First Aid with CPR/AED—Adult and Child and CPR—Infant American Red Cross Health Science 2 Mrs. Roberts Certifications • Standard First Aid (Valid for 3 years) • Adult/Child/Infant CPR & Adult AED (Valid for 1 year) Expectations • Attend ALL class sessions or make up missed sessions • Demonstrate competency in all required skills • Participate in all skill sessions and scenarios • Score at least 80% on each section of the written exam LESSON 1: BEFORE GIVING CARE Recognizing and Responding to an Emergency • By recognizing an emergency and taking immediate action to help, you give a suddenly ill or injured person the best chance for survival. • Emergencies can often be recognized because of unusual sights, appearances, behavior, odors or noises. Overcoming Barriers to Act • There are many reasons why bystanders do not get involved in an emergency situation. • It is normal to feel hesitant or unsure about what to do. Good Samaritan Laws • Enacted in all states to protect people who voluntarily give emergency care, without accepting anything in return. • May protect you from legal liability as long as you– – – – Act in good faith Are not negligent Act within the scope of your training Never abandon a person once you start care • You MUST OBTAIN CONSENT to help an ill or injured person Obtaining consent • • • • • State your name Tell the person you are trained in first aid Ask the person if you can help Explain what you think may be wrong Explain what you plan to do “DO NOT give care to a conscious person who refuses it” Preventing Disease Transmission • Standard Precautions (AKA “Universal Precautions”) – Avoid contact with blood or other body fluids – Avoid touching objects that may be soiled with blood or other body fluids – Place barriers between you and the injured or ill person – Wash your hands immediately after giving care with soap and water Cleaning up a Blood Spill • Clean immediately • Use disposable gloves and paper towels to clean up the area • Flood the area with 1 ½ cups of liquid chlorine bleach mixed in 1 gallon of water • Let it stand for 10 minutes • Dispose in a biohazard bag SKILL PRACTICE: Removing Gloves Emergency Action Steps Check Call Care When to CALL first • Unconscious adult or adolescent age 12 or older • Witnessed sudden collapse of child or infant • Unconscious infant or child known to be at high risk for heart problems When to CARE first • Unwitnessed collapse of an unconscious person younger than 12 • Any victim of drowning Moving an Injured or Ill Person • “Do No Further Harm” • Remember CHECK—CALL—CARE • Emergency Moves – Walking Assist – Pack-Strap Carry – Two-Person Seat Carry -- Clothes Drag -- Blanket Drag -- Foot Drag LESSON 2: CHECKING AN ILL OR INJURED PERSON Checking a Conscious Adult • When it comes to first aid, an “Adult” is someone who is about 12 years of age or older • After checking the scene, you should check the adult first for life-threatening conditions. • Obtain consent to give care • A head-to-toe examination should be done to check a conscious adult • Care for the person based on their condition • Take steps to minimize shock Checking a Conscious Child or Infant • For first aid, a “child” is someone who is about 1 to 12 years old. • For the use of a pediatric AED, a child is someone between the ages of 1 and 8 or weighing less than 55 pounds. • For first aid, an “infant” is someone who is less than 1 year old. • Check the scene then check the child for life threatening conditions. • Obtain consent from a parent or guardian, if present. • Care for the child base on their condition • Take steps to minimize shock Recognizing and Caring for Shock • Likely to develop after any serious injury or illness including severe bleeding, serious internal injury, significant fluid loss or other conditions. • A person showing signs of shock needs immediate medical attention. • Body systems and organs begin to fail. • Goals of first aid get help quickly and give care to minimize shock Signs of Shock • • • • • • Restlessness or irritability Altered level of consciousness Nausea or vomiting Rapid breathing and pulse Pale or ashen, cool, moist skin Excessive thirst Care Steps for Shock • • • • • CALL 9-1-1 Monitor the person’s ABCs Control any bleeding Keep person from getting chilled or overheated Elevate legs about 12 inches (ONLY if you don’t suspect a neck, back or hip injury) • Comfort and reassure (Do not let them eat or drink anything) Checking an Unconscious Adult Remember your ABCs A = Airway B = Breathing C = Circulation and severe bleeding Checking an Unconscious Child or Infant • Again, Remember your ABCs • With a child or infant, you should check for a pulse. – Child – Carotid pulse – Infant – Brachial pulse LESSON 3: BREATHING EMERGENCIES AND CONSCIOUS CHOKING Breathing Emergencies • Respiratory distress: having trouble breathing • Respiratory arrest: can not breath at all • Very important to recognize breathing emergencies in children and infants before the heart stops beating. – Adults hearts stop because they are diseased. Children and Infant’s hearts are usually healthy and stops because of a breathing emergency. Conscious Choking Adult, Child and Infant • Choking is a breathing emergency that can lead to death if not cared for immediately. • A person is choking only when their airway is completely obstructed. • Universal sign of choking = clutching the throat • Care involves 5 back blows and chest thrusts for infants and 5 back blows and 5 abdominal thrusts for adults LESSON 4: RESCUE BREATHING Rescue Breaths - Adult • Process of breathing air into a person who is not breathing to provide vital organs including the brain a constant supply of oxygen. • Each breath should last about 1 second. With each breath, watch the chest clearly rise and fall. • Blow just enough air to make the chest rise. Rescue Breathing—Child • Respiratory arrest can lead to cardiac arrest if not cared for immediately. • Given to a child or infant who is not breathing but has a pulse. • Give 1 breath every 3 seconds and check for signs of life every 2 minutes (about 40 breaths). Rescue Breathing—Infant • Do not tilt the head back at all. Keep in a neutral position. • Give 1 breath every 3 seconds, checking for signs of life about every 2 minutes. • Make a seal over infant’s mouth and nose. Rescue Breathing • Continue rescue breathing on a child or infant: – As long as they have a pulse but still not breathing – Until help arrives and takes over – The child or infant begins to breath on their own – Scene becomes unsafe – You become too tired to continue LESSON 5: CARDIAC EMERGENCIES Recognizing a Heart Attack • Heart attack – when the heart muscle is damaged from a lack of oxygen and blood supply by either disease or trauma. • A heart attack can lead to cardiac arrest. • Cardiac arrest – heart stops functioning altogether CPR?? • C =Cardio = Heart • P = Pulmonary = Lung • R = Resuscitation = Restore life Cardiac Chain of Survival • CPR alone is not enough to help someone survive a cardiac arrest • Greatest Chance of Survival Defibrillation • An electric shock that interrupts the heart’s chaotic electrical activity. • AED = automated external defibrillator – Analyzes heart’s electrical rhythm and, if necessary, prompts the responder to deliver a shock. LESSON 6: CPR AND UNCONSCIOUS CHOKING CPR - Adult • Cardiac Arrest: Unconscious, not breathing and show no other signs of life. • CPR can help circulate blood that contains oxygen to vital organs by a combination of chest compressions and rescue breaths. CPR - Child • Children rarely suffer a cardiac emergency. They suffer a respiratory emergency that develops into a cardiac emergency. • Common causes of respiratory emergencies that develop into cardiac emergencies: – – – – – – – Motor vehicle crashes Drowning Obstructed airway Smoke inhalation Poisoning Falls Firearm injuries CPR - Infant • Cardiac emergencies are RARE in an otherwise healthy infant. • Usually preceded by trauma or a breathing emergency or SIDS. • Genetic or congenital problems may increase an infants risk of a cardiac emergency. Unconscious Choking • If rescue breaths do not go in, you must act quickly to get air into the person. • Similar to CPR, except you look for a foreign object between compressions and breaths. • Chest compressions are used to help force air from the person’s lungs to dislodge the object. LESSON 7: AED - ADULT AED • Automated External Defibrillator • AED analyzes the heart’s electrical rhythm and, if necessary, prompts you to deliver a shock to a victim of sudden cardiac arrest. • This shock, called defibrillation, may help the heart to re-establish an effective rhythm. AED Precautions • • • • • • DO NOT touch the victim while the AED is analyzing. DO NOT touch the victim while the device is defibrillating. Make sure no one is touch the person. Do not use alcohol to wipe the victim’s chest. Do not use if a person is wet or lying in water. Do not use adult pads on a child under age 8 or less than 55 pounds. • Remove any medication patches. • Do not use a cell phone within 6 feet of the AED. FIRST-AID: SOFT TISSUE INJURIES First Aid • Immediate care that is given to the victim of an injury or illness to minimize shock • STAY CALM • AVOID PANIC • Evaluate the situation THOROUGHLY 2 Basic Types of Injuries • Soft Tissue – Layers of skin, fat and muscle • Musculoskeletal – Muscles, bones and joints Soft Tissue Injuries • Layers of skin, fat and muscle. • Wound: physical injury that damages the layers of the skin – Open: break in the skin or mucous membrane – Closed: no break in the skin or mucous membrane but injury occurs in the underlying tissues • Bruise (contusion or ecchymosis) • Hematoma Signs of Internal Bleeding • Tender, swollen, bruised or hard area of the body, such as the abdomen • Rapid, weak pulse • Cool, moist, pale, or bluish skin • Vomiting or coughing blood • Excessive thirst • Becoming confused, faint, drowsy or unconscious Treatment of Closed Wounds • Apply direct pressure • Elevate if it does not cause more pain • Apply ice or cold pack Bruise Healing Process Open Wounds • • • • Abrasion: skin scraped off, bleeding limited Incision: cut caused by a sharp object Laceration: tearing of tissues by excessive force Puncture: caused by a sharp object such as a pin, nail, pointed instrument • Avulsion: tissue is torn or separated from the victim’s body • Amputation: body part is cut off Care for a Minor Open Wound 1. Wash hands!!!! 2. Wear gloves 3. Apply direct pressure to control bleeding by using a sterile dressing 4. Wash wound with soap and water. (irrigate for 5 minutes with clean running tap water) 5. Apply triple ABX ointment (Neosporin) 6. Cover with a sterile dressing and a bandage IF it is still bleeding or may come in contact with dirt or germs 7. Wash you hands immediately after completing care. Care for a Major Open Wound • Wash hands • Wear gloves • Control bleeding by applying direct pressure with a sterile dressing • Apply a bandage snugly over the dressing • Call 9-1-1 • Wash your hands immediately after completing care Stitches? • Advantages – Speed up healing process – Lesson chance of infection – Improve appearance of scars • When are they needed? – – – – Bleeding from artery or uncontrolled bleeding Edges of skin do not fall together Wound would leave obvious scar on face Wound over ½ inch long When to call 9-1-1 • Trouble breathing • Uncontrolled bleeding • c/o severe pain or cannot move a body part without pain • If you think the force of the injury caused serious damage • SKILL: Controlling Bleeding Burns • Causes – – – – Heat (thermal) Chemicals Electricity Radiation (sun) • Types of burns – Superficial Burns (1st degree) – Partial Thickness (2nd degree) – Full Thickness (3rd degree) st 1 Degree Burns nd 2 Degree Burns rd 3 Degree Burns Skin Graft Caring for Burns Caring for Burns • COOL and COVER all burns • Chemical burns: continue flushing for 20 minutes or until EMS arrives – Will continue to burn as long as chemical is on skin • Electrical burns: may affect heart’s rhythm – Be prepared to give CPR and use an AED • Radiation burns: aloe cream or spray – Avoid further sun exposure; use sunscreen What NOT to do: • • • • DO NOT Apply ice or ice water DO NOT Break blisters DO NOT Use any type of ointment on a severe burn DO NOT Remove clothing that is stuck to the burned area • DO NOT Try to clean a severe burn When to call 9-1-1 • Burns that cover more than one body part or a large surface area • Burns to the airway • Child < 5, Elderly > 60 • Burns resulting from chemicals, electricity or explosions Lightning Precautions to take during a Thunderstorm • Stay inside a building with 4 solid walls that is grounded • If inside car, roll up windows and do not touch metal • Stay away from water • Stay away from telephones except in emergencies • Stay away from hilltops • Stay away from metal Care for Special Situations • DO NOT remove embedded objects • Small foreign object in eye; flush with water • Severed body part: wrap in sterile gauze or clean cloth, place in a plastic bag and put in ice water. – DO NOT freeze • Report animal bites to local animal control Nosebleeds – Have person sit and lean forward – Pinch nostrils together for 10 minutes – Apply ice pack to bridge of nose – If bleeding does not stop, apply pressure on the upper lip just beneath the nose – If person loses consciousness; place in recovery position Abdominal Injuries • Keep person lying with knees bent, if it doesn’t cause pain • If organs are exposed, do not apply pressure to organs or push them back inside • Loosely apply a warm moist, sterile dressing or a clean cloth over the wound to keep the organs warm Just remember: • • • • Control bleeding Minimize risk of infection Always use barriers to avoid contact with blood Use bandages and dressings that help control bleeding and minimize the danger of infection • Take steps to minimize shock FIRST-AID: INJURIES TO MUSCLES, BONES & JOINTS Muscle, Bone & Joint Injuries • 4 types of muscle, bone and joint injuries – Fractures – Dislocation – Sprain – Strain • Giving proper care is much more important than identifying the type of injury • Assume any injury to an extremity includes a bone fracture Care for Muscle, Bone and Joint Injuries Rest : do not move or straighten Immobilize: stabilize in the position found Cold: apply ice (20 minutes on, 20 minutes off) Elevate: only if it does not cause more pain Key Points • A person with an injured lower extremity should not bear weight until advised by a medical professional • If an injured extremity is blue or extremely pale, call 9-1-1 immediately Splinting • A method of immobilizing an injured extremity and should ONLY be used if you have to move or transport a person to seek medical attention and if splinting does not cause more pain If you have to splint-• Splint an injury in the position in which you find it • Splint the injured area and the joints or bones above and below the injury site • Check for circulation before and after splinting Types of Splints • Anatomic splints: use an uninjured body part as a splint to immobilize an injured area • Soft splints: folded blankets, towels, pillows and a sling • Rigid Splints: boards, metal strips and folded magazines or newspapers • The ground can be used as a splint. An injured leg stretched out on the ground is splinted Sling and Binder • Used to stabilize an injured arm. Keeps the arm from moving up and down as well as away from the trunk of the body. It also should be used only if you have to move or transport a person to seek medical attention and if splinting does not cause more pain. Care for Head, Neck and Back Injury • May cause death or life-long neurological damage • If you suspect a head, neck or back injury: – Call 9-1-1 – Have person respond verbally and avoid nodding or shaking head – Minimize movement by placing hands on both sides of the person’s head. Maintain an open airway. Do not change their position. – Monitor the “ABCs” FIRST-AID: SUDDEN ILLNESS General Guidelines of Care • • • • • • Do no further harm Monitor breathing and consciousness Help the person rest in the most comfortable position Keep the person from getting chilled or overheated Reassure the person Given any specific care needed Fainting • Temporary loss of consciousness • Caused by a temporary reduction of blood flow to the brain • Usually self-correcting—when they collapse, normal circulation to the brain resumes • As long as the person recovers quickly, there is not need to call 9-1-1 Diabetic Emergency • Diabetes mellitus: Condition in which the body does not produce enough insulin or does not use insulin effectively • If a person is awake and able to swallow, give him/her sugar (juice, candy, non-diet soft drink or table sugar) • If not able to swallow or no sugar available, call 9-1-1 immediately Seizures • When injury, disease, fever, poisoning or infection disrupts normal functions of the brain, the electrical activity of the brain becomes irregular. This irregularity can cause a sudden loss of body control known as a seizure. • Protect the person from injury. • Remove nearby objects that could cause injury. Protect the person’s head. When to call 9-1-1 for a Sz • • • • • Seizure lasts > 5 minutes Repeated seizures, without gaining consciousness Injury Person has diabetes or is pregnant Person fails to regain consciousness after seizure Stroke • “brain attack”—blockage of blood flow to a part of the brain • May cause permanent damage to the brain if the blood flow is not restored. Sudden signals of a stroke: • Weakness of numbness o one side including face or arm or leg • Difficulty speaking or slurred speech • Sudden dizziness • Blurred vision or sudden severe headache For a brain attack, think F.A.S.T.! • Face—Weakness on one side of the face • Arm—Weakness or numbness in one arm • Speech—Slurred speech or trouble getting the words out • Time—Time to call 9-1-1 if you see any of these signals. Note the time that the signals begin. Poisoning • A poison is any substance that can cause injury, illness or death when introduced into the body. • Poisons enter the body in 4 ways: – Inhalation Do not give anything by – Swallowed mouth unless directed to do so by the PCC – Absorption – Injection • If you think someone has been poisoned, call the Poison Control Center – 1-800-222-1222 Allergic Reactions • Caused by the activity of the immune system. • Use emergency action steps, CHECK—CALL— CARE and give care for any life-threatening conditions • Severe allergic reaction: Anaphylaxis • Person may have Epinephrine Auto-Injector (Epi Pen) FIRST-AID: HEAT- AND COLDRELATED EMERGENCIES Heat-Related Emergencies • Heat Cramps: painful muscle spasms that usually occur in the legs and abdomen • Heat exhaustion: is an early sign that the body’s cooling system is becoming overwhelmed – Symptoms: cool, moist, pale, ashen or flushed skin, headache, nausea, dizziness, weakness, exhaustion or heavy sweating • Heat stroke: (late stage) when the body’s systems are overwhelmed by heat and stop functioning Care for Heat-Related Emergencies • • • • Move person to a cool place Loosen tight clothing Apply cool, wet towels to the skin, fan the person If the person is conscious, give small amounts of cool water (not cold) • If person refuses water, vomits or starts to lose consciousness, call 9-1-1 Cold-Related Emergencies • Hypothermia: condition when the entire body cools because its ability to regulate temperature fails – Care: move person to a warm place, monitor ABCs, remove wet clothing and dry person, wrap in a blanket. Drink warm liquids. • Frostbite: condition when body tissue freezes after being exposed to the cold environment – Care: do not attempt to rewarm the frostbitten area if there is chance that it may refreeze or you’re close to hospital. If not, soak in warm water until normal color returns. Loosely bandage the area with dry, sterile dressings. Separate toes and fingers with gauze. Avoid breaking blisters. Call 9-1-1 ASAP. THE END!!! FIRST AID EXAM