2. Chapter 4 First Aid and CPR Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc.

3. Chapter 4 2 Objectives Determine what is wrong with an injured or sick client. Perform an initial assessment and a focused exam. Perform cardiopulmonary resuscitation (CPR) for the one- rescuer adult

4. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 3 Objectives (cont.) Perform responsive and unresponsive foreign body obstructed airway (FBOA) for adult Successfully complete 16 first-aid and CPR procedures.

5. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 4 Basics of First Aid 4-1 Consent Responsibilities of First Aid Providers Sizing Up the Scene The Initial Assessment Focused Examination

6. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 5 Basics of First Aid First aid is the initial help and care provided to a sick or injured person. It is not a replacement for medical help.

7. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 6 Consent Consent must be obtained before applying first aid to a conscious adult. Consent is implied for an unconscious person.

8. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 7 Responsibilities of First Aid Providers Recognize an emergency based on the client’s appearance, behavior, or surroundings. Make a decision to help. Call EMS if the situation dictates.

9. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 8 Responsibilities of First Aid Providers (cont.) Safely gain access to the client and determine what is wrong. Provide first aid. Stay with the client until EMS arrives.

10. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 9 Sizing Up the Scene Determine the possibility of threats to yourself, the client, and bystanders.

11. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 10 Sizing Up the Scene (cont.) Determine the nature or cause of the illness or injury. Determine the number of sick or injured. Then call EMS if necessary, and report your findings.

12. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 11 The Initial Assessment For a conscious and responsive client, introduce yourself by name, state that you know first aid, and ask if you can help. Based on the client’s response, you can perform an initial assessment.

13. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 12 The Initial Assessment (cont.) Form an impression of the client by asking yourself the following questions: – How does the client look? – How is the client behaving? – Does the client appear to be in distress or pain? – Do you see any bleeding? – What color is the client?

14. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 13 The Initial Assessment (cont.) For an unresponsive client, follow these steps: – Assuming no neck or back injuries, position the client on his or her back. – Check for responsiveness by lightly tapping the client on the shoulder and speaking to him or her. If no response, continue with the ABCs.

15. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 14 The Initial Assessment (cont.) ABCs of an initial assessment Airway – check by using the head tilt- chin lift method. For suspected neck or back injury use the jaw thrust maneuver. Breathing – check for breathing using the look, listen, and feel method. Circulation – check for signs of circulation.

16. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 15 Focused Examination Conduct a focused exam unless the patient requires resuscitation. The focused exam immediately follows the initial assessment. Focused exams need not be performed on clients with minor injuries or illness. NEVER move a client with suspected neck or back injuries.

17. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 16 Focused Examination (cont.) Have someone hold the client’s head, then perform the following steps: – Head – look at and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling.

18. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 17 Focused Examination (cont.) – Eyes – gently open the eyes and compare the pupils. They should be the same size. – Neck – look and feel for deformities, bruises, depressions, open wounds, tenderness, and swelling. Check for a medical alert necklace.

19. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 18 Focused Examination (cont.) – Chest – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. – Abdomen – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling.

20. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 19 Focused Examination (cont.) – Pelvis – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. – Legs – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Compare the skin color, temperature, and size of both legs.

21. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 20 Focused Examination (cont.) – Arms – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Compare the skin color, temperature, and size of both arms. – Back – slide your hand under the back as far as it will go, without moving the client. Look and feel for bleeding, deformities, bruises, open wounds, depressions, tenderness, and swelling.

22. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 21 When should you move a client with a neck or back injury? Section 4-1 Apply Your Knowledge Answer: NEVER move a client when you think that the client has a neck or back injury.

23. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 22 Cardiopulmonary Resuscitation 4-2 The Chain of Survival Using Barrier Devices and Face Masks Using a Bag-Valve Mask Cardiopulmonary Resuscitation Foreign Body Airway Obstruction

24. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 23 The Chain of Survival Sudden cardiac arrest occurs when the heart suddenly stops beating. Ventricular fibrillation (VF) occurs when the heart stops beating and just quivers.

25. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 24 The Chain of Survival (cont.) Four links in the chain of survival: – Early access to EMS. – Early CPR. Improves chance of survival twofold. – Early defibrillation, or restoration of normal heart rhythm. – Early advanced care. Paramedics provide the necessary combination of drugs, airway management, and defibrillation to improve the chances of survival for clients of cardiac arrest, heart attack, stroke, and choking.

26. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 25 Using Barrier Devices and Face Masks Follow appropriate infection control procedures, including use of latex or vinyl gloves and barrier devices.

27. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 26 Cardiopulmonary Resuscitation Three “red flags” for victims of sudden cardiac arrest: – No response when spoken to or touched. – No breathing or inadequate breathing. – No signs of circulation such as coughing, movement, or pulse.

28. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 27 Foreign Body Airway Obstruction Foreign body airway obstruction (FBAO) can occur in clients of all ages. Perform abdominal thrusts or chest thrusts until object is expelled.

29. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 28 Section 4-2 Apply Your Knowledge Name the four links in the chain of survival. Answer: 1.Early access to EMS. 2.Early CPR. 3.Early defibrillation. 4.Early advanced care.

30. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 29 Emergencies The most common types of emergencies are: – Injuries to bones, joints, and muscles – Diabetic emergencies – Heat emergencies – Cold-related emergencies – Poisons – Heart attack – Stroke – Minor wounds – External bleeding – Internal bleeding – Shock – Anaphylaxis – Burns

31. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 30 Section 4-3 Apply Your Knowledge What are four signs or symptoms of an injured extremity? Answer: 1.Deformity 2.Pain and tenderness 3.Swelling 4.Bruising

32. Copyright © The McGraw-Hill Companies, Inc. Chapter 4 31 Chapter 4 Credits Slides 11, 17, 18, 19, 20, and 21Aaron Haupt