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INTRODUCTION WHAT IS FIRST AID? First Aid is the provision of initial care for an illness or injury AIM OF FIRST AID Preserve life Prevent condition from worsening Promote recovery RESPONSIBILITIES OF A FIRST AIDER Assess situation Protect from danger. Prevent cross infection. Comfort and reassure casualties. Assessment of casualties Early treatment by priority. Arrange for appropriate help. CHAIN OF SURVIVAL What is Chain of Survival? It is the sequence of actions that will increase chances of survival. CHAIN OF SURVIVAL – 1ST LINK (EARLY RECOGNITION AND ACCESS) Recognition of early warning signs, such as chest pain and shortness of breath, that prompts a person to call 995 before collapse. CHAIN OF SURVIVAL – 2ND LINK (EARLY CPR) CPR is Cardio-Pulmonary Resuscitation CPR is a temporary intervention that attempts to restore breathing and circulation. Loses its value if third and fourth link are not rapidly carried out. CHAIN OF SURVIVAL – 3RD LINK (EARLY DEFIBRILLATION) Defibrillation is a process in which an electronic device sends an electric shock to the heart to stop an extremely rapid, irregular heartbeat, and restore normal heart rhythm. Most effective way to convert ventricular fibrillation (VF) back into normal heart rhythm. CHAIN OF SURVIVAL – 4TH LINK (EARLY ACLS) ACLS is Advanced Cardiac Life Support. It includes the use of equipment to support ventilation, establish intravenous access, administer drugs control arrhythmias and prepare casualty for transportation. CHAIN OF SURVIVAL Any delay could be fatal or results in poor chance of survival should be avoided! PRIMARY SURVEY Purpose of Primary Survey: to diagnose and treat life threatening injuries which, if left undiagnosed and untreated, could lead to death D-R-S-A-B-C-D. PRIMARY SURVEY D for Danger Check surroundings for danger. Remove the danger or move the casualty to a safe environment if required. PRIMARY SURVEY R for Response Establish level of response. Firmly taps casualty’s shoulders and ask loudly: “Hello! Hello! Are you Okay?” PRIMARY SURVEY S for Shout If casualty is unresponsive, immediately call out for help: “Help! Call for Ambulance, 995. Get an AED !” If a phone is available nearby, call ambulance first. PRIMARY SURVEY A for Airway Head Tilt-Chin Lift manoeurve is effective in opening the airway. HOW TO DO HEAD TILT CHIN LIFT? 1. Place one hand on the casualty’s forehead and apply pressure to tilt the head back. 2. Place two fingers of the other hand at the angle of the jaw bone. 3. Lift the chin forward and support the angle of the jaw, helping to tilt the head back. PRIMARY SURVEY B for Breathing (Awake) Ask casualty to take deep breath and observe chest movement. Observe for any abnormal speech. If laboured or painful breathing, expose chest and look for life threatening injuries. PRIMARY SURVEY B for Breathing (Unconscious) While maintaining an open airway, the rescuer will check the casualty's breathing. Rescuer’s ear over casualty’s mouth and nose. Observe casualty's chest. LOOK – for chest rise and fall LISTEN – for air inhalation and exhalation FEEL – for the flow of air on your cheek CHECKING FOR BREATHING If No breathing, Start CPR. PRIMARY SURVEY C for Circulation Rapid Body Survey (<30s) for major hemorrhage, treat if found. Perfusion (SCTM) Skin Colour (Pale/Pink/Cyanosed) Capillary Refill Time Temperature (Warm/Cold) Moisture (Dry/Moist) PRIMARY SURVEY D for Defibrillation Use of Automated External Defibrillator (AED). It is a portable electronic device that diagnose and correct arrhythmia of the heart. Most effective way to convert ventricular fibrillation back into normal heart rhythm. SECONDARY SURVEY Systematic process for checking other injuries. D for Assess AVPU GCS Disability cerebral function. E for Environment/ Examine Protect from Environment/ Expose to check for injuries Head-to-Toe VITAL SIGNS Level of consciousness (LOC) Respiration Pulse Body Temperature (if required) HISTORY To find details what happened and any previous history. SAMPLE Symptoms Presented Allergies Medication Past Medical History Last meal Event history REASSESMENT Vital Signs Review Wound Dressings or Bandages CPR PROTOCOL D-R-S-A-B-C Check for Danger Check for Response Shout for help Open Airway Check for Breathing Chest Compression CPR Cycles of 30 Chest Compression : 2 Ventilations CHEST COMPRESSION Landmark at lower half of the sternum. Compression rate is at least 100 per minute. Compress at least 5cm Ensure full recoil of the chest after each compression 1&2&3&4&5& 1&2&3&4&10& 1&2&3&4&15 1&2&3&4&20 1&2&3&4&25 1&2&3&4&30 CHEST COMPRESSION CHEST COMPRESSION •Each Ventilation over 1 sec, just enough to make the chest rise. •Ventilation volume: 400ml – 600ml. WHEN TO STOP CPR? Repeat the cycle (30:2) until •Someone can take over •Casualty wake up or show signs of life. •AED analysing rhythm.