Emergency First Aid

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Transcript Emergency First Aid

First Aid With
CPR & AED
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Course Objectives
• Be able to safely assess emergency situations and carry out
appropriate action including informing emergency services
• Identify and understand the limits of first aid
• Discuss and demonstrate the appropriate care for a casualty
• Perform CPR, demonstrate appropriate first aid care, and
know how to use an AED, while doing no harm to a casualty
• Identify strategies that will promote a safe and healthy
lifestyle
Introduction to First Aid
First Aiders Roles &
Responsibilities
First Aid Terms
• First aid is the care given by first person on
scene
• First aider is a person who takes charge and
provides care to casualties
• Medical care is given by professionals,
doctors, nurses, paramedics and firefighters
Goals of First Aid
• Preserve life
• Prevent injuries or illnesses becoming
worse
• Promote recovery
Priorities of a First Aider
1. Airway – open and clear
2. Breathing – effective breathing
3. Circulation – effective circulation
(skin temperature, colour and sweating)
Casualty
• Adults – 8 years +
• Child – 1 to 8
• Infant – less than 1 year old
Signs & Symptoms
• Signs: objective indications of something that
is typically detected by a physician.
• Symptoms: subjective indications of
something that is typically reported by a victim
5 Common Fears
• Doing the wrong thing / making things
worse
• Personal safety
• Diseases
• Dealing with blood / gross situations
• Getting sued
The Good Samaritan Act
• Identify yourself
• Ask Permission
• Act Reasonable
( no cutting, sewing or poking)
• Stay with casualty
Principle of Abandonment
Once you start providing first aid to a
casualty, you must continue helping unless:
• It is necessary in order to activate EMS
• Someone with equal or greater training takes
over
• Continuing to provide assistance would be
unsafe
• You are physically exhausted
Personal Protective Equipment (PPE)
• When providing first aid or CPR at a minimum
put on gloves ( latex free )
• Eye protection
• Use masks or face shields
• Gowns
Emergency Medical Services
Activating EMS
• Provide the dispatcher with:
• the number of casualties
• age and gender of casualties
• condition of casualties
• location of emergency
• Stay on line until the dispatcher tells you it is okay to
hang up
• Ask dispatcher the estimated time of arrival for EMS
• If a bystander calls EMS, ask them to report back to you
to ensure that EMS has been activated
Utilizing Bystanders
•
•
•
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•
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•
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Phone EMS
Wait for EMS
AED available
Remove hazards from scene
Crowd control
Get supplies (e.g., blankets)
Protect casualties belongings
Write down details of incident
Emergency Scene
Management (ESM)
Emergency Scene Management
• Emergency Scene Management (ESM) is a
rapid, systematic and orderly manner used to
treat a casualty in an emergency
• Steps to ESM
– Scene Survey
– Primary Survey
– Secondary Survey
– On Going Care
Scene Survey
• Check for hazards (ladder, glass, chemicals, etc.)
• What is the risk to you? What, if any, further risk is
there to the casualty?
• What happened?
• Possible spinal injury?
• How many casualties are there?
• Is the scene changing?
• Is there an AED or First Aid kit close by?
Primary Survey
• Check responsiveness
Level of Consciousness
(1) Alert
(2) Verbal
(3) Painful
(4) Unconscious
Primary Survey
• Check Airway
• Check Breathing
• Check Signs of Circulation
Secondary Survey
Talk to a responsive casualty, or ask bystanders to
find out more about what happened and the
casualty’s history
Happened?
Hurt?
History?
On-Going Care
• Give first aid for any injuries or illness
discovered during assessment
• While waiting for help:
• Monitor the casualty
• With serious injury, repeat the ABCs,
every 5 minutes
Triage Assessment
Breathing
Bleeding
Burns
Bones
Review: ESM
Unconscious
• Scene Safety
•
•
•
•
M.O.I.
Id. self / consent
Unresponsive
Call 911
• Primary survey
• Secondary survey
• Ongoing casualty care
Conscious
• Scene Safety
• M.O.I.
• Id. self / consent
• Responsive
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•
•
•
Primary survey
Secondary survey
Call 911 ?
Ongoing casualty care
Recovery Position
An unconscious adult or child who is breathing
and has no other life threatening emergencies
should be placed in the recovery position
Head & Spinal Injuries
Responsive Casualty
Head Injuries
• Concussion - bruising or
swelling of the brain
• Hematoma - pooling of
blood in the brain
• Laceration - tearing of the
brain tissue
General Signs & Symptoms Head Injuries
•
Deformity
•
Black Eye(s)
•
Bruising
•
•
Unequal pupils
Disabling headache or
one of sudden onset
•
Blood/Fluid from
Eyes/Ears/Nose
•
Projectile vomiting
•
Paralysis
•
Ringing in ears
•
Confusion
Spinal Injuries
• Falls from heights, sports injuries,
car accidents and direct blows to
spine are common causes of
spinal injuries
• Spinal injuries are also
associated with head injuries
Spinal Injuries
Signs & Symptoms of a Spinal Injury
• Numbness, tingling, weakness in arms and/or
legs
• Respiratory distress
• Fluid in the ears
• Deformity
• Pain in back or neck
• Inability to move arms and/or legs
• Loss of sensation or paralysis in upper or lower
extremities or below injury site
Spinal Injuries
• Do not move the casualty any more than
necessary
• Support the head and neck to prevent
worsening the injury
Pelvic Injuries
• Broken pelvis may cause severe internal
bleeding and organ damage
• Foot on injured side usually turns outward
• Can be a life-threatening injury even if no
significant injuries can be seen
• Complications include: injury to the spine and
damage to the bladder
Signs & Symptoms of Pelvic Injuries
• Signs of pain and tenderness around the
hips
• Inability to walk or stand
• Signs and symptoms of shock
Fainting & Shock
Shock
Failure of the cardiovascular system to
provide oxygen to cells and tissue
Causes include:
• External / internal bleeding
• Allergies
• Infection
• Dehydration
• Burns
• Trauma
• Heart attack
• Nervous system injuries
Signs & Symptoms of Shock
• Pale Skin
• Anxiety
• Sweating/Clammy • Cyanosis(blueness)
Skin
of lips/ears
• Cold
• Trembling
• Weakness
• Labored breathing
• Nausea
• Weak/rapid pulse
• Thirst
Shock
Treat the cause
Rest & Reassure
Warm
Elevating the legs is no longer recommended
The risk of further injury outweighs the benefit of
elevation when a person is injured.
Fainting
• Fainting occurs when there is a temporary
lack of oxygen to the brain, causing a
person to ‘black out’ temporarily
• Casualty will be responsive within 10
seconds
Bleeding & Wound Care
Bleeding
• Many injuries cause external or internal
bleeding
• Bleeding may be minor or life
threatening
Classification of Bleeding
Arterial Bleeding – squirting, bright red
Venous Bleeding – steady flow, dark red
Capillary Bleeding – dark red
Control of Bleeding
Direct Pressure
Rest
Signs of Infection
Swelling
Heat
Ache
Redness
Pus
External Bleeding
•
Amputations (partial & complete)
•
Embedded Objects
•
Nosebleeds
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Scalp or Ear
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Gums, tongue and check
•
Palm of the hand
Abdominal Injuries
• Include closed and open wounds
• Commonly result from a blow or a fall
• May involve internal and/or external bleeding
• Can be a life-threatening injury even if no
significant injuries can be seen
Abdominal Injuries
• Closed abdominal injury can be life
threatening. Internal organs may have
ruptured and there may be serious internal
bleeding
• Open abdominal injury can be life
threatening. May involve significant
bleeding. Organs possibly protruding from
wound
Bites & Stings
•
Animal Bites
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Snake Bites
•
Insect Bites and Stings
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Leeches and Ticks
•
Jellyfish Stings
Internal Bleeding
• Any bleeding within body when blood does not
escape from wound
• Closed wound may cause local bruise
• More serious injury can cause deeper organs
to bleed severely
• Can be life threatening
Internal Bleeding
Minor:
Major:
• Contusion
(Bruise)
• Swelling and deformity
over specific areas
(abdominal, head,
chest, pelvis) or over
major organs (spleen,
liver, kidneys)
• Minor
swelling
can occur
Seek Medical Attention
• Bleeding is not easily controlled
• Any deep or large wound
• Wound is infected
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•
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Any bite from an animal or human
Foreign object or material embedded in the wound
The casualty is unsure about tetanus vaccination
The casualty may need stitches for:
• Cuts on the face or hands when the edges do not close together
• Gaping wounds
• Cuts longer than 1 inch
Burns
Burns
•
Burns are injuries to the skin and other
tissues caused by heat, radiation, electrical
or chemical
•
They are the leading cause of injuries in the
home
Severity of the Burn
•
The depth of the burn (degree)
•
The amount of body surface that is burned
(rules of nine)
•
The part(s) of the body that is burned
•
The age and physical conditions of the
casualty
Burn Depth
First Degree
Second Degree
Third Degree
Complications
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Shock
Infection
Swelling
Medical Conditions
Diabetes, Seizures,
Asthma & Allergies
Diabetic Emergency
• Problem of maintaining a
balance of blood sugar and
insulin in body
• Without treatment, can quickly
progress to a medical
emergency
• Diabetics may carry glucose
tablets in case of low blood
sugar
Diabetic Emergency
• Type 1 - Insulin Dependent
• Type 2 - Non-Insulin Dependent
Low Blood Sugar = Insulin Shock
(hypoglycemia)
High Blood Sugar = Diabetic Coma
(hyperglycemia)
Low Blood Sugar
• Sudden dizziness, shakiness, or mood
change (even combativeness)
• Headache, confusion, difficulty paying
attention
• Pale skin, sweating
• Hunger
• Clumsy, jerky movements
• Possible seizure
High Blood Sugar
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•
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•
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Frequent urination
Drowsiness
Dry mouth, thirst
Shortness of breath, deep rapid breathing
Breath smells fruity
Nausea, vomiting
Eventual unresponsiveness
Seizures
• Caused by a sudden disruption of the
brain cells
• Epilepsy, brain injury, diabetes, fever,
drugs, alcohol and poisoning can all
cause seizures
Seizures
1.
Clear Area
2.
Protect Head
3.
9-1-1
4.
Recovery
•3 H’s
•Happen, Hurt, History
•Follow-Up
Asthma
• In an asthma attack, airway becomes narrow
and person has difficulty breathing
• Many asthma casualties know they have the
condition and carry medication for
emergencies
• Untreated, a severe asthma attack can be
fatal
Asthma
•
Asthmatic attacks are often caused
by triggers such as cold, pollen,
paint smoke pet hair, foods, insect
bites etc
•
During an attack, airflow is restricted
or reduced to the lungs one of three
ways:
•
Muscles around the air passage tighten
•
Inner linings of air passages swell
•
Amount and thickness of mucous
increases
Anaphylaxis
• Anaphylaxis is a severe and potentially lifethreatening allergic reaction, which needs
immediate medical attention
• Causes include:
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Insect bites and stings
Foods
Inhaled substances
Chemicals
Medications
Epinephrine
• Epinephrine helps the victim breathe by
relaxing constricted airways in the lungs
• It increases heart rate, diverts blood to the
muscles, constricts blood vessels and opens
the airways
• The epinephrine auto-injectors delivers its
dose directly into muscle
Cardiovascular Diseases
(CVD)
Risk Factors
Preventable
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Diabetes
High Blood Pressure
(HBP)
High Blood Cholesterol
(HBC)
Stress
Lack of exercise
Smoking
Obesity
Alcohol
Diet
Not preventable
• Hereditary
• Age
Stroke & TIA
Stroke & TIA Signs and Signals
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Numbness
Sudden weakness
Trouble speaking
Vision problems
Severe headache
Dizziness
Anatomy of the Heart
The function of the heart is to circulate (pump) blood
throughout the body to provide oxygen and nutrients
and to remove waste products
Angina & Heart Attacks
Angina:
A disease caused by the
narrowing of the coronary artery
Heart Attack:
Death to an area of the HEART
muscle due to a lack of oxygen
Heart Attack
Heart Attack
Pale
Indigestion
Anxious
Tightness
S.O.B.
Overall Weakness
Sweat
Nausea
Sudden Cardiac Arrest
&
Cardiopulmonary
Resuscitation (CPR)
Sudden Cardiac Arrest
Sudden cardiac arrest
occurs when the
heart's electrical
system malfunctions
and the heart stops
beating effectively
Time is Critical
Adult CPR (One Rescuer Sequencing)
1.
2.
3.
4.
5.
6.
7.
8.
9.
Assess environment
Determine unresponsiveness
Activate EMS
Attempt to get AED
Open airway
Check for breathing
Landmark and begin compressions
Provide two rescue breaths
30 compressions:2 breaths until EMS arrives or
victim responds to treatment
Reminders
• Ensure chest rises with each breath
• Location of Hands
• Allow chest to recoil completely or return
to its normal position
• Compression rate: 100/minute
Automated External
Defibrillator (AED)
Introduction
What is an AED???
•
•
•
An Automated External
Defibrillator (AED) is a
machine that can monitor
heart rhythms
It can tell if the heart has
stopped beating effectively
If required, the machine
can then deliver an electric
shock to the heart
How AED Units Work
Defibrillators work by giving
the heart a controlled
electric shock, forcing all
the heart muscles to
contract at once, and,
hopefully jolting it back into
a normal heart rhythm
Do AED units replace the use of CPR?
• CPR's function is to circulate blood and
oxygen throughout the body
• The AED does not take the place of CPR
• The function of an AED is to restore a
normal heart rhythm
Using an AED
• Turn “ON” AED unit
• Voice and visual
instructions occur
immediately
• Follow prompts
When pads are attached
to the patient the AED will
automatically assess the
patient.
Prompts: “Assessing
heart rhythm” and “Do
not touch the patient”
When ready to deliver a
shock, the unit will advise:
• “Press the shock button now”
• Button will illuminate when
system is charged
AED Algorithm
Chain of Survival
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•
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Early activation of EMS
Early CPR
Early defibrillation
Effective advanced life support
Integrated post-cardiac arrest care
Choking
Effective vs. Ineffective Breathing
• Effective breathing can be defined as
having: a good air supply, an open airway, an
intact chest wall and one functioning lung
• Ineffective breathing occurs when the body
is not getting enough oxygen to function
Choking
•
•
•
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Unable to speak
Unable to cough
Hands at throat
Face changing
colour
Choking
1. Determine severity of
obstruction.
2. If mild, encourage coughing
and reassure victim.
3. If severe, shout for help,
start cycles of 5 back blows
and 5 abdominal thrusts
until airway is clear, or
victim becomes
unconscious.
Choking
1.
2.
3.
4.
5.
6.
7.
Assess environment
Determine responsiveness
Activate EMS
Attempt to obtain AED
Open airway
Assess breathing
Landmark and provide 30 chest
compressions
8. Look in mouth for object (remove only if object seen)
9. Give one rescue breath, if it fails reposition head and try again
10. Repeat sequence until successful or EMS arrives
Special Considerations
Special Considerations for:
• Pregnant casualty
• Obese casualty
• Self-Rescue
Questions? Comments?
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return to me.
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