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American Red Cross First Aid/CPR/AED For Schools & the Community Lay Responder (non-professional) Deciding to Act • Consent to give first aid • Actual consent• Implied consent- - definition -if its an adult - child with and without parent -mentally competent/non-mentally competent Good Samaritan Law Article 1. How many states have enacted this law? 2. Why was it DEVELOPED? 3. What does the law protect you from? 4. What doesn’t the law protect you from? 5. List the 5 things you must do so the law will protect you? Do No Further Harm Article 1. List the 3 reasons you would have to move an injured victim? 2. What should you AVOID when you are moving an injured victim? 3. What is the proper technique called to move an unconscious or severely injured victim. Universal Precautions p. 711 • • • • • Universal Precautions1. 2. 3. Follow any situation with possible contact with blood and other bodily fluids. Emergency Action Principles ( 3C’s) • Check – Scene • • • • Safe? Clues # of victims Bystanders to help – Victim • Injuries • Life threatening conditions – – – – – Unconscious Trouble breathing Chest pain or pressure No pulse Bleeding severely • Call – 911 or local emergency # for ambulance & get an AED if available – Give • Exact location • Telephone # • What happened • # and condition of victims • What help is being given • DON’T HANG UP TILL DISPATCHER DOES! • Care for victim – Life threatening injuries 1st ( ABCS) – Less severe – Help victim stay calm, relaxed Checking Conscious Adult 1. State your name, certifications,obtain consent and ask what happened. 2. Check for life threatening injuries, from head to toe. (A,B,C,S) 3. Do not ask the victim to move and do not move the victim. 4. Look for a medical alert tag and ask questions. 5. Call 911 or have someone call if serious. Position Terms: • Supine - On their back • Prone- Face down • Recovery- On the side( roll as one unit, no twisting. Checking Unconscious Adult 1. 2. 3. 4. See text pg 723 Check the scene Tap & Shout“Are you alright?” “Go call 911.” & get AED Check for Signs of Life (A, B, C’ S) – Open airway Head Tilt Chin Lift (tilt head back, lift chin) listen for breathing no more than 10sec. • If suspect back, neck or head injury Do not Tilt Neck – Breathing: recovery position Choking Terms P.725 • Partial Airway Obstruction- when a victim can partially move air to and from the lungs, cough, & speak. • Complete Airway Obstruction- When a victim can no longer speak, cough, breath. – Universal distress Signal- Conscious Choking Adult ( Breathing Emergencies) • • • • • 1. GET CONSENT 2. Call 911 & get an AED 3. Give 5 Back Blows 4. Give 5 Abdominal thrusts 5. Alternate until choking stops or they become unconscious. – – – – Stand behind victim Find belly button Make fist with other hand Place thumb side of fist against middle of victims abdomen (just above belly button) – Grab fist with other hand – Quick upward thrusts – CONTINUE UNTIL- object is up, victim can breath, coughs on own, or victim becomes unconscious * Chest Thrusts- obese, pregnant females If you are alone & Choking 1. Give yourself abdominal Thrusts 2. Use the back of a tall chair to perform the thrusts for you. 3. Call 911 from a land line phone( they will trace call) Unconscious Choking - Find hand placement ( heal middle of sternum) 5. 30 chest compressions( at least 2in deep) 6. 2 Rescue Breaths 7. If breaths don’t go in, RE-TILT & TRY AGAIN 8. 30 chest compressions 9. LOOK FOR OBJECT 10. 2 more breaths 11. Continue with cycles How to Give A Rescue Breath • 1. Head Tilt Chin Lift (open airway) and pinch nose. • 2. Give a slow breath with a complete seal (each breath should last 1 sec.) • 3. Watch the chest rise • Gastric Distention- when you ventilate( breath) too hard and the air skips the lungs and goes into the stomach. Unconscious Choking Adult • Stop cycles if – Object removed – Chest rises with rescue breaths • Check for signs of circulation • If none continue with compressions and breaths – – – – Victim starts breathing on own EMS arrives & takes over Someone else takes over If you are too exhausted to continue After 5 Cycles Re-check for SIGNS OF LIFE If you DO NOT know they are choking After the first set of rescue breathes for an ADULT & the breaths DO NOT go in -YOU REPOSITION & TRY THE BREATHS AGAIN! Cardiopulmonary Resuscitation (CPR) • See text pg 734 • No Signs of Life, No AED, Unconscious • Adult- 12 years or older – Place yourself midway between the head & chest (kneeling) CPR • 1. Give 30 Chest Compressions – At least 2 inches deep – Takes about 18 sec (rate of approx 100 per min) • 2. Give 2 rescue breaths – Lasts about 1 sec each – Continue sets of 30 compressions & 2 breaths for 2mins or 5 cycles then re-check for signs of life. • Once CPR is started continue until – – – – – See signs of life Scene is unsafe AED available Too exhausted Someone takes over Cardiac Chain of Survival • 4 links 1. Early recognition and access to emergency system - call 911 2. Early CPR - keeps blood and oxygen flow to organs, prevents brain damage and death 3. Early Defibrillation - Automated External Defibrillator (AED) - Electronic shock to heart 4. Early Advanced Life support - Paramedics Hearts Electrical System The hearts electrical system sends out signals to pump blood, but if the heart is damaged by a disease or injury the electrical system can be disrupted. - Fibrillation- most common abnormal heart rhythm that causes sudden cardiac arrest occurs when ventricles quiver. Hearts electrical system continued.. • Ventricle Fibrillation or V-Fib- electrical impulses fire at random • Ventricular tachycardia (V-Tach)electrical system tells ventricles to contract too quickly Automated External Defibrillator (AED) • Child (1-8 or less than 55lbs) pediatric pads • Do not use in water • Cell phone at least 6ft. away • Can use with a pace maker • Remove clothing on chest & wipe chest • Remove nitroglycerin pads • AED will talk you through procedures **FOR EVRY MINUTE THE AED IS NOT IN USE IT DECREASES THE CHANCE OF SURVIVAL BY 10% AED Steps 1. TURN ON AED AND JUST SIT AND LISTEN TO DIRECTIONS…… 1. Remove clothing from chest/wipe chest dry 2. Place Electrode pads on person’s chest 3. Plug in connecter 3. Analyzing rhythm, stand clear 4. Shock advised 5. Push shock 6. Start 5 cycles of CPR 7. Re-analyzing rhythm stand clear Recognizing a heart attack p.739 • Heart Attack- death of cardiac muscle to the heart due to a blockage • Signs ( most people ignore or deny) – Chest discomfort or pain (may spread to other body areas) – Sweating – Nausea – Shortness of breath – General ill feeling • Deaths are reduced by recognizing early symptoms of heart attack Cardiac Arrest • Cardiac Arrest- when the heart stops following a heart attack/blockage Sudden Cardiac Arrest- is when the heart stops beating suddenly & unexpectedly, when this happens bloods stop flowing to all vital organs • Respiratory Arrest- when breathing stops Each year there are approx. 300,000 cardiac arrests outside of the hospital. 2000 of those occur under the age of 25 & lead to premature death. Clinical & Biological Death The best chance of survival is within the first 4 mins. • Clinical Death- after breathing & circulation have stopped you have 4-6 minutes of stored oxygen before your cells begin to die. • Biological Death- after 10 minutes, brain activity stops. Injuries • Check – Scene – Victim • Life threatening • Head to toe • Call 911 • Care – Give care until help arrives Injuries • Types – Wounds/ Burns (Soft Tissue) – Muscle, Bone, & Joint Muscles, Bones, & Joints pg. 716 • Muscles – Strain: tearing or stretching of muscles or tendons • Tendons- strong fibers that attach muscle to bone • Bones – Fracture: a break, chip, or crack in a bone • Types: – Open (compound) – Closed (simple) • Deformity, snap, and pain may be present Muscles, Bones, & Joints Pg. 717 • Joints – Sprain: tearing of ligaments at a joint • Wrist, knee, ankle, & finger • Ligaments- strong, tough, soft tissue bands that attach bone to bone – Dislocation: the movement of a bone out of its position in the joint. Usually caused by a violent force tearing the ligaments that hold the bone in place. • Finger – Apply ice, immobilize and go to doctor – **** Do not try to pull it out Muscles, Bones, & Joints • Signs of severe injury: – Can not move or use body part – A snap or a pop is heard – Bone is visible – Significant bruising, swelling, or deformity Care for Muscle, Bone & Joint Injuries PG. 717 • R- Rest • I- Immobilization • C- Cold Apply ice for up to 72 hours • 20 min on 20 min off • E- Elevate ** Keep part immobile, if have to move victim, 1st splint injury. Do not elevate a severe injury unless it has been splinted Immobilizing Muscle, Bone & Joint Injuries PG. 716 • Splint: • Types • Anatomical- Splinting an uninjured body part to an injured body part. • Ex’s• Soft• Ex’s• Rigid• Ex’s- Guidelines to Splinting • Only if victim must be moved • Only if you can do without causing more pain • Splint in position you found it • Splint above and below site of injury • Check for proper circulation before and after splinting (feeling, warmth, & color) Steps to Splinting 1.Support injured area 2.Check circulation 3.Place splint 4.Tie splint in place 5.Recheck circulation Care for Wounds (External Bleeding) Pg. 740 • Minor Wounds – Cleaned & covered – Open Wounds • Control bleeding • Prevent infection – Clean & cover – Closed Wounds • Apply cold • Major Wounds – Call “911” and control bleeding Wounds 740 • • • • • Bruise Incision Laceration Abrasion Avulsion * If you cut off a finger you would put it in_______ and take it with you. • Puncture Infection- Bleeding • Use Latex Gloves • Arterial- bright red (oxygenated) • Venous- darker blood ** Approximately 2 pint per 25 pounds Clues to Internal Bleeding • Tender, swollen, bruised or hard areas of the body • Cool, moist, pale or bluish skin • Vomiting or coughing up blood • Excessive thirst • Confused, faint, drowsy, or unconscious ** Serious Internal Bleeding- Call “911” immediately Control Bleeding Pg. 742 1. Cover with a dressing and press firmly using Direct Pressure 2. Elevate Injury 3. If bleeding doesn’t stop – Add additional dressings over top Shock (see text pg 733) • Circulatory system fails to deliver blood to all parts of the body • Life threatening condition • Types – Insulin – Traumatic (sudden injury) – Anaphylactic (sting, medication, seafood etc.) Shock • Signals of Traumatic Shock – Restlessness or irritability – Altered consciousness – Pale, cool, moist skin – Looks disoriented – Rapid breathing – Rapid pulse – Dilated pupils Caring for Shock • • • • • Lie down and rest Control external bleeding Maintain normal body temp Elevate legs if injuries allow Make sure advanced help is on the way Seizure P. 712 • Seizure – Do not hold or restrain victim – Do not place anything in their mouth ( unless trained) – Remove objects that may cause injury – Cushion head/place something under head – PUT IN RECOVERY POSITION? WHY? Sudden Illness Pg. 712 • Stroke • Diabetic Emergency – Help victim remain calm & get medication • Poisoning/ Allergic Reactions – Call 911 & Poison Control # Caring for Sudden Illnesses • • • • • • • • • Care for life threatening conditions Have victim rest in comfortable position Keep from getting chilled or over heated No food or water Reassure victim Send someone to meet EMS Ask about medical conditions & medications Monitor, try to minimize risk of shock Watch for changes in consciousness or breathing