Title: Emergency Lifesaver Course
1Emergency Lifesaver Course
- Objectives of First Aid
- Preserve Life Prevent Worsening Pain Relief
- Necessity of First Aid
- Importance of the first 5 minutes
- Necessity of independent aiders - the courage to
help - In saving others, society saves us
- Casualty (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 Calmly and quickly call 119 and
explain the situation
Early CPR Perform CPR or other first aid as
necessary until ambulance arrives
Quick Emergency Measures Ambulance team provides
further expert care
Early Medical Care Professional care at medical
institution
4Is Resuscitation Possible?
100
1
2
3
75
Death rate
50
25
0
1hour
3
2
5
10
15
30
1min
30s
time
? 50 die within 3min after circulatory arrest ?
50 die within 10min after pulmonary arrest ? 50
die within 30min of major bleeding
Average ambulance arrival time is 6min from
call
5Preserve airway
If unconscious
Emergency Aid
First Aid
Artificially ventilate
If not breathing
If no heartbeat
Chest compressions
If airway blocked
Remove obstruction
If bleeding heavily
Stop bleeding
Make comfortable. Treat fractures, wounds,
injuries, burns, drowning. Transportation.
OtherAid
6Age Divisions for First Aid Treatment
- Life Saving
- CPR(observation, airway, breathing, circulation)
- Bleeding
- Age 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 bleeding
- Impaired consciousness? Preserve airway
- Breathing absent or impaired? Ventilate
- No signs of circulation? CPR
Is casualty breathing?
Watch response
Signs of circulation
Whenventilating
Any coughing?
Give two breaths
Any movement?
8Signs of Circulation Checking the Pulse
- Adults, children
- (carotid artery)
- Infants, newborns
- (brachial or femoral
- artery)
9?Conscious?
No
Yes
?Get help
?Breathing?
Insufficient
?Open airway
Sufficient
?Breathing?
Sufficient
Put in recovery position and observe
?Ventilate (2 times)
Yes
If breathing still insufficient continue
ventilating (one breath every 5 seconds)
?Circulation signs? (breathing, coughing,
movement)
?? CPR (15 compressions 2 breaths) for 4 cycles
Yes
If breathing recovers or casualty protests,
stop ventilating
?Circulation signs?
? Continue CPR (15 compressions 2 breaths)
10Observation Consciousness
- Call Are you alright? Can you hear me? into
casualtys 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
unconscious Do not move or slide the
casualty For infant/newborn casualty, scrape the
sole of the foot
Can you hear me?
11Get Help
- Choose someone and request their help.
Please call 119 for an ambulance
12The Airway
- The airway is the path taken by air through the
mouth and nose - to 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 Breathing
- Place your ear above the casualtys 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 1 2 3 4 5 6 No breathing Ventilate
16The Recovery Position
- For the casualty who is breathing sufficiently
but is not fully conscious. Use the casualtys
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 -Tracheostomy etc.
18Breathe for the Casualty
- Open your mouth wide, take a deep breath, and
seal your lips around the casualtys mouth. Blow
into the lungs, looking along the chest until you
see the chest rise slightly. - Blow about 10cc per kg of casualtys weight.
(e.g. 500-800cc)
Problems Open airway? Nostrils? Seal? Airway
obstructions?
19Remove your mouth and watch the chest fall
Pros and cons of Mouth-to-Mouth Ventilation
Requires no special tools Can be done by one
person, even a child Easy to see if its working
Risk of infection Risk of secondary poisoning May
feel unpleasant
20Preventing Infection
- A non-return valve resuscitation mask can be
used. - If youre worried about infection you can perform
chest compressions only.
21Ventilating when circulation signs are present
1
2
5
7
1
9
1
2
4
6
8
10
2
3
1
Breathe gently for two seconds
Breathe gently for two seconds
Breathe gently for two seconds
No breathing
Ventilate
Ventilate
Ventilate
Check signs for no more than ten seconds. Look
for autonomous breathing, coughing or
movement. Breathing may still be insufficient.
Circulation Signs present
22Breathing Age groups
Method
Duration
Amount
Frequency
Mouth-to-mouth
2 sec.
500-800cc (10cc/kg)
Every 5 sec.
Adult
1 - 1.5 sec.
Until chest rises gently.
Every 3 sec.
Child
Mouth-to-nose Mouth-to-mouth-and-nose
Infant
1 sec.
Every 1 - 2 sec.
Newborn
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
casualtys ribs.
Heart
Hand 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.
Hand position
Sternum
One finger-space
Lower limit for compression
Xiphoid process
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 on the sternum
Middle finger in the notch
27- Now 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
- ? Sit level with the casualtys chest
- ? Correct hand position, with the heel of the
hand - ? Lock your elbows
- ? Position your shoulders over the chest
- ? Using your body weight, compress straight down
towards the ground
Adult casualty Compress 3.5?5cm Rhythm of 100
per min.
29Compression technique
- Avoiding pressure on the casualtys 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 Vertically
- With elbows straight, push straight down.
Release pressure promptly. Take care not to lose
your position.
31Cardiac Compressions
- Compressing the heart between the sternum and
spine causes blood to circulate. - Compress 15 times at a rate of 100
compressions/minute.
sternum
heart
spine
upstroke
downstroke
32How NOT to do it!
Dont bend your elbows
33Cardio-pulmonary Resuscitation(CPR)
- Repeat cycles of 15 compressions to two breaths
(ratio 152) - After the first four cycles, check again for
signs of circulation - for no more than 10
seconds
3410 second check for signs of life
15 chest compressions
2 breaths
2 breaths
No breathing. Ventilate.
Checking signs
No signs of life
Starting CPR
One cycle 15 compressions 2 breaths
35Removing Obstructions (1)
- Open the casualtys 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.
Dont move the head when inspecting the
mouth. Do you need to remove dentures?
36Removing Obstructions (2)
- Turn casualtys 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 casualtys shoulder blades using the heel of
your hand.
38Heimlich Maneuver (Sitting)
- Only on conscious casualties aged gt 8 years
-
Put the ball of the thumb against the upper
stomach area Put your chest against the
casualtys back. Put both arms under the
casualtys 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.
41? Conscious?
No
Yes
? Call for help
? Breathing?
Not enough
? Open airway
Enough
? Breathing?
Enough
Recovery position (continue to monitor)
? Two breaths
Yes
? Check signs of life Breathing? Coughing?
Moving?
If breathing sufficient, continue ventilations (1
every 2 to 3 sec.)
?? Perform CPR (152)
Yes
If breathing recovers or casualty objects, stop
ventilations
? Check signs of life
? Perform CPR (152)
42CPR for Children, Babies and Newborns
- Mouth-to-Mouth
- Two breaths.
- 11.5 seconds apart.
- Chest should rise gently.
Mouth-to-Nose Mouth Two breaths. Breathe for 1
sec.
Baby Newborn
Child
43Baby Newborn
Child
44Removing Obstructions Baby Child
Thoracic Compressions Face upward. Compress
lower sternum as for CPR, 5 times.
Back Slaps Turn over, facing downwards Support
chin with fingers Slap 5 times with heel of hand
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 pad
bone
wound
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 wont move.
3. Insert the stick. Steady the pad.
6. Record the time.
48- Legal 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. -
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