Presentation on theme: "CPR/AED/First Aid Training"— Presentation transcript:
1CPR/AED/First Aid Training byRob Sundquist, MS ATC LATDirector of Sports Medicine/Head Athletic TrainerCreekview High School
2Chain of SurvivalThe chain of survival are four steps to help increase the chances of an injured person of surviving a cardiac arrest.
3Chain of Survival – step one After determining that there is an injury needing advanced care; if unconscious tap and shout.Call 911Questions you will need to answer:Nature of the emergency?Where are you?How many are hurt?Ages of who is/are hurtWho are you?Has treatment started?Only hang up when instructed to do so by operator.
4Chain of Survival – step two Begin CPRMost adult cardiac arrests (CA) victims heart is in ventricular fibrillation (VF) - Abnormal chaotic heart rhythm that prevents the heart from pumping blood.CPR will not usually stop VF but plays an important part in pushing oxygenated blood to the brain and heart and prolonging VF so that an AED will be useful.CPR can double or triple the victims survival rateFor every passing minute without CPR; rate of surviving drops 7-10%.With CPR there is only a 3-4% drop each minute
5Chain of Survival – step three Use an AEDThe use of the AED will stun the fibrillating heart, if the heart is still viable the normal pacemakers in the heart will begin firing and start a normal rhythm.If used within 5 min; chances of survival is 49-75%.Using an AED is simple.
6Chain of Survival – step four Advanced Care – EMSResponse time is 7-8 minutes – CPR is extremely important.
8Heart Attack Myocardial infarction Coronary heart disease is the leading cause of death in our nation.During MI - part of heart muscle is starting to die.Caused by a blockage of an artery (coronary) due to buildup of cholesterol deposits or a blood clot.Victims are usually awake and can talk but feels severe painMost critical time is within the first 30 minutes after Sx begin.
9Heart Attack Most common symptoms Pain or pressure in the center of the chest – which last more than 3-5 minutes.Pain might feel pressure, fullness, squeezing, or heavinessPain might spread to shoulder, neck, lower jaw and down arm (usually the right).Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then begin again.Other Sx – lightheadedness, fainting, sweating without fever, nausea, shortness of breathMost victims will downplay symptoms, you must take action!!!Call 911, get the nearest AED, and have the person rest in a position that is comfortable where they can breathe easily.Put them in an area that you can get them to the floor easily and paramedics can get in.
10Cardiac ArrestWhen the heart stops beating. Usually caused by VF, which begins where the heart muscle is injured.Without blood flow and no pulse the person becomes unconscious and stops breathing and collapses.VF and cardiac arrest may be the only symptom of a heart attack.AED is only thing that will stop a VF
11StrokeIts is a rapid onset of neurological problems like weakness, paralysis in one or more limbs, difficulty speaking, visual problems, intense dizziness, facial weakness, altered consciousness, and severe headache.Two causesblood vessel to brain is blocked by a blood clotblood vessel to brain breaks#3 cause of death and #1 cause of serious disability among Americans
12Stroke Most signs overlooked; three major signs to observe facial drooparm weakness – most obvious when victim attempts to extend arms with eyes closed – one or both may not move very wellspeech difficulties – slurring of words and sentencesCall 911 immediately if see signs of strokeProvide CPR if needed
13Foreign body obstruction Usually caused by food, but can be caused by many objectsMajor signsUniversal choking signalpoor ineffective coughsinability to speakhigh pitched sounds while inhalingincreased difficulty breathingBlue lips or skin (cyanosis)Loss of consciousness and responsivenessHeimlich maneuver in conscious victimCPR in unconscious victim
15Step one Make sure area is safe Check unresponsiveness – tap and shout – “Are you alright”If no response – call 911 or send someone directly to callGrab AED if one present or send someone to get one.
16Step two If possible place victim supine and on a hard surface. If victim is prone – roll overTry protecting the neck as much as possible if you suspect neck injury
17Begin CAB’s C = Circulation If not breathing or see abnormal breathing begin chest compressionsAgnal breathing – gasps that occur at the beginning of CA – not efficient – act as they are not breathingNo checking for pulse or signs of circulation just go straight to CPRPlace one palm on the chest between the nipple lineInterlock your other hand on top of the hand on the chestBring your shoulder over the topMake sure you have a wide base (knees spread just outside your shoulders)Press down 1 ½ -2 inches at a rate of 100 compressions per minute – hard and fastMake sure chest recoils completelyComplete 30 compressions and then give two breaths.Do not stop unless and AED is available, victim moves, or you substituted out (if two rescuers are available – switch every five cycles of 30:2 – approx two minutes) – reduces fatigue
18A = Airway B = Breathing Head tilt and Chin lift If you do not detect normal breathing – give two breaths lasting 1 second each (may use barrier)Watch chest rise, allow exhalation before next breath.If breaths do not go in – reposition head and try again.Practice
20PracticePractice compressions 30 times twice – alternate with partner – no breaths60 sec test – just compressions – try to get compressions – allows to learn rhythm. Perform 1-2 times or as neededTwo minute test – performing 30:2 (includes breath) - should complete five cycles in that time.
21Very important to limit interruptions of chest compressions. During the beginning stages of CA – chest compressions are more important than breaths. Oxygen level will stay high for the first few minutes but blood is not moving to due to the heart not pumping.Breathing becomes as important as the length of CPR continuesVery important to limit interruptions of chest compressions.Be mindful not to give to many breaths, too much breath or too forceful – may cause gastric filling and the resultant complications, and/or cause diminished blood flow and reduce survival.
22Vomiting/other breathing If someone does throw up – do not panic.Roll victim towards you. Use your body to hold them.Clean out the mouth – roll back and continue.Mouth to noseUse when it is impossible to use the mouth due to injury.Face shields and masks – may be used -Very little chance of transfer of bodily fluids if perform mouth to mouth without mask.Using shield or mask can slow down the CPR process“Chest compression only” CPR is more beneficial than no CPR at all.
23Recovery positionIf victim begins breathing and having a pulse then turn victim to their side with lower arm in front.No position is perfect- just make sure they are stable, near a true lateral position, and there is no pressure on the chest to impair breathing
24Potential neck injury If two or more responders One stabilizes the neck – they will be in charge if victim needs to be movedPlace hands on the sides of the head and neck, using your hands to cup around the neck.Place pressure on head with forearms near the earsElbows should be on the ground, wrists in ulnar deviation so that they come in contact with the head.This will limit the amount of movement that will occur if you have to move your body, for example moving so that CPR can be administered or when EMS puts on a neck brace.If movement is necessary then move body as one.
26Child CPR (ages 1-8) Similarities with Adult CPR Location on chest for compressions is the same – nipple lineRatio of compressions to breaths the same – 30:2Differences with Adult CPRIn the chain of survival you will perform CPR first for two minutes performing five cycles of 30:2 – then call 911 (if you are alone)Reason is that most child and infant cardiac arrests are due from asphyxiation, so they will benefit more from the CPR.The depth you use for compression is 1/3 to ½ depth of the chest. Use one or two hands – which ever is more comfortable.
27Infant CPR Similarities with adult CPR Similarities with Child 30:2 ratio of compressions to breathsSimilarities with ChildPerform CPR first in the Chain of Survival, for the same reasons.If small enough you may carry to phone with you after completing the five cycles – use speaker phoneDepth of compressions.Differences with CPRYou will perform chest compressions one finger below nipple lineYou will place your mouth over mouth and nose of infantYou will only puff air inIf unsure if it is a child or not, if it can fit on your arm, then treat as an infantPractice
29Foreign Body Airway Obstruction (FBAO) Heimlich Maneuver
30Choking Universal sign of choking – hand around throat Ask questions Are you choking? Can you speak? May I help you? – Very important.If they say no leave them alone until they pass out – then it is assumed they want help.If a person can speak or can cough - do not help
31Abdominal thrusts Practice Place yourself behind victim scissor you legsFront leg between victims legsSlightly bend kneesPlace hands on navelplace hands on chest if woman is pregnant or victim is severely overweightPull in and upcontinue until object is out or they pass outUse chest thrusts if you are unable to circumvent the abdomenIf pass out lower them carefully to the floor begin CPROnly difference with CPR is you check mouth for object before breaths.Finger sweep only if you see object.Practice
32Infant FBAO Infant – Finger sweep if see object Practice Conscious – place infant on forearm with babies mouth between fingers – back blows to upper backUnconscious –after back blows - five compressions –look for objectgive breathrepeat cycle – back blows, compressions, look and breathsFinger sweep if see objectPractice
34What is an AED?Automated external defibrillator – is an computerized defibrillatorit can analyze heart rhythmrecognize shockable rhythmadvise the operator whether the rhythm should be shockedvery easy to useAED’s computer chips analyze the rate, size and wave shape of human cardiac rhythm.will not shock a properly functioning heartwill not shock a heart that has stopped – VF is not present
35Universal steps of AED use Place AED parallel to patients left earPower on the AED firstSome automatically turn on when openedAttach the AED to the patients chest with electrode padsRemove clothing – to bear chestBe kind to femalesDry patient or shave chest in area of electrode placement if neededPlace one pad above right nipple and one to the side and below the left nipple. (CPR is continued up to the point of placing the pads on)Analyze rhythmMake sure everyone is clear (must say “stand clear of the victim”). No contactPush analyzeCharge AED if shock is required (some machine charge automatically)
36Shock if indicated – (after checking everyone is clear again) Begin CPR for five cycles then analyze againIf shock is advisable again you clear everyone and shockIf shock is not advisable – continue with CPRIf victim has pulse and is breathing put into recovery position.DO NOT take off pads or turn off AED until prompted by EMS
37Special Considerations WaterMust remove victim from water or wet surfaceDry before attaching padsMetal surfacesIs victim lying on metal surface? – if so move victimThe metal surface may cause the shock form the AED to hit you.ChildrenChildren 8 and older use as soon as possibleChildren 1-8 – CPR for two minutes before using AEDTransdermal medicationsRemove patch and wipe clean before attaching AED padsImplanted pacemakers and defibrillatorsDo not place an AED electrode directly over implanted device.Move at least one inch to the side of devicePractice
39Medical emergencies Breathing difficulties Anaphylaxisis Seizures Asthma problems are increasingMost have medicinesMay need assist victim is administratingIf symptoms continue to get worse call 911AnaphylaxisisSevere reaction to allergenVictim may have epinephrine injectorMay need to administerCall 911 if medicine is not administeredSeizuresGeneral rules – 1) Prevent injury 2) ensure open airway 3) maintain open airway after seizure is completed – place in recovery positionNever try to restrain victim, place anything in the mouth.
40Injury emergencies Bleeding Direct pressure best way If bleeding continues add more gauze or cloth; do not remove gauze or clothUse elastic bandage to apply pressure to gauze and hold it in place.The use of tourniquets should be avoided unless in extreme mattersThe efficacy of elevation and pressure points is inconclusive; if used, use only in conjunction with direct pressure and when there is no apparent fracture or other underlying injury.
41Wounds and abrasions Irrigate wounds until free of any foreign matter. Small wounds and abrasions should be cleaned thoroughly then have triple antibiotic ointment placed on it and covered.Larger wounds need to also be cleaned then covered and taken to doctor for possible stitches
42Burns Thermal burns Electrical burns Cool burn with cold water until pain ceasesDo not cool for more than 10 min. Can lead to further damageBurn blisters cover with loose gauze, but keep intact – breaking them can lead to infectionElectrical burnsMake sure electrical current is shut off before trying to help victim.CPR and defibrillation may be needed as well as burn treatmentAll electrocution injuries should be checked out by a physician
43Spine stabilization Suspect possible spinal injury if… Car accident Injured from fall greater than their heightComplains of neck pain, tingling, or extremity weaknessIs not fully alertAppears to be intoxicatedAppears frail or is >65 yrs oldHas sustained a head injury- Manually stabilize the neck until help arrives.
44Musculoskeletal trauma – sprains, strains, contusions, fractures For sprains, strains, contusions – apply ice for 20.Sprains elevate and place compression bandageR.I.C.E. – rest, ice, compression, elevationIf victim has aversion to cold – place wet cloth between ice and skinYoung kids and elderly especially susceptibleContusion you want to stretch the injury as well as iceIf you are unsure of the injury suspect fracture – do not move or straighten injury. Place ice on area and splint in position, send to ER.If suspect dislocation – splint as is and send to ER.
45Dental injuries Avulsed tooth Hold onto by the crown not the root (part embedded into gumRinse off with water (do not scrub)Either place back into socket or place in glass of milk and see a dentist immediatelyClean bleeding wound with saline solution or tap waterUse cotton to apply pressure to stop bleeding
46Environmental injuries SnakebiteDo not suck wound, it will only exasperate the problemIn case of Coral snake – wrap a bandage around the extremity of the bite – it will help slow the poison – then get to medical facility immediately.Coral snake bites and sucksOther snake bites, wash area with soap and water, try not to move extremity very much and get to medical facility.Cold injuriesHypothermiaImmediately begin re-warming – remove wet clothes and wrap body surface with anything at hand; get to medical facility immediatelyIf far from medical facility you begin active warming – placing near heat source, placing in warm (not hot) water.FrostbiteRemove wet clothing, usually occurs on extremities, do not re-warm if there is any chance it could freeze again or you are close to a medical facility.Use luke-warm water if you are far from medical facility
47Heat InjuriesHeat cramps – muscle cramping, usually due to extreme loss of fluidsGet to cooler areaReplace fluidsIce and stretch areaHeat exhaustionDizziness, could have flushed skin or cool and clammy, disoriented, nausea, headacheGet victim to cool area immediatelyPlace ice on side of neck (carotid artery), arm pits, and groin areaWatch for shock; could lead into heat strokeHeat Stroke – medical emergency – call 911 immediatelyExtreme disorientation, possible unconsciousness, very little sweating, internal temperature of >105.Cool down by any means
48DrowningGet victim out of water as soon as possibleBegin CPR immediatelyIf you are alone – finish five cycles of CPR before calling 911
49Poisons Poison control center – 1-800-222-1222 Chemical Burns Brush off any powder and remove all contaminated clothingAlki or acid exposure – rinse with copious amounts of water.Ingested poisonsDo not ingest any medication; milk, activated charcoal, syrup of ipecac unless instructed by poison control
50ShockDevelops when there is not enough blood flowing to the cells of the bodyCauses in adults;loss of bloodheart attack,allergic reactionSymptomsfeel cold and shiver,feel weak, faint, or dizzy,restless,vomit,feel thirstyTreatmentCall 911Put victim on their backIf not leg injury or pain raise legs 12 inchesCover victim with blanketIf bleeding is visible – use direct pressure