Presentation on theme: "Emergency Lifesaver Course"— Presentation transcript:
1Emergency Lifesaver Course Objectives of First AidPreserve Life ・ Prevent Worsening ・ Pain ReliefNecessity of First AidImportance of the first 5 minutesNecessity of independent aiders - the courage to helpIn saving others, society saves usCasualty (person injured or taken ill)Responder （passer-by)
2Tokyo Ambulance Call-outs in 2001 606,695 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.
3The Chain of Survival Early Access Early CPR Quick Emergency Measures Calmly and quickly call 119 and explain the situationEarly CPRPerform CPR or other first aid as necessary until ambulance arrivesQuick Emergency MeasuresAmbulance team provides further expert careEarly Medical CareProfessional care at medical institution
4Is Resuscitation Possible? １００１２３７５Breathing StopsMajor BleedingHeart StopsDeath rate５０２５０２３５１０１５３０１hour30s１mintime① 50% die within 3min after circulatory arrest② 50% die within 10min after pulmonary arrest③ 50% die within 30min of major bleeding* Average ambulance arrival time is 6min from call
5Preserve airway First Aid Emergency Aid Stop bleeding Other Aid If unconsciousIf not breathingArtificially ventilateIf no heartbeatChest compressionsIf airway blockedRemove obstructionIf bleeding heavilyStop bleedingMake comfortable.Treat fractures, wounds, injuries,burns, drowning. Transportation.Other Aid
6Age Divisions for First Aid Treatment Life SavingCPR（observation, airway, breathing, circulation)BleedingAge Divisions Adult 8 years or over Child Between 1 and 8 years Infant Between 1 month and 1 year Newborn Less than 1 month old
7Observation and First Aid Heavy bleeding? Stop bleedingImpaired consciousness? Preserve airwayBreathing absent or impaired? VentilateNo signs of circulation? CPRIs casualty breathing?Watch responseSigns ofcirculationWhen ventilatingAny coughing?Give two breathsAny movement?
8Signs of Circulation: Checking the Pulse Adults, children （carotid artery）Infants, newborns （brachial or femoralartery）
9(breathing, coughing, movement) If breathing still insufficient ①Conscious?NoYes②Get help④Breathing?Insufficient③Open airwaySufficient④Breathing?SufficientPut in recoveryposition and observe⑤Ventilate (2 times)Yes⑥Circulation signs?(breathing, coughing, movement)If breathing still insufficientcontinue ventilating (one breathevery 5 seconds)⑦⑧ CPR (15 compressions: 2 breaths)for 4 cyclesYesIf breathing recovers orcasualty protests, stopventilating⑥Circulation signs?⑧ Continue CPR(15 compressions: 2 breaths)
10Observation: Consciousness Call “Are you alright? Can you hear me?” into casualty’s ear while tapping their shoulder. See if they can talk or respond. If no response, get progressively louder/harder (no more than 3 times!) Judge whether casualty is conscious or unconsciousDo not move or slide the casualtyFor infant/newborn casualty, scrape the sole of the footCan youhear me?
11Choose someone and request their help. Get HelpChoose someone and request their help.Please call119 for anambulance
12The AirwayThe airway is the path taken by air through the mouth and noseto the lungs. （Consciousness problems/ not breathing/ airway obstruction）
13Opening 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.
14Opening the Airway (2): neck injuries Grasp the jawbone with both hands and gently ease upwards, applying pressure with all 4 fingers on both sides.
15Observe BreathingPlace your ear above the casualty’s 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 for no more than 10 seconds to judge whether or not casualty is breathing.Count “ ”“No breathing”“Ventilate”
16The Recovery PositionFor the casualty who is breathing sufficiently but is not fully conscious. Use the casualty’s own hand under their jaw to keep the airway open.
17Artificial Ventilation Keeping the airway open, pinch the nostrils so that air cannot escape through the nose but is forced into the lungs.Mouth-to--Mouth-Nose-Mouth & nose-Mask-Tracheostomyetc.
18Breathe for the Casualty Open your mouth wide, take a deep breath, and seal your lips around the casualty’s mouth. Blow into the lungs, looking along the chest until you see the chest rise slightly.Blow about 10cc per kg of casualty’s weight. (e.g cc)Problems:Open airway?Nostrils?Seal?Airway obstructions?
19Remove your mouth and watch the chest fall Pros and cons of Mouth-to-Mouth VentilationRequires no special toolsCan be done by one person, even a childEasy to see if it’s workingRisk of infectionRisk of secondary poisoningMay feel unpleasant
20Preventing InfectionA non-return valve resuscitation mask can be used.If you’re worried about infection you can perform chest compressions only.
21Ventilating when circulation signs are present １２１２１２３４５６７８９１０１Breathe gently for two secondsBreathe gently for two secondsBreathe gently for two seconds“No breathing”VentilateVentilateVentilateCheck signs for no more than ten seconds.Look for autonomous breathing, coughing or movement.Breathing may still be insufficient.“Circulation Signs present”
22Mouth-to-mouth-and-nose Breathing: Age groupsFrequencyAmountDurationMethodAdultEvery 5 sec.cc（10cc/kg）2 sec.Mouth-to-mouthChildEvery 3 sec.Until chestrises gently.sec.InfantMouth-to-noseMouth-to-mouth-and-noseNewbornEvery sec.1 sec.
23Chest Compressions: Correct Hand Position The heart is located within the ribcage, slightly to left of centre.An incorrect hand position will make compressions less effective, and break the casualty’s ribs.HeartHand position
24Hand 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.HandpositionSternumOne finger-spaceLower limit forcompressionXiphoidprocess
25Finding the correct hand position Trace the underside of the ribs with your index and middle fingers.ribs
26Place 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.Index finger onthe sternumMiddle finger inthe notch
27Now rest the heel of the other hand on the sternum next to the extended index finger. This is the correct hand position for compressions.
28Cardiac Compressions - Essential Points ① Sit level with the casualty’s chest② Correct hand position, with the heel of the hand③ Lock your elbows④ Position your shoulders over the chest⑤ Using your body weight, compress straight down towards the groundAdult casualty:Compress 3.5〜5cmRhythm of 100 per min.
29Compression technique Avoiding pressure on the casualty’s 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
30Compress VerticallyWith elbows straight, push straight down. Release pressure promptly. Take care not to lose your position.
31Compress 15 times at a rate of 100 compressions/minute. Cardiac CompressionsCompressing the heart between the sternum and spine causes blood to circulate.Compress 15 times at a rate of 100 compressions/minute.heartsternumspinedownstrokeupstroke
32How NOT to do it!Don’t push at an angleDon’t bend your elbows
33Cardio-pulmonary Resuscitation(CPR) 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
34One cycle 10 second check for signs of life 15 chest compressions 2 breaths2 breaths“No breathing. Ventilate.”“Checking signs”“No signs of life”“Starting CPR”One cycle15 compressions : 2 breaths
35Removing 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?
36Removing Obstructions (2) Turn casualty’s 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.
37Back Slaps Slap sharply and strongly 4 or 5 times between the casualty’s shoulder blades using the heel of your hand.
38Heimlich Maneuver (Sitting) Only on conscious casualties aged > 8 yearsPut the ball of the thumb against the upper stomach areaPut your chest against the casualty’s back.Put both arms under the casualty’s armpits.Squeeze inward and upward.
39Heimlich Maneuver (Astride) With the heel of one hand on the upper stomach area, support with the other hand and push sharply upwards and inwards.
40Compression 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.
41Breathing? Coughing? Moving? ① Conscious?NoYes② Call for help④ Breathing?Not enough③ Open airwayEnough④ Breathing?EnoughRecovery position(continue to monitor)⑤ Two breathsYes⑥ Check signs of life Breathing? Coughing? Moving?If breathing sufficient, continue ventilations (1 every 2 to 3 sec.)⑦⑧ Perform CPR (15:2) YesIf breathing recovers or casualty objects, stop ventilations⑥ Check signs of life⑧ Perform CPR (15:2)
42CPR for Children, Babies and Newborns Mouth-to-MouthTwo breaths.1～1.5 seconds apart.Chest should rise gently.Mouth-to-Nose & MouthTwo breaths.Breathe for 1 sec.Baby &NewbornChild
43Baby & Newborn Child Casualty Hand Position Technique Extent Rate (1-8 yrs)Lower half of sternumHeel of one handAbout 1/3 depth of chest100/minuteBaby(1-12 month)One finger width below line joining the nipplesMiddle & ring fingers onlyAt least 100/minuteNewborn (less than 28 days)About 120/minuteBaby & NewbornChild
44Removing Obstructions: Baby & Child Back Slaps Turn over, facing downwardsSupport chin with fingersSlap 5 times with heel of handThoracic CompressionsFace upward.Compress lower sternum as for CPR, 5 times.Cycle both techniques. If becomes unconscious start CPR!
45Bleeding 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 padbonewound
46Bleeding 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.
471. Prepare the tourniquet. 4. Turn the stick until bleeding stops.2. Tie loosely. Insert a pad.5. Secure the stick so it won’t move.3. Insert the stick. Steady the pad.6. Record the time.
48Legal 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.”(総務庁長官官房交通安全対策室・交通事故現場における市民による応急手当促進方策委員会報告書・平６．３)