Unit 5:Advanced First Aid Monday 23rd April 2012 Unit 5:Advanced First Aid

Task 3: your log……. So far, we have covered….. DRABC Unconscious/conscious casualty CPR Fainting Shock Angina/Heart attack Internal/External bleeding Penetrating Chest wounds

Outcomes for today Identify the structure of the respiratory tract Describe the functioning of the respiratory system Define hypoxia Identify and explain the causes of hypoxia Define hyperventilation Explain the treatment of hyperventilation Demonstrate how to manage an incident of choking

The Respiratory System

Hypoxia “Insufficient oxygen in the body tissues”, which results in a deterioration in body function. First aid manual, 9th edition

Signs and symptoms rapid breathing (tachypnoea) Breathing that is distressed or gasping Difficulty speaking Cyanosis (grey-blue skin) Anxiety Restlessness Headache Nausea and, possibly vomiting Respiratory arrest (breathing stops) Initially cyanosis will be more obvious in the extremities, such as lips, nailbeds, earlobes (peripheral cyanosis). As the condition worsens, the rest of the body will be affected (central cyanosis)

Causes of Hypoxia Injury or condition Causes Insufficient oxygen in inspired air Airway obstruction Conditions affecting the chest wall Impaired lung function Damage to the brain or nerves that control respiration Impaired oxygen uptake by the tissues

Causes of hypoxia Injury or condition Causes Insufficient oxygen in inspired air Suffocation by smoke or gas; Changes in atmospheric pressure, eg at high altitude or in a depressurised aircraft Airway obstruction Blocking or swelling of the airway; hanging or strangulation; asthma; choking; anaphylaxis; something covering the nose and mouth Conditions affecting the chest wall Crush injuries; chest wall injury with multiple rib fractures or constricting burns Impaired lung function Lung injury; collapsed lung; lung infections Damage to the brain or nerves that control respiration Head injury or stroke; some forms of poisoning; paralysis of nerves controlling the muscles of breathing eg spinal cord injury Impaired oxygen uptake by the tissues Carbon monoxide poisoning, shock.

What is hyperventilation? A manifestation of acute anxiety, and may accompany a panic attack. Hyperventilation causes an increased loss of carbon dioxide from the blood, leading to chemical changes within the blood

Signs and symptoms Unnaturally fast breathing Fast pulse rate Apprehension Dizziness or faintness Trembling, sweating, dry mouth Tingling and cramps in the fingers, hands, feet and mouth Reference: First aid manual, 9th edition

Treatment and care of hyperventilation Remove casualty from cause of distress Speak clearly-be firm, calm, kind and reassuring DO NOT- rebreathe air from a paper bag Reference: First aid manual, 9th edition how-to-help-someone-with-hyperventilation

Choking

Choking- signs and symptoms Ask the casualty – “Are you choking?” Mild obstruction: casualty able to speak, breathe and cough Severe obstruction: casualty unable to speak, breathe or cough, with eventual loss of consciousness SJA- girl choking on popcorn

Choking-Treatment and care choking scenario red cross video child choking scenario

REMEMBER….. Any casualty who has been given abdominal thrusts MUST seek medical advice If the casualty loses consciousness, open the airway and check breathing. If not breathing, begin CPR to try to relieve the obstruction

Quick quiz 1. What is hypoxia?

Insufficient oxygen in the body tissues”, which results in a deterioration in body function.

2. List 10 causes of hypoxia

Suffocation by smoke or gas, Changes in atmospheric pressure, as in an aircraft Blocking or swelling of airway, Hanging or strangulation, Something covering the mouth and nose, Asthma, Choking, Anaphylaxis. Crushing, for example by a fall of earth or sand or pressure from a crowd, Chest wall injury, such as multiple rib fractures or constricting burns Lung injury, collapsed lung, lung infections such as pneumonia A head injury or stroke that damages the breathing centre in the brain, Poisoning, Paralysis of the nerves controlling the muscles of breathing such as spinal cord injury. Carbon monoxide poisoning, shock.

3. Identify 5 symptoms of hypoxia

rapid breathing (tachypnoea) Breathing that is distressed or gasping Difficulty speaking Cyanosis (grey-blue skin) Anxiety Restlessness Headache Nausea and, possibly vomiting Respiratory arrest (breathing stops)

4. Identify 3 actions you could take to help a person who is hyperventilating

Remove casualty from cause of distress Speak clearly-be firm, calm, kind and reassuring Try to use guided breathing technique to slow respirations

5. Explain how you would help some one who is choking

Encourage casualty to cough Remove any obvious obstruction 5 sharp back blows 5 abdominal thrusts Repeat cycle 3 times, check mouth after each step

UNIT 5: advanced first aid Asthma

what is asthma?

“Incidence”, OR, How common is asthma? 5.4m people in the UK are currently receiving treatment for asthma. 1.1m children in the UK are currently receiving treatment for asthma. There is a person with asthma in one in five households in the UK.

What happens during an asthma “attack”? Air enters the respiratory system from the nose and mouth, and travels through the bronchial tubes. In response to an irritant, the muscles of the bronchial tubes go into spasm. They tighten and thicken, and become swollen, making it difficult for air to move. what happens during an asthma attack?

Why does this happen? You may be more likely to develop asthma if…. what causes asthma? Many things can trigger an asthma attack-it tends to be very different for each individual. asthma triggers

Asthma: signs and symptoms Difficulty breathing Wheezing Difficulty speaking, leading to short sentences and whispering Coughing Distress and anxiety Cyanosis (features of hypoxia) Exhaustion

Care and Treatment Keep calm and reassure the casualty Get them to have a puff of their inhaler Encourage them to breathe deeply and slowly Encourage them to sit in a comfortable position A mild attack should ease in a few minutes. If not get them to take another dose of inhaler If attack is severe, call for emergency help Monitor vital signs until help arrives what to do during an asthma attack

Anaphylaxis Anaphylaxis is a severe, life-threatening, generalised or systemic hypersensitivity reaction.

Anaphylaxis It is characterised by rapidly developing life-threatening airway and/or breathing and/or circulation problems usually associated with skin and mucosal changes.

What happens during “anaphylaxis”? what happens during an allergic reaction? how allergies develop

Signs and symptoms Red, itchy skin or weals Red, itchy watery eyes Swelling of hands, feet, and/or face Abdominal pain, vomiting and diarrhoea Difficulty breathing, (ranging from tight chest to severe difficulty, causing wheezing and gasping) Pale or flushed skin Visible swelling of tongue and throat with puffiness around eyes Feeling of terror Confusion and agitation Signs of shock, leading to collapse and loss of consciousness

Recognising anaphylaxis Anaphylaxis is likely when all of the following 3 criteria are met: Sudden onset and rapid progression of symptoms Life-threatening Airway and/or Breathing and/or Circulation problems Skin and/or mucosal changes (flushing, urticaria, angioedema) The following supports the diagnosis: Exposure to a known allergen for the patient

Care and treatment Patients having an anaphylactic reaction in any setting should expect the following as a minimum: 1. Recognition that they are seriously unwell. 2. An early call for help: tell ambulance control that you suspect anaphylaxis Check whether casualty is carrying Epinephrine (Adrenaline) and help them to use it. Administer into thigh, it can be given through clothing) Help casualty to sit up in the position that best relieves any breathing difficulties (if she becomes pale with a weak pulse, help her to lie down with legs raised and treat for shock) Monitor and record vital signs and level of response while waiting for help to arrive. Repeated doses of Adrenaline (epinephrine) can be given at 5 minute intervals if no improvement