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First Aid With CPR & AED canfitpro Mission United as members, canfitpro delivers the world’s best, accessible, affordable, and attainable fitness education and experiences. Vision As the leading global provider of fitness and wellness education, canfitpro empowers people to lead passionate and fulfilling lives through safe, fun, and effective physical activity. 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 • • • • • • • • 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 • • • • 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 • Scalp or Ear • 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 • Snake Bites • Insect Bites and Stings • 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 • • • • 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 • • • 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 • • • • • • • 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: • • • • • 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 • • • • • • • • • 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 • • • • • • 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 • • • • • 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 • • • • 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? Please fill out an evaluation form and return to me. THANK YOU!