ProTrainings Basic Life Support Manual · Welcome to your ProTrainings Basic Life Support or BLS...
Transcript of ProTrainings Basic Life Support Manual · Welcome to your ProTrainings Basic Life Support or BLS...
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WelcometoyourProTrainingsBasicLifeSupportorBLScourse.BasicLifeSupportcoursescanbetakenasaclassroom,blendedor100%onlinecourse.Pleasecheckifyouareabletotakethiscourseas100%onlineifyouworkinthemedicalsectorasapracticalmoduleisoftenrequired.ThismanualgoeswithallofourBasicLifeSupportcoursesandgivessupportinginformationtoyourcourse.Theremaybesubjectscoveredinthismanualthatwerenotonyourcoursebutyoumayfindtheminteresting.Moreinformationandaccesstofreevideosandmaterialsisavailableatwww.probls.co.uk.
TheclassroomcoursemustbeconductedwithaProTrainingsapprovedinstructor.Youcanfindapprovedinstructorsnearyoubysearchingonwww.procourses.co.ukorbycontactingusdirectlyonsupport@protrainings.euor01206805359.
ThismanualisdesignedtobeusedexclusivelybystudentswhohavecompletedaProTrainingsFirstAidCourseoracoursethathasbeencertifiedbyProTrainingsEuropeLtd.YoucanvalidateyourcertificateandreceiveaPDFversiononlinefromthebottomofwww.probls.co.ukoranyofourwebsites.
Oncompletionofaclassroomcourseyouwillreceiveacertificateandwallet-sizedcardfromyourinstructorinthepost.YoucanalsodownloadacertifiedCPDcertificatefromyourfreeProTrainingsloginarea,aswellasotherdownloads,remindersandweeklyrefreshers.Ifyoudonothavealogin,[email protected].
Makesureyouregisteronlineforthelatestupdates,theseareautomaticforonlinestudents.Yourinstructorshouldhaveregisteredyoualreadyandifyouaredoinganonlinecourseyouwillhavealreadyreceivedyourlogindetailsifyouhavethisbook.OnlineyouwillhaveaccesstovideosandresourcesaswellasbeingabletoprintyouCertifiedCPDcertificateandtocreateyourfreetrainingportfoliorecord.
Formoreinformationonfirstaidandmedicalissuesregisterfreeatwww.firstaidshow.comforthelatestnewsanddetailsofhowyoucanviewoniTunes,Reku,YouTubeandmanyotherformats.
Ifyouhaveanyproblemswithloginorcertificates,[email protected].
BelowareexamplesoftheProTrainingsclassroomcertificateyouwillreceiveinthepostafteryourcourse.OnlinecoursecertificatesareavailableonlinetoprintalongwithCertifiedCPDStatements.
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ProTrainingsBasicLifeSupportManual
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BeforewestartBeforewestartitisworthgivingyouthedefinitionsofsomeofthetermsusedinfirstaid.
GoodSamaritanLaw-statesthatapersonactingingoodfaith,renderingreasonablefirstaidwillnotbeheldaccountablefordamagestothepersontheyareassisting,unlessgrosswilfulmisconductisused.Thislawisnotvalidinsomecountries,forexampletheUK,butotherlawsaretheretoprotectthefirstaider.
Consent-apatientallowingyoutogivefirstaid.Thisisgainedbyaskingthepatientifyoucanhelpthem.Youcanalsoaskaparentorfamilymember.
InformedConsent-youinformingthepatientoftheconsequences,followedbythepatientgivingyoupermissiontogivefirstaid.
ImpliedConsent-whenapatientisunconscious,itisgiventhat,ifthepersonwereconscious,theywouldrequestfirstaid.
Abandonment-initiatingcareandthenstoppingwithoutensuringthatthepersonhasthesamelevelorhighercarebeingrendered.
Negligence-whenyouhaveadutytorespondandyoufailtoprovidecareoryougiveinappropriatecare,andyourfailuretoprovidecareorinappropriatecarecausesinjuryorharm.
UniversalPrecautions-usinggloves,masks,gowns,etc.,foreverypatienteverytime,whenthereisapossibilityofcomingintocontactwithanybodilyfluids
ClinicalDeath-themomentbreathingandheartbeatstop.Typicallyapersonhasahighlikelihoodofbeingrevivedwithoutmuchcellulardamagewhenclinicallydeadforapproximately0-6minutes.Within6-10minutesbraincelldamageishighlylikely.
BiologicalDeath-irreversibledamagetobraincellsandtissues.Ifapersonhasbeenclinicallydeadfor10minutesormore,therewillbeirreversiblecelldamage.Resuscitationisunlikelybutnotimpossible.Withfirstaidwealwaysassumethereisachanceofsurvivalandcontinuetogivehelp.
Child–Agedoneyearoldtopuberty.
Infant–FromBirthtooneyearold.
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FirstAidintheWorkplaceManycountrieshavespecificrulesandregulationsfortheprovisionoffirstaidintheworkplace.IntheUK,theHealthandSafetyExecutive(HSE)laysdownlawswhereemployershavetoprovideadequatenumbersoffirstaidtrainedstaff,whetherthisisaone-dayEFAWorathree-dayFAWCourse.
TheHSEstronglyrecommendsanannualrefresherforfirstaidtrainedstaffandthiscanbedoneusingouronlinetrainingcourseorashands-ontrainingwithacertifiedinstructor.
OtherrequirementsintheUKworkplaceandothercountriesincludethebusiness’responsibilitytokeeparecordofallaccidentsandillnessesinvolvingtreatmentthatoccurintheworkplace.
UnderUKregulations,thecompletedpagesofthisaccidentbookhavetoberemovedandstoredsafelyinaccordancewiththeDataProtectionAct.
ThereareadditionallawsthatrequiretheemployertoreportaccidentstotheHSEwheretheaccidentresultsinmorethansevendays’absencefromwork,deathorseriousinjury,includingnearmissesandindustrialdiseases.
Companiesmayalsohavetheirownin-housefirstaidrecordsthatafirstaiderintheworkplacemayneedtocomplete.
Otherdutiesofafirstaiderintheworkplacemayincludere-stockingfirstaidkits,ensuringadequateprovisionoffirstaidkitsandensuringthatanycontaminatedmaterialiscleanedupanddisposedofcorrectlyfollowinganaccidentatwork.
FurtherinformationonRulesandRegulationsintheworkplaceintheUKcanbefoundontheHSEWebsitewww.hse.gov.uk/firstaid.
HealthandSafety(FirstAid)Regulations(1981)-themainactthatcoversfirstaidintheworkplace.Thisisworthhaving-youcangetitfromHMSOBooks.
ManagementoftheHealthandSafetyatWorkRegulations1999-thisensurescompaniescarryoutriskassessmentsonallaspectsofworkcarriedoutbytheiremployees.
RIDDOR-ReportingofInjuries,DiseasesandDangerousOccurrencesRegulations.
COSHH-ControlofSubstancesHazardoustoHealth(2002).
SocialSecurityAdministrationAct1992-covershowcompaniesreportinformationonincidents.
HealthandSafetyatWorkAct1974-thisrequiresbusinessestomakeprovisionsavailabletoensurethattheyprotecttheirstaffagainstinjuryanddisease.Itcoverscompanies’useofcontractorsandotherpeopleenteringtheirpremises.
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SomeImportantPartsoftheBodyHeartConsistsoffourchambers,aboutthesizeofyourfist,locatedunderthebreastbone.Thefunctionoftheheartistopumpbloodtothebrain,lungsandbody.Yourbodyhasabout5.6litresofblood,whichcirculatesthroughthebodythreetimeseveryminute.
Thecardiovascularsystemcomprisestheheart,arteries,capillariesandveins.
LungsTherearetwolungsandtheirfunctionistotakeinoxygenandreleasecarbondioxide.Roomaircontains21%oxygen.Ourbodiesuseabout4-6%.
Whenwebreatheoutweexhalecarbondioxideandabout16%oxygen.
BrainTellstherestofthebodywhattodoandneedsoxygenonaregularbasis.Braincellswillbegintodiein4-6minuteswithoutoxygen.
Theaveragehumanbrainweighs1.36kilos(threepounds)anduses20%ofthebody'soxygen.
Cells
Allcellsofthebodyrequireoxygencontinuouslytocarryoutnormalfunctions.Carbondioxideisproducedasawasteproductandmustbeeliminatedfromthebodythroughthelungs.Redbloodcellstransportoxygentothetissue.
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TheFearsofFirstAidWehavefoundthatwhenpeopleattendafirstaidcourse,theyareoftenreluctantparticipantsbecausetheyhavefearsandconcernsaboutadministeringfirstaid.Addressingthesefearsandshowingthattheyareeasilyresolvedmakestherestofthelessonmucheasiertounderstandandenjoy.
Fearofbeingsued-thisisthefirstfearpeoplehaveaboutadministeringfirstaid.Manycountrieshavea"GoodSamaritanAct"orsimilarlawthatprotectsfirstaidersofalllevelsfromunnecessarylawsuits.Thekeypointstorememberaretoactwithinyourtraining,askpermissiontohelp,don'tleavethepatientunlessyouhavetoalerttheEMSandactasanormalprudentpersonwoulddo.
Fearofinfection-frombloodandotherbodyfluids.Peoplearegenerallyreluctantofclosecontactwithbodyfluids,aswellbeingconcernedaboutinfectionssuchasHIVandhepatitis.Thisisaddressedbytheeffectiveuseofbarriers,whichwillbecoveredlateroninthelesson.
Fearofdoingsomethingwrong-orsimplynotknowingwhattodo.Theworstmedicalconditionyouhavetodealwithiswhensomeonehasnoheartbeatandisnotbreathing.Inthissituation,thepersonisdeadandyoumustrememberthatyoucannotmakeapersonanyworseiftheyaredead.Anyhelpyouprovidetothatpersoncanonlyincreasetheirchanceofsurvival.Theworst-casescenarioisthattheywillremaindead.
Fearofhurtingthepatient-CPRisareallybasicskill.Medicalresearchtellsusthatanyformofoxygencirculationisthemostimportantfirststepinprovidinglifesupport.TherealproblemisnotindoingCPRwrong,itisinnotdoingCPRatall.Therearesomeinstanceswhereyoucoulddoharm,butwewillcovertheseasthelessoncontinues.Generallyspeaking,firstaidisaboutcaringforthepersonandgettingtheEmergencyMedicalServices(EMS)thereasquicklyaspossible,andinmanycasesthismaymeanjustsittingwith,andprovidingcomfortto,thepatient.
Fearforyourownsafety-ironically,inrealrescuesthisoftenisnotanissue.Infact,inmanycasespeopleautomaticallyentersceneswithoutadequateconsiderationforthemselves.Wewillbelookingatscenesafetyandhowyoucanusethreesimplestepstoensurethatyoukeepyourselfsafeinalaterlesson.
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AskingPermissiontoHelpOnesimplewayofprotectingyourselfagainstthefearofpossiblelegalactionistoobtainthepatient’spermissionbysaying:"Hi,mynameisKeith.Iamafirstaider.MayIhelpyou?"
Aconsciouspatientmayanswerverbally,bynoddingormaybeofferinguphisinjuredlimbtoyou.Allofthesecanbetakenasgainingtheperson'sconsent.
Withanunconsciouscasualty,theycannotgiveyoupermissiontohelp.However,consentcanbeassumedtohavebeengivenasthepatientislikelytohaveaskedforhelpiftheywereconscious.Youshouldstillaskthepersonandintroduceyourself,butwhentheycannotansweryoucanstillhelp.Keeptalkingthewholetimeyouarehelping,asthehearingisthelastthingtogoandthefirsttocomeback.
Ifsomeonerefusesyourhelpandyouarenotabletohelpthem,youcanstillassistbycallingtheEMS,referringtobossesorfamilymembersandtryingtoreassurethem.
Asafirstaiderintheworkplace,youmayhaveadutyofcare.Inthesecasesthecasualtywillusuallyhavetocometoyouforyourhelp.
ChainofSurvivalThechainofsurvivalconceptisdesignedtoshowyouyourroleinanemergencyprocedure.Followingeachlinkinthechaininthecorrectordercangreatlyincreasethepatient'schancesofsurvival.
RememberthelinksinthechainareEarlyActivationoftheEmergencyServices,EarlyCPR,EarlyDefibrillationandEarlyAdvancedLifeSupport.ThefirstaidercarriesoutthefirsttwolinksandoftenthethirdAEDlink,butifhelpisnotcalledforthenthefinallinkwillnotarrive.
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Makesureyoukeepyourself,bystandersandthepatientsafewhenapproachingthesceneofanaccident.Alwaysremembertostop,think,thenact.Checkforanythingthatmaybeadanger,suchasbrokenglass,bodyfluids,electricity,gasortraffic.Rememberthatscenesafetyisyourprimaryconcern.
ChecktheSceneKeyquestionstoask:
• Isitsafeformetohelp?• Whathappened?• Howmanypatientsarethere?• AmIgoingtoneedtocallEMS?• DoIhavemypersonalprotectiveequipmentonandreadytouse?• IsthereanAEDavailable?
CheckthepatientIfitissafetohelp,checkthepatient.
Tapthepatientandintroduceyourself.Ifthereisnoresponse,activateEMS.ToactivateEMS,Call999or112.
IFPATIENTNOTBREATHINGANDYOUAREALONE,PHONEFIRST–ThenstartCPR,donotleavepatienttogolookingforanAED,theEMSwillbringone
IFPATIENTNOTBREATHINGANDYOUARENOTALONE-sendsomeonetocalltheEMSandgettheAED,makesuretheyknowthelocation,whathashappenedandhowmanypeopleareinvolved.
TellthemtocomebacktoyouandtellyouwhattheEMShasadvised.
WhenyoucalltheEMStheywillbeabletogiveyouanyadviceandsupportthatyouneed.Workouthowtousespeakerphoneorhandsfreewithyourphonesoyoucandealwiththepatientwhilegettingadvice.
SceneSafety
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TheABCD’sTheABCD’sconceptisdesignedtogivethefirstaideraguidetowhattodofirstinafirstaidemergency,andtoshowalltheprimarycareandlifethreateningconditions.
A-Airway-openthepatient'sairwaybymovingthetonguefromthebackofthethroat,whichoftenblocksbreathing.
B-Breathing-checkforbreathingforupto10seconds.
C-Circulation-iftheyarenotbreathing,administerCPR.
D-Defibrillation-wherethereisnocirculation,usedefibrillationtoadministeranelectricshock.Thisinterruptsacardiacarrestandshouldallowthehearttostartagain.
S-Seriousbleeding,ShockandSpinalinjury-onceABCD’sareok,wemoveontothese.Allthesewillbecoveredinourcourse.
Beforeenteringintoarescuescene,therescuershouldperformaninitialassessmenttoensurethatthesceneissafe.Next,personalprotectiveequipmentshouldbeworntoprotecttherescuerbeforebeginningtohelp.Ifalone,therescuermayneedtoputthepatientintherecoveryposition,iftheyarebreathing,whileleavingtocontactEMS.Ifthepatientisnotbreathing,thenperformCPR.Therecoverypositionallowsthepatienttobreatheeasily,staysafe,andittakesawaytheriskofthemchokingiftheyvomit.
Barriers–GlovesandFaceShieldsThefearofinfectionmaydetersomepeoplefromprovidingemergencyfirstaid.Effectiveuseofbarriers,includingglovesandfaceshields,protectbothyouandthepatientfromtheriskofinfection.Therearespecialrulesinsomeworkplacesforthecorrectdisposalofglovesandotherinfectedmaterials,soitisbesttocheckyourlocalguidelines.
Therearemanytypesoffacemask,suchaspocketmasksorkeyfobmasks.Theycomeindifferentpackagesbutareallbasicallythesame.TheBSiHSEfirstaidkitsintheworkplacenowcontainafacemask.
Alwaysuseabarrierwhendealingwithanyfirstaidemergency
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PuttingGlovesOnAlwaysusedisposablegloveswhenprovidingfirstaidcare.Ifyouhavealatexallergy,usealatexalternativesuchasnitrileorvinyl.Beforeprovidingcare,makesuretheglovesarenotrippedordamaged.Youmayneedtoremoveringsorotherjewellerythatmayripthegloves.
Remembertouseskin-to-skinandglove-to-glove.Pinchtheoutsidewristoftheotherglovedhand.Pullthegloveoff,turningthegloveinside-outasyouremoveit.Holditintheglovedhand.Usethebarehandtoreachinsidetheothergloveatthewristtoturnitinside-out,trappingtheothergloveinside.Disposeofglovesproperly.Ifyouhavedothiscorrectly,theoutsideofeitherglovewillnevertouchyourexposedskin.
HowBloodbornePathogensareSpreadBloodbornepathogenscanbespreadinanumberofways:
• Sexualcontactistheprimarymodeoftransmission• Whenacontaminatedsharpobjectcutsorpuncturestheskin.Parenteralexamples
include:needlestick,illegaldrugusage,cutsfrombrokenglass,bites• Whenaninfectedbodyfluidgetsintoanopencutormucousmembrane,forexample
insideeyes,mouth,earsornose• Whenacontaminatedobjecttouchesinflamedskin,acneorskinabrasion
Intactskiniswonderfullycreatedasourfirstdefenceagainstdisease.Bloodbornepathogenscannotsoakthroughnormal,intactskin.
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RecoveryPositionCheckthattherearenoinjuriesthatcouldbemadeworsebymovingthepatientandplacethemcarefullyontheirsideusingtherecoveryposition.MonitortheirvitalsignsandkeepthemwarmandcomfortableuntiltheEMSarrive.
Ifyoususpectspinalinjuryandthepatientisinnoimmediatedanger,donotmovethem.Ifyouhavetomovethemontotheirside,asyouhavetoleavethemtogethelportheystarttovomit,thenusetherecoveryposition.
Firstaidistopreventthepatientgettingworseandthiscanbedonewithsomesimpleeasyskillsthatwillbelearntonthecourse.
P-PreserveLife
P-PreventDeterioration-stopthesituationgettingworse
P-PromoteRecovery
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HeartAttacksHeartattacksarecausedbyablockageintheheart,starvingitofbloodandoxygen.Theblockagecanbeintheformofnarrowing,plaque,clotsoramuscularspasm,andcanbefatal.HeartattackisthemostcommonformofdeathintheUK.Theyarenotcommonwithchildrenbutitisimportanttoknowaboutthemjustincaseandsoyouknowwhattodowithanadultsufferingfromaheartattack.
Suddencardiacarrestiswhentheheartstops,butaheartattackiswhentheheartisinmajortrauma.Itcouldstopatanytime.
Abigproblemisthatthepatientoftenwillnotacceptthattheyarehavingaheartattackandthisdelaysthetreatment.
Symptoms• Crushingpaininthecentreofthechest,withpainradiatingbetweentheabdomenand
jaw,possiblydownonearm• Labouredbreathing• Rapidorirregularpulse• Nausea/vomiting• Pale,coldandclammyskin• Grey/blueappearance• Feelingofchronicindigestion
Treatment• Calmthepatientandplacetheminthe"W"position,withheadandlegsraised• AlertEMS• MonitorthepatientsABCs• Loosenclothing• BepreparedtobeginCPRifthepatient'sconditionworsens
AspirinGive300mgtablettothepatientforthemtotake.Theymustchewthetablet,notswallowit,asthishelpsthebodytoabsorbitmorequickly.TheAspodholdstwoAspirinsafelyanywhereyougoandisavailablefromyourProTrainingsdashboard.
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ControllableRiskFactorsTherearemanythingsthatcanincreasetheriskofheartdisease.Someofthemarecontrollableandothersnot.Factorsinclude:cigarettesmoking,highbloodpressure,obesity,lackofexercise,highbloodcholesterollevels,uncontrolleddiabetes,highfatdietandhighstresslevels.
SignsandSymptoms• Chestdiscomfort• Pressure,tightnessthatlastslongerthantwominutes• Nausea• Sweatingshortnessofbreath• Denial• Feelingofweakness
UncontrollableRiskFactorsRace,heredity,sexandage.
Womenpresentmorewithshortnessofbreath,extremefatigueorflulikesymptoms.Aboutathirdofwomenexperiencenochestpain.
TreatmentRecognisethesignsofaheartattackandactivateEMSbycalling999or112.
• Ifpossibleplacethepatientinthe"W"positionwithheadandlegsraised.• Givenothingtoeatordrink• Keepthepatientcalmandquiet• Prepareincasetheygointocardiacarrest
Angina(Adultsonly)AnAnginaattackisnotaheartattack,andAnginaisusuallycontrolledbydrugsbutcandevelopintoamoreseriouscondition.Anginaiscausedbyabuild-upofcholesterolplaqueontheliningofthecoronaryarteryoracollapsedarterialwall,whichmakesithardforthebloodtoflowfreelytotheheart.Anattackcanoftenfollowphysicalexertionorstress.Medicationrelaxesthewallsofthebloodvesselstoallowbloodtoflow.
SymptomsItwillseemlikeaheartattackatfirst.Patientwillexperiencesuddenweakness,anxietyandfear,andtherewillbeevidenceofstressorphysicalactivity.
TreatmentPositionthepatientinthesamewayasforheartattackpatients.Locateandensuretheytaketheirmedication.Usuallywithmedicationandrest,thepainwillease.Ifitdoesnot,orifthisistheirfirstattack,alertEMS.
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OlderChildandAdultCPR
ProvidingCPRcanbeexhaustinganditmaybecomelesseffectiveasyougrowmoretired.Wherepossible,itisbesttosharetheworkwithanotherrescuer.ItisnotimportantiftheotherpersonisCPRtrainedasyoucantellthemwhattodo.Therescuertellstheotherpersonwhattodowhileheisdoingthechestcompressionsandthenwhilehedoesthebreathsthesecondrescuergetsready.Oncompletionofthebreaths,thesecondrescuertakesover.
It'sagoodideatotrytoswapovereverytwominutes.Ifyoubecometiredandnooneisthere,considerjustdoingchestcompressionstohavearestfromthebreaths.
Hands-onlyCPRHands-onlyCPRhelpsencouragelayrescuerstogetinvolvedwhomaynototherwisehelp.ManypeoplearereluctanttogivethebreathsandthisisonereasonwhypeopledonotperformCPR.Withthisnewtechnique,bloodiscirculatedaroundthebody,oxygenatingthebody'stissuesandorgans.
Therescuerdelivers5-6cmdeepcompressionsatarateof100to120compressionsperminutewithouttheneedtodeliverrescuebreaths.Hands-onlyCPReliminatesthefearoftransmittingdiseasebyremovingthemouth-to-mouthcomponentofCPR.
ItisstilladvisedthatyouhandovertoasecondrescuereverytwominutestoensurethatthebestpossiblecompressionsaregivenbeforetheAEDorEMSarrives.
CPRHandovertoaSecondRescuer
AdultCPRisperformedonceyouhavecheckedforpatientresponsivenessandcheckedforbreathingforupto10seconds.Ifthepatientisnotbreathing,activateEMS,perform30compressionsatarateof100to120compressionsperminuteatadepthof5-6cminthecentreofthechest.Compressionsshouldbethesamespeedonthepushandthereleaseandinaregularinterval.Fullrecoilofthechestisvitaltoallowthehearttofillwithblood.
These30compressionsshouldbefollowedbytworescuebreaths.Beforecarryingouttherescuebreaths,makesuretheairwayisopenbytitlingtheheadback,liftingthechinandsqueezingthesoftpartofthenose.Thensealyourmouthoverthepatient’sandblowgentlyforaboutonesecond,youwillseethechestrise.BreathscanbedeliveredasmouthtonosebysealingthemouthormouthtotracheostomyiftheyhaveaStomaintheirneck.
RepeatthecycleuntilanAEDorEMSarrives.Donotwastetimebetweenthecompressionsandthebreaths.Thereshouldbeonlya5-10secondbreakingivingthecompressions.Maximum10secondstoavoiddelaysincompressions.Itisvitaltokeeptheoxygen-richbloodpumpingaroundthebody,whichiswhycompressionsaresoimportant.
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FirstAidFlowchart–OlderChildandAdult
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ChildCPR–1yeartoPubertyChildCPRisaverysensitiveandworryingthingtothinkabout,letalonetohavetodo.ChildrennormallyneedCPRbecauseofarespiratoryproblemratherthanacardiac(heart)condition,whichismorecommonwithadults.Thisiswhywefirstgivefiverescuebreathsandthen30compressions,followedbytwofurtherbreaths.Youthenrepeat30:2untilyouarerelieved,theEMSarrives,thechildshowssignsofrecoveryoryouaretootiredtocontinue.
Whendoingthebreaths,coveryourmouthoverthechild'sandpinchthenoseclosedoruseafaceshield.Youneedtogentlyblowforaboutonesecond,youwillseethechestrise.
Todothe30compressions,placeonehandinthecentreofthechestandpushdownatleastone-thirdofthedepthofthechestatarateof100to120compressionsperminute.Ifyoucannotdothisthenusebothhands.Onethirdisabout5cmonachild.
Ifpossible,sendabystandertocalltheEMSimmediately.Ifyouareonyourown,youshouldusethe"callfast"approachandcarryoutoneminuteofCPR,thenmakethecallyourself.
InfantCPR–BirthtoOneYearOldInfantCPRisagainaverysensitiveandworryingthingtohavetodo.Infants,likechildren,wouldnormallyneedCPRbecauseofarespiratoryproblem.Firstgivefiverescuebreathsandthen30compressions,followedbytwofurtherbreaths.Youthenrepeat30:2untilyouarerelieved,theEMSarrives,theinfantshowssignsofrecoveryoryouaretootiredtocontinue.
Whendoingthebreaths,coveryourmouthovertheinfant'smouthandnoseoruseafaceshield.Blowgentlyforaboutonesecond,youwillseethechestrise.
Todothecompressions,placetwofingersinthecentreofthechestandpushdownatleastone-thirdofthedepthofthechest.Do30compressionsatarateof100to120compressionsperminute.Onethirdisabout4cmonaninfant.
WithaninfantyoumaybeabletocarryhimcarefullytomeettheparamedicwhilecontinuingCPR,althoughCPRisbestdoneonafirmsurface.
Ifthereisabystander,sendthemtocalltheEMSimmediately.Ifyouareonyourown,youshouldusethe"callfast"approachandcarryoutoneminuteofCPR,thenmakethecallyourself.
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FirstAidFlowchart–Child
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FirstAidFlowchart–Infant
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DrowningYoudonotinhalealotofwaterinmostcasesofdrowning.Anywaterconsumedisgenerallyswallowedandoftenvomitedwhenresuscitationtakesplace.
Makesurethesceneissafe.Usethe"callfast"approachanddooneminuteofCPRbeforegoingforhelpifalone.
Givefiverescuebreathsbeforestartingchestcompressions.Thereasonforthisisthatthepersonisnotbreathingbecauseofarespiratoryproblemratherthanacardiacproblem.
CPRwithadrowningcasecanbemoresuccessfulthanwithasuddencardiacarrest.
Secondarydrowningisaproblemthatcanoccurhoursafteradrowningoraneardrowningcase,soprofessionalmedicaladviceshouldalwaysbetaken.
CardiacArrestSurvivalRatesSomedataonCPRhasbeenreleasedbyZollMedical.Whenacardiacarrestoccurs,onlyhalfofvictimswillneedashock.Theotherhalfwillrequirehigh-qualitycardiopulmonaryresuscitation(CPR).Ageneralfigureisthatforeveryone-minutedelayintheAEDarriving,thepatient’schanceofsurvivaldropsby10%.ThisfigureisbasedonnoonedoingCPR.
IfeffectiveCPRisdelivered,thechanceofsurvivaldropsbyjust3-4%perminute.Toclarifythesefigures,itassumesthatthepersonhas100%chanceofsurvivalatpointofsuddencardiacarrest.
ThisevidencehighlightsthateffectiveandpromptCPRisvitalforthepatient’schanceofsurvival.Assuch,effectivetrainingintheseskillsisessential.
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SurvivalratesofwhentheAEDarrivesForabouteveryoneminutetheAEDunittakestoarrive,thepatient’schanceofsurvivaldropsby10%.ThetargettimeistogettheAEDunittothepatientwithinfourminutes,butthisisnotalwayspossibleifthereisnotoneonsite.
ItisvitaltoaskifthereisanAEDunitwhenyoucallforhelp,sothatsomeonecanlooktoseeifthereisonethatcouldarrivesoonerthentheEMS.
WhydoweneedAEDUnitsandwhyaretheyImportant?TheCPReffortsofafirstaiderarethemostimportantstepinsavingapatient’slife.However,whentraditionalCPRdoesnotsucceedinkeepingthepatientalive,anAEDunitwillbeofhugevaluetothefirstaider,whiletheywaitfortheEMStoarrive.
EarlyuseofanAEDunitsaveslivesasitinterruptstheabnormaltwitchingoftheheart(VF),oftenshockingtheheartbeatbackintoanormalrhythm.
AEDunitsareincrediblyeffective,andveryeasytouseastheyhavevoicepromptstotellthefirstaiderwhattodoandwhen.However,trainingfirstaidersintheuseofAEDunitscansignificantlyincreasethechancesofapatient’ssurvivalthroughconfidentandcompetentuseoftheequipment.
TheonlyproblemwithAEDunitsisthattherearenotenoughofthem.Thecostofthemoftenputscompaniesoffbuyingthem,butthisischangingandmoreunitsarebeingplacedwheretheyareneeded.
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WherecanyoufindanAEDUnit?AEDunitscanbefoundinmanyplaces,soyouneedtoaskandbeobservant.SomeworkplaceshaveAEDunitsandthesewillusuallybeinacentrallocation.Youwillalsofindtheminpublicplaces,suchasairports,railwaystations,doctors’surgeries,dentists,shoppingcentresorsportsclubs.
Whenyouaredealingwithacardiacarrest,aswellascallingforhelpyouneedtoaskifthereisanAEDunit,assomeonemayknowwhereoneisandtimeiscritical.
HavealookaroundwhenyouareoutandaboutandyouwillbesurprisedhowmanyAEDunitsthereare.
UniversalAEDSignThereisauniversalsignforanAEDunitanditcanbefoundanywherethereisanAEDunitplaced.
ThesignmaybeplacedontheAEDboxoraboveit,soitcaneasilybeseenfromadistance.
ThissignisalsousedtodirectyoutothenearestAEDunit.
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Different types of AED
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ConsciousChoking–ChildandAdult
Partialobstruction–theycanstillbreath.
Fullairwayobstruction–noaircanpassintooroutoflungs,theycannotbreath.
Ask,"Areyouchoking?"
Ifapersonisunabletobreatheorspeak,treatthepatientasbelow.Iftheycantalkorcough,allowthemtocontinueuntiltheycleartheobstructionoryoufeelyouneedtocalltheEMS.
TreatmentActivateEMS.
ForAdultandChildStandbehindthevictimwithonefootin-betweenthevictim’sfeetandyourotherfootbehindyou.
Performfivebackslapsbetweenthepatient’sshoulderblades.Placetheflatsideofyourfistjustabovethepatient’sbellybutton.Grabthebackofyourfistwiththeotherhandandpullinwardsandupwards.
Continuebackslapsandabdominalthrustsuntiltheobjectisclearedorthepatientbecomesunconscious.Intheeventthatthepatientbecomesunconscious,youwouldperformCPR.
Advisethepatienttoseekmedicalhelpafterwards,eveniftheobjecthasbeensuccessfullycleared.
InfantAdministerfivebackblowsandchestthrustsusingyourtwofingers,untiltheobstructionisclearedorthepatientbecomesunconscious.Placetheinfantonyourlapdownyourlegswiththeheadlowesttoletgravityhelptheobjectcomeout.
SpecialCircumstancesIfthepatientispregnantortoolargetoreacharound,placeyourfistinthemiddleofthechesttoperformchestthrusts.
Neverpracticeabdominalthrustsonarealperson
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UnconsciousChokingThisiswheresomeoneis:
• Unconscious• Nosignsoflife• Absentbreathing• Patientmayhavecollapsedafteryouhave
beenperformingbackslapsandabdominalthrusts
TreatmentActivateEMSifyouhavenotalreadydoneso.Ifyouknowthepatientisnotbreathing,startCPR.
Give30chestcompressionsasperCPR,100-120compressionsperminute,5-6cmindepth.
Checkthemouthforaforeignbody.Ifsomethingisvisible,sweepitoutwithafinger.
Neverdoblindfingersweeps
Attempttworescuebreaths-ifthefirstbreathdoesnotmakethechestrise,repositiontheheadandre-attemptbreaths.Ifthecheststilldoesnotrise,repeatthecycleofcompressions,foreignbodycheckandbreathingattemptsuntilthechestrises.
Afterrescuebreathsmakethechestrise,continuecyclesof30compressionstotwobreathsuntilEMSpersonneloranothertrainedpersontakesover,signsoflifeareevident,thescenebecomesunsafe,AEDbecomesavailableoryouaretooexhaustedtocontinue.
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GlossaryofTermsABCDs-referstotheprioritysequenceforassessingtheorderofprimarycare.Airway,Breathing,CPR/ChestCompressions,Defibrillatorandthenthe“s”forSeriousbleeding,ShockandSpinalinjury
AED-AutomaticExternalDefibrillator
BP-BloodPressure
BPM-BeatsPerMinute
Child-Agedfromoneyearoldtopuberty
COSHH-ControlofSubstancesHazardoustoHealth
CPR-CardioPulmonaryResuscitation
DRAB-referstotheprioritysequenceforprimarycare.Danger,Response,AirwayandBreathing.Oftenalsowitha“C”forCPR/ChestCompressions
EMS-EmergencyMedicalServices
ERC-EuropeanResuscitationCouncil
FAST-usedinstrokeidentification,Face,Arms,SpeechandTime
HSE-HealthandSafetyExecutive
Infant-Frombirthtooneyearold
ILCOR-InternationalLiaisonCommitteeofResuscitation
PPE-PersonalProtectiveEquipment
RIDDOR-ReportingofDiseasesandDangerousOccurrencesRegulations1995
SAMPLE-usedtorememberthethingstolookforwhenassessingillnesses.Signs/Symptoms,Allergies,Medications,Pre-existingmedicalconditions,LastmealandEvents
Sign-somethingyouseeonapatient
SCA-SuddenCardiacArrest
Symptom-somethingthepatienttellsyou
VF-VentricularFibrillation
VT-VentricularTachycardia
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