First aid fundamentals (28th October 2010)
1st
2nd
part : education Department of anaesthesiology and inten. medicine, SNP 1 st.
part :education Department of Traumatology, Rastislavova 43 st.
Seminary room KAIM 2nd floor, SNP st. 1, we ask students to wait for teacher
on the 2nd floor in front of University Department of Anaesthesiology & Intensive Care
Exercise date
Time
Seminary room
KAIM
Lecture
PA
14.00 – 15.30h
3.11.2010
Wednesday
10.00-10.45h
DM 4ab
29.10.2010
Friday
KAIM
12.00- 12.45h
Substitute date
3.12.2010
Friday
TEST
14.00- 14.45 h
Substitute date
Substitute date is for students, who were not able to arrive for normal date.
3.12.2010 14.00h TEST: 10 MCQ First aid ( Basic life support adults, Pediatric basic life
support, Shock, Wounds, Heat Stroke, Burns ,
Emergency Rescue and Transfer – Removal from Automobile,…
Literature: First Aid Manual, Latest Update, St John Ambulance Association, 2005,
www.erc.com,
Moule P., Albarran J., 2009: Practical resuscitation for healthcare professionals
www. books.google.com
Paediatric
basic life
support
Monika Grochová MD, PhD
Klinika anestéziológie a intenzívnej medicíny LF
UPJŠ a UNLP Košice
• www.erc.edu
www.resus.org.uk
• Resuscitation (2005, 2010) 67
Supplement
• Resuscitation (2005, 2010) 67
Basic life support
A
B
C
irway – airways opening
reathing – arteficial ventilation
irculation – recovery of circulation
CBA adults
Paediatric basic life support
• simplification based on the knowledge that
many children receive no resuscitation at
all because rescuers fear doing harm
Age:
- An infant is a child under 1 year of age
- a child is between 1 year and puberty
25 kg, 8. years
CPR IN CHILDREN
• Adult CPR techniques
can be used on
children
• Compressions 1/3 of
the depth of the
chest
30
3
0
BASIC LIFE SUPPORT (BLS)
Approach safely
Check response
Shout for help
Open airway
Campbell
head tilt
and chin lift,
BASIC LIFE SUPPORT (BLS)
Approach safely
Check response
Shout for help
Open airway
Check breathing
Look, listen and feel for NORMAL breathing
Breathing
• Take
a breath and cover the mouth and nasal apertures
of the infant with your mouth, making
sure you have a good seal
• Blow steadily into the infant’s
mouth and nose over 1—1.5 s,
sufficient to make the chest
visibly rise
• Take another breath and
repeat this sequence
five times
Breathing
No effective breathing:
- the airway may be obstructed
• Open the child’s mouth and
remove any visible obstruction.
• Ensure that there is adequate
head tilt and chin lift,
try the jaw thrust method
• Make up to five attempts to
achieve effective breaths; if still
unsuccessful, move on to chest
compressions
Breathing, circulation
• look for signs of a circulation
any movement, coughing
normal breathing=circulation is present
(not agonal gasps, which are infrequent, irregular breaths)
Basic life support
• Chest compressions
–
–
–
–
–
–
–
–
–
To 1. year 2 fingers (2 thumbs circular)
Over 1. yer one hand/two hands
Low part of sternum
Thumb over processus xiphoideus
Compression by 1/3 of antero-posterior distance
AED
Children > 1 year
Smaller size of pads for children to 8 years
50 – 75 J (4 J/kg)
Chest compression
Chest compressions
•
to depress the
sternum by
approximately one
third of the depth of
the chest
•
and repeat at a rate
of about 100 min−1
Chest compressions : breaths
30:2
AED IN CHILDREN
• Age > 8 years
• use adult AED
• Age 1-8 years
• use paediatric pads /
settings if available
(otherwise use adult
mode)
• Age < 1 year
• use only if
manufacturer
instructions indicate it
is safe
AED DEFIBRILLATION
ATTACH PADS TO CASUALTY’S BARE CHEST
ANALYSING RHYTHM - DO NOT TOUCH VICTIM
SHOCK INDICATED
• Stand clear
• Deliver shock
SHOCK DELIVERED FOLLOW AED INSTRUCTIONS
30
2
Recovery position
Approach safely
Approach safely
Check response
Check response
Shout for help
Shout for help
Open airway
Open airway
Check breathing
Check breathing
Call 112
Call 112
5 rescue breaths
Attach AED
30 chest cmpressions
Follow voice prompts
Anatomical diferencies of airwais
by children
Postresuscitation care
• Aproppriate tissue perfusion
• Cooling – if unconsiousness after CPR
– 32 – 34°C of body core 12 – 24 hours
– Warming 0,25 – 0,5°C / hour
– AE- infection, koagulopathy, glykémia, ións,
circulation
– Avoid hyperthermia - antipyretics
ETICS and CPR
• Start – not start
• Parents´presens during CPR
• Decision to stp CPR- team leader,
not parents
CPR of newborn
Newborn resuscitation
• Lungs distension- ambu- bag with face mask,
in term newborn f: 30-60/min
if bradycardia persists - increase oxygen concentration
• Mecónium – desuflation by weak newborns
• Compressions- breathing ratio 3:1
90 compressionsií and 30 breaths
• Adrenalín, if despite art. Vent.with O2 bradycardia
<60/min
dose 0,01-0,03 mg/kg i.v., into ETT 5-7 x more
• Check HR every 30 sekúnd, STOP if HR > 60/min
• Circulation support evective only by lungs distension
• Temperature of body core maintenance
Foreign body airway
obstruction
– Combination of methods needed
– 5 hits back blows
– 5 chest compressions (till 1year) / abdominal
thrusts over 1 year
– Horisontal rib´s position – abdominal organs
damage risk
ANY QUESTIONS?