far away from help.

First aid also teaches how to look after minor injuries that don't need professional attention, but the first point is key. The goal of a first aider is to keep the patient alive, and if possible ready for transport, not to make injuries all better fixed. As an example, Tony's right on here: I've only rarely heard of CPR making someone's heart start beating again on its own. The point is too keep blood to the brain until the King of Wakanda professionals can step in.

Who Knows It?
In that the Avengers spend so much time engaged in either battle or disaster relief, I'm pretty sure Steve would make knowing some kind of first aid a requirement on joining the team. I would like to take this opportunity to say that anyone who writes about a Mandatory Avengers First Aid Course will be my friend forever, because those things are goofy enough as it is, without throwing Wolverine into the mix.

Not everyone we're writing about is actually in the Avengers, but first aid is still a pretty widely-held skill set when it comes to people who would interact with Our Heroes. Anyone who has a job that requires them to potentially deal with sick or injured people is going to know first aid. For example: Police officers (Monica and Misty), military personnel (Rhodey, Carol and Jarvis [and probably Steve, though first aid in 1944 ≠ first aid now]), spies and agents of S.H.I.E.L.D. (Sharon, Jessica Drew, Natasha, Bobbi, Maria Hill, and Nick), and people who have worked in science labs (Hank, Jan, Bill and Reed). That's just for starters, too. Many workplaces require at least one available first aider at all times. Lots of people take one course or another on their own, especially if they think they're likely to deal with say, Tony Stark; who's a disaster zone in progress a lot of days.

It's up to each writer, but I tend to default to most people around the Avengers knowing first aid.

Basic Use in Meatspace
So here's what's supposed to happen:
Assess Scene: A first aider is not supposed to enter a situation that has the potential to injure the person offering assistance. This is on the theory that two injured people are more trouble to rescue than one (As an example: not far from where I live, one worker saw another lying unconscious on the ground, and didn't think to assess the danger but just went in after him. It turned out the area the unconscious worker was in was flooded with poison gas from a mine shaft. Both workers died).

Assess the patient: the first aider is also supposed to do a careful and complete assessment of the patient. Treating immediate needs like oxygen and blood circulation, and then moving onto secondary care of potentially dangerous but not immediately lethal conditions. Secondary care includes treatment for shock, hypothermia, burns, cuts that aren't going to bleed out immediately, broken bones, and so on. This is also supposed to be done in an orderly fashion.

Stay where you are: When encountering a sick or injured person, a first aider should keep the injured person where zie is and assess the situation. Only when the first aider is confident that it is safe to do so, can the person be moved. If there is any doubt, or moving the person has the slighest potential to make things worse, zie should stay where zie is. The main reason for this is that there are often unseen internal injuries, especially to the neck and spine, that moving a patient could aggravate.

The only exception to these steps is if the patient and/or the first aider is in more danger if they stay were they are. For example, if the building is about to explode.

Probable Use in Comics
Which is the thing with comics and fic for comics fandoms: the building is always about to explode (/burn down/be vaporised by aliens/turn into a giant mushroom/be trampled by dinosaurs). Therefore, writers can and do realistically short cut a lot of the above, and that's okay. Steve is going to just rush into a burning building to save Tony. Tony can totally just grab Steve and go, because potential spinal injuries are less bad than guaranteed consumption by mutant giant squid. (Plus there are ways to move someone in a hurry that minimise the risk of further injury). Also, someone who is experienced in dealing with combat injuries, such as all of the Avengers after about two weeks on the job, will be able to cram a lot of this assessment stuff into a pretty short time.

Also, in that a lot of our heroes are meta humans, we're going to feel less worried about some of them. Luke isn't going to bleed out from a bullet wound (externally, at least); Carol's unlikely to suffer from electrical burns, Logan's pretty much going to be fine no matter what, and Tony has a healing factor for the period in which he had the Extremis (start of New Avengers through the end of Secret Invasion, more or less). Plus the whole lot of them, meta or not, regularly bounce back from getting punched through walls, with no apparent damage done.

However, we're still talking about writing H/C. These people can and do suffer from injuries, and can and do require healing cock treatment. In fact, being meta human can make treatment more complicated. A canon example is the New Avengers arc wherein Luke Cage suffered a serious heart attack, and they couldn't do surgery because of the whole unbreakable skin issue. Tony likewise has heart conditions largely unknown to medical science, and regular sedatives or pain killers may or may not work on Steve (my canon on this is a little fuzzy). There's a whole lot of wiggle room one way or another when it comes to writing this stuff.

TL;DR
I am in no way suggesting that authors extensively quote the standard first aid manual every time they write about an injury. That would be pretty dull. There is, however, a right and a wrong way to treat any situation involving an injury, that most characters will probably know. Even a little research beforehand will save an author from writing about characters using chest compressions to make an already established heartbeat stronger (I swear I actually read that once), or smearing antibiotic cream on second degree burns, or moving a potential spinal injury for no reason.

Also, first aid is fun! We've all read hypothermia fic, and CPR seems to come up a fair bit, but did you know that part of treating shock actually is hand holding and talking comfortingly to the patient? And there's all sorts of excuses to feel people up! (-coughs- which makes being a first aider sound skeevier than it actually is, but work with me, here).

For Example
In a Different Light by marinarusalka
In which Hank applies proper treatment after Tony gets chemicals in his eyes. Oh, and there's hilarious and touching H/C plotty goodness that follows.

Good Things Come in Cold Packages by Nix
Hypothermia porn. Why mess with the classics?

Hold Me Down by Elspethdixon and Seanchai
More hypothermia porn. Sort of, there's damaged heart stuff and emotional trauma as well. These two write great H/C in which many people (well, usually Tony) are injured and then receive correct medical treatment (and sex).

Plus, you know, everything I've written on the topic is technically flawless, because I'm perfect like that -g-

I've been trying to think of more than this all morning, and there's totally more out there, but apparently my brain's melted. Please comment with your favourites. Or pet peeves when it comes to incorrect first aid. Or glaring errors anywhere in the above essay.