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Emergency Lifesaver Course Objectives of First Aid Preserve Life Prevent Worsening Pain Relief Necessity of First Aid Importance of the first 5 minutes.

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Presentation on theme: "Emergency Lifesaver Course Objectives of First Aid Preserve Life Prevent Worsening Pain Relief Necessity of First Aid Importance of the first 5 minutes."— Presentation transcript:

1 Emergency Lifesaver Course Objectives of First Aid Preserve Life Prevent Worsening Pain Relief Necessity of First Aid Importance of the first 5 minutes Necessity of independent aiders - the courage to help In saving others, society saves us Casualty (person injured or taken ill) Responder passer-by)

2 Tokyo Ambulance Call-outs in ,695 calls (up 5.4 ) One every 52 seconds. 204 teams responding to 3,018 calls each. 1 in 20 citizens used service. Average response time at scene 5-6min.

3 The Chain of Survival Early Access Calmly and quickly call 119 and explain the situation Early CPR Perform CPR or other first aid as necessary until ambulance arrives Quick Emergency Measures Ambulance team provides further expert care Early Medical Care Professional care at medical institution

4 min hour 30s 50% die within 3min after circulatory arrest 50% die within 10min after pulmonary arrest 50% die within 30min of major bleeding Is Resuscitation Possible? Death rate time * Average ambulance arrival time is 6min from call

5 Make comfortable. Treat fractures, wounds, injuries, burns, drowning. Transportation. Other Aid If no heartbeat If unconscious Emergency Aid First Aid Preserve airway Artificially ventilate Chest compressions Remove obstruction Stop bleeding If bleeding heavily If not breathing If airway blocked

6 Age Divisions for First Aid Treatment Life Saving CPR observation, airway, breathing, circulation) Bleeding Age Divisions Adult 8 years or over Child Between 1 and 8 years Infant Between 1 month and 1 year NewbornLess than 1 month old

7 Observation and First Aid Heavy bleeding? Stop bleeding Impaired consciousness? Preserve airway Breathing absent or impaired? Ventilate No signs of circulation? CPR Is casualty breathing? Any coughing? Any movement? Signs of circulation Watch response Give two breaths When ventilating

8 Signs of Circulation: Checking the Pulse Adults, children carotid artery Infants, newborns brachial or femoral artery

9 Continue CPR (15 compressions: 2 breaths) If breathing still insufficient continue ventilating (one breath every 5 seconds) Put in recovery position and observe CPR (15 compressions: 2 breaths) for 4 cycles Ventilate (2 times) Open airway Get help If breathing recovers or casualty protests, stop ventilating Conscious? Circulation signs? Breathing? Circulation signs? (breathing, coughing, movement) Breathing? Yes No Insufficient Yes Sufficient

10 Observation: Consciousness Call Are you alright? Can you hear me? into casualtys ear while tapping their shoulder. See if they can talk or respond. If no response, get progressively louder/harder (no more than 3 times!) Can you hear me? Judge whether casualty is conscious or unconscious Do not move or slide the casualty For infant/newborn casualty, scrape the sole of the foot

11 Choose someone and request their help. Get Help Please call 119 for an ambulance

12 The airway is the path taken by air through the mouth and nose to the lungs. Consciousness problems/ not breathing/ airway obstruction The Airway

13 Opening the Airway Lift the chin forwards with the index and middle fingers of one hand while pressing the forehead backwards with the heel of the other hand. Do not put pressure on the soft parts of the chin or throat. Do not do this if there is a risk of a neck injury.

14 Opening the Airway (2): neck injuries Grasp the jawbone with both hands and gently ease upwards, applying pressure with all 4 fingers on both sides.

15 Place your ear above the casualtys mouth and nose. Look along the chest and abdomen. If she is breathing you will hear and feel the breath on your face and see movement. Observe Breathing Count No breathing Ventilate Observe for no more than 10 seconds to judge whether or not casualty is breathing.

16 The Recovery Position For the casualty who is breathing sufficiently but is not fully conscious. Use the casualtys own hand under their jaw to keep the airway open.

17 Keeping the airway open, pinch the nostrils so that air cannot escape through the nose but is forced into the lungs. Artificial Ventilation Mouth-to- -Mouth -Nose -Mouth & nose -Mask -Tracheostomy etc.

18 Breathe for the Casualty Open your mouth wide, take a deep breath, and seal your lips around the casualtys mouth. Blow into the lungs, looking along the chest until you see the chest rise slightly. Blow about 10cc per kg of casualtys weight. (e.g cc) Problems: Open airway? Nostrils? Seal? Airway obstructions?

19 Remove your mouth and watch the chest fall Pros and cons of Mouth-to-Mouth Ventilation Requires no special tools Can be done by one person, even a child Easy to see if its working Risk of infection Risk of secondary poisoning May feel unpleasant

20 Preventing Infection A non-return valve resuscitation mask can be used. If youre worried about infection you can perform chest compressions only.

21 Ventilating when circulation signs are present No breathing Ventilate Breathe gently for two seconds Circulation Signs present Ventilate Breathe gently for two seconds Check signs for no more than ten seconds. Look for autonomous breathing, coughing or movement. Breathing may still be insufficient. Ventilate Breathe gently for two seconds

22 Breathing: Age groups Mouth-to-nose Mouth-to-mouth- and-nose Infant 1 sec.Every sec. Newborn sec. Until chest rises gently. Every 3 sec. Child Mouth-to-mouth 2 sec cc 10cc/kg Every 5 sec. Adult MethodDurationAmountFrequency

23 The heart is located within the ribcage, slightly to left of centre. An incorrect hand position will make compressions less effective, and break the casualtys ribs. Chest Compressions: Correct Hand Position Heart Hand position

24 Hand position: lower half of the sternum (breastbone) For adults and children, the first hand should be placed on the sternum one finger-space from the lower end. Sternum One finger-space Xiphoid process Hand position Lower limit for compression

25 Finding the correct hand position Trace the underside of the ribs with your index and middle fingers. ribs

26 Place the middle finger in the sternal notch, and the index finger on the sternum Using two fingers, trace the underside of the ribs to the notch where the sides join in the middle. Leaving your middle finger in the notch, rest the index finger next to it on top of the sternum. Middle finger in the notch Index finger on the sternum

27 Now rest the heel of the other hand on the sternum next to the extended index finger. This is the correct hand position for compressions.

28 Cardiac Compressions - Essential Points Sit level with the casualty s chest Correct hand position, with the heel of the hand Lock your elbows Position your shoulders over the chest Using your body weight, compress straight down towards the ground Adult casualty: Compress 3.5 5cm Rhythm of 100 per min.

29 Compression technique Avoiding pressure on the casualtys ribs, compress only the narrow sternum. This maximises the safety and effectiveness of the compressions. Use this part (the heel of the hand) to compress the chest

30 Compress Vertically With elbows straight, push straight down. Release pressure promptly. Take care not to lose your position.

31 Cardiac Compressions Compressing the heart between the sternum and spine causes blood to circulate. Compress 15 times at a rate of 100 compressions/minute. sternumheart spine upstrokedownstroke

32 How NOT to do it! Dont push at an angleDont bend your elbows

33 Repeat cycles of 15 compressions to two breaths (ratio 15:2) After the first four cycles, check again for signs of circulation - for no more than 10 seconds Cardio-pulmonary Resuscitation(CPR)

34 15 chest compressions 2 breaths 10 second check for signs of life One cycle 15 compressions : 2 breaths No breathing. Ventilate. 2 breaths Checking signsNo signs of lifeStarting CPR

35 Removing Obstructions (1) Open the casualty s mouth with the crossed finger technique. Cross the thumb and index finger. Place the thumb on the upper teeth, the index finger on the lower teeth, and twist to open the mouth. Don t move the head when inspecting the mouth. Do you need to remove dentures?

36 Removing Obstructions (2) Turn casualtys head to one side. Wrap your finger with a handkerchief or cloth, and wipe out any obstructions. Make sure to clean away all blood or body fluids.

37 Back Slaps Slap sharply and strongly 4 or 5 times between the casualtys shoulder blades using the heel of your hand.

38 Heimlich Maneuver (Sitting) Only on conscious casualties aged > 8 years Put the ball of the thumb against the upper stomach area Put your chest against the casualtys back. Put both arms under the casualtys armpits. Squeeze inward and upward.

39 Heimlich Maneuver (Astride) With the heel of one hand on the upper stomach area, support with the other hand and push sharply upwards and inwards.

40 Compression from Behind With one knee raised, put open hands on the lower trunk beneath the ribs on either side of the spine. Squeeze strongly, inwards and upwards.

41 Perform CPR (15:2) If breathing sufficient, continue ventilations (1 every 2 to 3 sec.) Recovery position (continue to monitor) Perform CPR (15:2) Two breaths Open airway Call for help If breathing recovers or casualty objects, stop ventilations Conscious? Check signs of life Breathing? Check signs of life Breathing? Coughing? Moving? Breathing? Yes No Not enough Yes Enough

42 CPR for Children, Babies and Newborns Mouth-to-Mouth Two breaths seconds apart. Chest should rise gently. Child Baby & Newborn Mouth-to-Nose & Mouth Two breaths. Breathe for 1 sec.

43 Child CasualtyHand PositionTechniqueExtentRate Child (1-8 yrs) Lower half of sternum Heel of one hand About 1/3 depth of chest 100/minute Baby (1-12 month)One finger width below line joining the nipples Middle & ring fingers only At least 100/minute Newborn (less than 28 days) About 120/minute Baby & Newborn

44 Removing Obstructions: Baby & Child Thoracic Compressions Face upward. Compress lower sternum as for CPR, 5 times. Back Slaps Turn over, facing downwards Support chin with fingers Slap 5 times with heel of hand Cycle both techniques. If becomes unconscious start CPR!

45 Bleeding Control: Direct Pressure Consider the cleanliness, thickness and position. Apply direct pressure to the wound. Use a plastic bag or rubber gloves to avoid infection. Gauze pad bone wound

46 Bleeding Control: Tourniquet Position between the wound and the heart. Centered a few cm from the wound. Using a wide (at least 3cm) triangular bandage or scarf. Tighten using a stick. Release pressure every 30 mins.

47 1. Prepare the tourniquet. 2. Tie loosely. Insert a pad. 3. Insert the stick. Steady the pad. 4. Turn the stick until bleeding stops. 5. Secure the stick so it wont move. 6. Record the time.

48 Legal Protection for First Aiders USA: Good Samaritan Law. If emergency aid is given with sincere spirit there will be no retribution even in the event of a mistake. JAPAN: Regarding actions made in good faith, in the absence of malice or negligence, there shall be no civil or legal liability. ( )

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