cardiopulmonary resuscitation (cpr)/first aid. copyright © 2004 by thomson delmar learning. all...

Cardiopulmonary Resuscitation (CPR)/First Aid

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Providing First Aid

Immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over

Reasons for providing correct first aid


Basic Principles ofProviding First Aid

Remain calm and avoid panic Evaluate situation thoroughly Have a reason for anything you do Treatment you provide will vary depending

on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help


First Steps

Recognize that an emergency exists Use all senses to detect problems Sometimes signs of emergency are

obvious and at other times they are less obvious


Next Steps

Check the scene and make sure it is safe to approach

What to observe If not safe, call for medical help If safe, approach the victim Call emergency medical services (EMS)

as soon as possible


Next Steps(continued)

If possible, obtain the victim’s permission before providing any care

Triage if necessary Check for other injuries Obtain as much information as possible


General Principles

Obtain qualified help as soon as possible Avoid any unnecessary movement of

the victim Reassure the victim Use a confident, calm attitude to help

relieve victim’s anxiety Avoid giving the victim anything to eat

or drink


General Principles(continued)

Protect the victim from cold or chilling, but avoid overheating

Work quickly in an organized and efficient manner

Do not make a diagnosis or discuss condition with observers at scene


General Principles(continued)

Maintain confidentiality and protect the victim’s right to privacy while providing treatment

Make every attempt to avoid further injury Provide only the treatment you are

qualified to provide


Performing Cardiopulmonary Resuscitation (CPR)

Cardio: the heart Pulmonary: the lungs Resuscitation: to remove from apparent

death or unconsciousness Breathe for the patient and circulate blood


Performing Cardiopulmonary Resuscitation (CPR) (continued)

Purpose: keep oxygenated blood flowing to the brain and other vital body organs

Performed until the heart and lungs start working again or until medical help is available

Clinical versus biological death



“CABD’s” of CPR (per 2010 guidelines)

C stands for circulation A stands for airway B stands for breathing D stands for defibrillation



Evaluate victim’s condition before starting CPR

Correct hand placement is essential before compressions are performed

Compression rate of at least 100 per minute



One-person rescue for adult victim Two-person rescue for adult victim CPR for infants CPR for children CPR for victims with FBAO

– (Foreign Body Airway Obstruction)

Reasons for stopping CPR



Reasons for stopping CPR– The scene becomes unsafe and you have to

evacuate yourself and your victim– Physically unable to continue– Persons with more training than yourself

accept responsibility for victim and take over their care

– The victim shows signs of life


Providing First Aid for Bleeding and Wounds

Wounds involve injuries to the soft tissues General classifications of wounds

– Open: break in skin or mucous membranes– Closed: no break in skin or mucous

membranes, but injury occurs to underlying tissues

• Wounds can result in bleeding, infection, and/or tetanus


Classifications of Open Wounds

Abrasion Incision Laceration Puncture Avulsion Amputation


Controlling Bleeding First priority because victim can bleed to

death quickly Bleeding can come from arteries, veins,

or capillaries Observe standard precautions

– Handwashing before/after care– Gloves – Goggles– Mask


Controlling Bleeding(continued)

Direct pressure Elevation Pressure bandages Pressure on pressure points Do not disturb clots Do not remove dressings Do not clean wound


Minor Wounds

First priority – prevention of infection Wash your hands before caring for wound Put on gloves Wash the wound with soap and water Rinse the wound thoroughly Use sterile supplies Tell the victim to get follow up medical

help - ALWAYS


Signs of Infection

Swelling Heat Redness Pain Fever Pus Red streaks

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Tetanus

Tetanus bacteria can enter an open wound

Serious illness Get tetanus shot or booster as needed


Objects Embedded in Wound

If superficial, gently remove Objects embedded in tissues should be

left and removed by physician


Closed Wounds

Can occur anywhere on body If bruise, apply cold application to

reduce swelling Observe for signs of internal bleeding Get medical help as quickly as possible Check breathing and treat for shock Avoid unnecessary movement of victim No food or fluids


Providing First Aidfor Shock

Also called hypoperfusion Shock: clinical set of signs and symptoms

that are associated with an inadequate supply of blood to body organs, especially brain and heart

Causes of shock


Providing First Aidfor Shock (continued)

Goals of treatment Positioning of victim Maintain body temperature Avoid food or drink Other principles of care


Types of Shock

Anaphylactic Cardiogenic Hemorrhagic Metabolic Neurogenic


Types of Shock


Hypersensitive or allergic reaction to a substance such as food, medications, insect stings or bites, or snake bites


Types of Shock


Damage to heart muscle from heart attack or cardiac arrest


Types of Shock


Severe uncontrolled bleeding leading to life-threatening condition(Hypovolemic Shock)


Types of Shock


Loss of body fluid from severe vomiting, diarrhea, or a heat illness, disruption in acid-base balance, as occurs in diabetes


Types of Shock


Injury and trauma to brain and/or spinal cord


Types of Shock(continued)

Psychogenic Respiratory Septic




Emotional distress, such as anger, fear or grief




Trauma to respiratory tract; respiratory distress, or arrest (chronic disease, choking)




Acute infection that infects the entire body by entering the bloodstream


Signs and Symptomsof Shock

Skin is pale or bluish-gray and cool or cold to the touch

Diaphoresis (excessive sweating) Rapid and weak pulse Respirations rapid, shallow, and

may be irregular Blood pressure very low or unobtainable


Signs and Symptomsof Shock (continued)

General weakness Anxiety and extreme restlessness Excessive thirst Nausea and/or vomiting Blurred vision or changes in appearance

of eyes


Providing First Aidfor Poisoning

Can happen to anyone regardless of age Poison: any substance that causes a

harmful reaction when applied or ingested Immediate action is needed First aid varies depending on

type of poison, injury involved, and the method of contact


Ways Poisoning Occurs

Swallowing various substances Inhaling poisonous gases Injecting substances Contacting the skin with poison


First Aid for Poisoning

If poison has been swallowed Methods to induce vomiting If poisoned by inhalation of gases If poisoned by contact with skin Contact with poisonous plants If poisoned by injection



If poison has been swallowed– Call Poison Control Center 1-800-222-1222– Call EMS: If warranted or delayed response

from Poison Control Center– Save container (label) for EMS– Estimate amount of ingestion if possible– Save emesis (if any) for testing– Induce vomiting ONLY if told to do so by EMS

or Poison Control Center



Methods to induce vomiting– Syrup of Ipecac (follow dosing instructions)

followed by 1-2 glasses of water– Warm salt water– Stimulate gag reflex– NOTE: Vomiting removes about one half of

the ingested poison



If poison has been swallowed– Do NOT induce vomiting if victim:

• Is unconscious• Swallowed acid or alkali• Swallowed petroleum products• Is convulsing (seizure)• Has burns on lips or in mouth

– Activated Charcoal may be recommended to neutralize poison



If poisoned by inhalation of gases– Remove victim from area immediately– Carbon monoxide

If poisoned by contact with poison– Use large amounts of water to wash the skin

for at least 15-20 minutes– Remove clothing, jewelry that may have come

in contact with poison



If poisoned by injection (insect/snake)– If extremity is affected LOWER the extremity

BELOW the level of the heart– Insect bite: Remove stinger by scraping the

stinger with edge of credit card or similar device

– Insect bite: DO NOT ATTEMPT TO REMOVE STINGER WITH FINGERS OR TWEEZERS – you will likely inject more poison by squeezing stinger



If poisoned by injection (insect/snake)– Insect bite: Wash area with soap and water

– Ticks: Use tweezers and slowly pull tick away from skin

– Snakebite: Wash wound with soap and water and immobilize the area



If poisoned by injection (insect/snake)– Snakebite: Wash wound with soap and water

and immobilize the area– Snakebite: Do NOT cut the skin (and suck

out the poison)– Snakebite: Do NOT apply tourniquet– Snakebite: Monitor respirations closely and

provide artificial ventilations if needed– Snakebite: Get medical help quickly


Providing First Aidfor Burns

Injury caused by fire, heat, chemical agents, radiation, and/or electricity

Classifications of burns– First-degree or superficial (redness)– Second-degree or partial-thickness (blister)– Third-degree or full-thickness (burned tissue)

(Some burn scales include a 4th degree, which is a more specific “3rd” degree.)


Treatment Objectives

Remove source of heat Cool the skin Cover the burn Relieve pain Observe for and treat shock Prevent infections – cover with cleanest

cloth and soak with cool/cold water (seek medical attention)


Treatment

First Degree Burns Usually not required for first-degree burns Removing source of heat Cool area down (water) Light coat of antibiotic ointment Cover is needed (shade) Assess and treat for signs of shock (Pain)


Treatment

Second Degree Burns Second degree burns will blister DO NOT rupture blister! Remove source of heat Cool area with cool water Cover (dressing) Assess and treat for shock (Very painful!)


Treatment

Third Degree Burns Third degree burns involve extensive

tissue, muscle and possibly bone damage. Remove source of heat Cover (dressing) Assess and treat for shock Pain may be less (damaged nerves)


Treatment


Chemical Burns

Chemicals splashed on skin or eyes– Flush affected area with large amounts of

water for 15-30 minutes or until medical help arrives

– For eyes: turn victim towardaffected eye to prevent chemical from going intounaffected eye.


Providing First Aidfor Heat Exposure

Overexposure to heat may cause a chemical imbalance in the body

Water & salt are lost through perspiration Also occurs when body cannot eliminate

excess heat Life-threatening


Heat Cramps

Muscle pains and spasms Caused by exposure to heat Loss of water and salt from perspiration Apply firm pressure on cramped muscle to

provide relief Encourage rest and move to cooler area Small sips of water or electrolyte solution

(e.g., sports drink)


Heat Exhaustion

Occurs when exposed to heat and there is loss of fluids through sweating

Signs and symptoms– Pale, clammy skin– Diaphoresis– Fatigue– Headache– Muscle cramps– Nausea/Vomiting


Heat Exhaustion

First aid care– Move victim (if safe to do so) to cooler area– Lay victim down, raise feet– Remove excess clothing– Apply cool, wet clothes– Small sips of water– Do not dry sweat from victim’s body


Heat Stroke

Prolonged exposure to high temperatures Medical emergency Needs immediate care! Body unable to eliminate excess heat


Heat Stroke

Signs and symptoms– Red, hot DRY skin– Rapid, but strong pulse– Victim may lose consciousness– Seizures

First aid care– Cool body quickly


Heat Stroke

First aid care– Cool body quickly– Tub of cool water– Ice or cold packs to wrists, ankles, axillary

areas and groin– Assess and treat for shock– Seek medical help immediately


Providing First Aidfor Cold Exposure

Exposure to cold external temperatures can cause body tissues to freeze and body processes to slow down

Needs immediate attention Degree of injury affected by wind velocity,

amount of humidity, and length of exposure to cold


Hypothermia

When body temperature is less than 95 degrees Fahrenheit or 35 degrees Celsius

Caused by prolonged exposure to cold Elderly more prone to hypothermia than

younger persons


Hypothermia

Signs and symptoms– Shivering– Numbness– Drowsiness– Poor coordination– Confusion– Loss of consciousness

Death can occur if body processes become too slowed down


Frostbite

Actual freezing of tissue fluids with damage to the skin and underlying tissues

Caused by exposure to freezing or below-freezing temperatures

Early signs and symptoms– Redness and tingling of affected areas– Pain to affected areas


Frostbite

Other signs and symptoms as progresses– Pale, glossy skin– White or grayish colored skin– Blisters– Loss of all sensation– Confusion– Lethargy– Unconsciousness


Frostbite(continued)

Objectives of first aid– Gradual warming of tissues– Do not rub or massage affected areas– Assess and treat for shock

Common sites: fingers, toes, ears, nose, cheeks


Providing First Aidfor Bone and Joint Injuries

Variety of injuries can occur Frequently occur during accidents, falls,

and among athletes Examples: fractures, dislocations, sprains,

and strains May have more than one type of injury to

bones and joints at the same time


Fracture

Break in the bone Closed or simple fracture


Fracture

Break in the bone Compound or open fracture


Fracture

Break in the bone Signs and symptoms

– Not always obvious– Pain– Deformity– Swelling– Tenderness– Discoloration– Protrusion of bone through skin


Dislocation

When the end of the bone is displaced from a joint or moved out of its normal position within a joint

Tearing or stretching of ligaments, muscles, and other soft tissues also frequently occurs

Signs and symptoms First aid care


Dislocation


Sprain

Injury to the tissues surrounding a joint Common sites: ankles and wrists Signs and symptoms Frequently resemble fractures or

dislocations – treat as fracture if in doubt First aid care


Sprain


Strain

Overstretching of a muscle Caused by overexertion or by lifting Frequent site: back Signs and symptoms First aid treatment


Splints

Devices used to immobilize injured part Types of splints

– Pneumatic or air splints– Padded boards– Traction splints

Splints can also be made from cardboard, newspapers, pillows, boards, etc.

Splints


Pneumatic - Air

Traction

Padded

Pneumatic - Vacuum


Splints(continued)

Need to be long enough to immobilize the joint above and below the injured area

Should be padded Tied in place Apply as not to create pressure on area If open wound, control bleeding before

applying splint


Splints(continued)

Never attempt to reposition bone Splint before moving victim Observe precautions when using

pneumatic splints (overinflating) Traction splints – Only trained personnel

are to apply traction splints


Circulation Check After Splint

Verify that the splints are not too tight Check skin temperature Check color Note swelling or edema Numbness or tingling Check pulse If circulation impaired, immediately loosen


Slings

Commercial slings Triangular bandages Use: support arm, hand, forearm,

and shoulder Positioning of sling Check circulation Limit movement of limb

Slings



Slings(continued)

If use knots– Placement – “short end” of triangular bandage

should extend back and under the elbow of the injured arm

– Padding

Special considerations for shoulder injury


Checkpoints for Circulation

Check circulation after bandage applied Signs of poor or impaired circulation

– Swelling or edema– Pale or cyanotic color– Coldness to touch– Numbness or tingling– Poor or slow capillary refill

Loosen bandage immediately if warranted


Neck or Spine Injury

Most dangerous types of injuries involving bones and joints

Movement can result in permanent injury resulting in paralysis

Avoid any movement of victim if at all possible

Wait for backboard and adequate help to arrive for transfer


Eye Injuries

Always involves danger of vision loss Usually best to avoid giving

major treatment Obtain help of a specialist Foreign objects in the eye Blows to the eye Penetrating injuries that cut eye tissue


Ear Injuries

Can result in rupture or perforation of eardrum

Torn or detached tissue Ruptured or perforated eardrum Clear fluid or blood-tinged fluid draining

from ear


Nose Injuries

Nosebleeds are usually more frightening than serious

Nosebleeds also called epistaxis Causes of nosebleeds First aid care


Abdominal Injuries

Can cause damage to internal organs and bleeding in major blood vessels

Intestines and other abdominal organs may protrude from open wound

Medical emergency Bleeding, shock, and damage to organs

can be fatal Signs and symptoms First aid care


Seizures

Strong involuntary contraction of muscles Electrical storm of the brain – uncontrolled

nerve impulses Causes – tumor, trauma, febrile, genetic

medical condition (epilepsy) Progression of a convulsion (aura) First aid care is directed at preventing

self-injury


Seizures

Time seizure Clear area Do not place anything in mouth Place victim on side protect airway

(prevent aspiration) Loss of bowel/bladder control Reassure victim once seizure ceases


Diabetes Mellitus

Metabolic disorder caused by lack of or insufficient production of insulin

Diabetic coma (sustained hyperglycemia, low insulin production)

Insulin shock (high level of insulin, low sugar)

Differentiate between diabetic coma and insulin shock


Summary

Proper first aid can save a life Provide only care you are qualified

to provide Always reassure victim and avoid

unnecessary stress and movement Obtain medical help as quickly as possible

Thank goodness we are DONE!!!!!


cardiopulmonary resuscitation (cpr)/first aid. copyright © 2004 by thomson delmar learning. all...

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