First Aid and CPR Training

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First Aid and CPR Training

• Black Hills High School
• Freshmen PE/Health

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Objectives

• Describe role and responsibilities of a first aid
  provider
• Able to provide and administer first aid /or CPR
• Describe Universal Precautions body substance
  isolation
• Have knowledge of God Samaritan Law

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What to expect when you call 911

• Dial 9-1-1, here at BHHS 9-9-1-1
• Do you need police, fire, or medical aid?,
  911, What are you reporting?
• Be prepared to answer
• Whats the problem?
• Whats approx. age?
• Is he/she conscious?
• Is he/she breathing?

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Patient Assessment

• Primary Assessment
• Put on gloves
• Ask patientWhat happened? How can I help you?
  Where do you hurt?
• A-Airway
• B-Breathing
• C-Circulation
• D-Defibrillation
• What does skin look or feel like?
• Head to toe sweep of major bleeding or other
  obvious injury
• Monitor level of consciousness

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Primary Care

• Head Stabilization. Tell patient not to move.
  Keep head immobile if injured.
• Expose and control all bleeding
• Natural position of patient, keep warm, treat
  for shock if needed

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Medical History

• Signs and symptoms
• Allergies?
• Medications?
• Previous and current medical history
• Last meal
• Events leading up to incident

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Secondary Survey

• Medic alert tag on wrist
• Head to toe

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CPR

• Check for safety
• Talk Touch
• Are you okay. Gentle touch
• Call for help/activate EMS system, 911,
• Help!, You go call 9-1-1 and come back!
• Open and Maintain Airwayhead tilt, chin lift,
  look carefully in mouth.
• Check for breathing

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Check for breathing

• Look
• Listen
• Feel for at least 5-10 seconds

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Ventilate

• Head tilt chin up
• Plug nose give two breaths (about one second
  long)
• Watch chest rise.
• If chest does not rise, try again

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Begin Chest Compressions

• Two hands, overlapped midline of nipple
• 1-1/2- 2 inches deep
• 2 breaths, 30 compressions
• Stop recheck, 5 intervals and then recheck.
• Rate of 100 compressions in one minute!
• Staying Alive Beat!

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Child CPR

• Follow same ABCs
• Compressions one hand, one inch deep
• 2 breaths, 30 compressions
• Re-check, 5 intervals

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Infant CPR

• Follow ABCs
• Two fingers to sternum
• 2 puffs, 30 compressions,
• (Two puffsenough to fill your cheeks)
• Recheck, 5 intervals

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• Adult CPR

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                                          CPR
for Children (Ages 1-8)     CLICK HERE FOR A
VIDEO DEMONSTRATION CPR for children is similar
CPR for adults. The compression to ventilation
ratio is 302. There are, however, 3 differences.


                                 
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PRACTICE!!!!!
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Infant CPR
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This is an AED
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Automatic External Defibrillator (AED)

• Cost 1,000-3,000.
• Airplanes, airports, shopping centers, schools,
  everywhere
• BHHSNurse station
• 85 of adults go into abnormal heart rhythm
  before their heart totally stops.
• This rhythm is usually called ventricular
  fibrillation

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AEDs cont

• The electrical shock is used to stop this
  quivering rhythm and allows the heart to re-start
  in the normal squeezing action.
• AN AED will not allow shock a patient that does
  not need it.

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CPR and AED.

• Airway
• Breathing
• Circulation
• Defibrillation listen to its instructions
• Special Circumstances
• Wet surfaces---not a good idea. Only for victims
  older than one year of age.

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Special considerations AED

• Use pediatric pads if available
• Remove medication patches on chest
• Do not place de-fib patches over implanted
  devices, give 1 clearance
• De-fib patches placed on right upper portion of
  chest below collar bone above nipple.
• Patches on bare skinmay need to remove hair
• While the machine is in use DO NOT touch the
  patient during analysis and shock.

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CPR Quiz

• 1. Victim responsiveness is checked by
• a.) Shaking and shouting at the victim
• b.) Patting gently on shoulder asking if they are
  alright
• c.) Checking pulse
• 2. If victim is unresponsive, you should
• a.) Dial 9-1-1 before starting CPR
• b.) Start CPR before dialing 9-1-1
• c.) Dial 9-1-1 and wait for the arrival

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• 3. To check if victim is breathing, you should
• a.) Listen for exhaled air
• b.) Feel for exhaled air
• c.) Watch rise and fall of chest
• d.) All of the above
• The most common airway obstruction is
• a.) Dentures
• b.) Food
• c.) Tongue
• d.) none of these

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• 5. The technique used to clear the victims
  airway is
• a.) Lift chin up, tilt head back
• b.) Push chin down, tilt head forward
• c.) lift chin up, turn head sideways
• 6. When ventilating an unconscious victim
• a.) Pinch the victims nose closed.
• b.) Do not over-inflate the victims lungs
• c.) Allow the victim exhale on his own
• d.) All of the above.

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• 7. When administering compressions, the rule to
  remember is
• a.) 1 hand, 1 inch for children
• b.)1/2 hand, ½ inch for infants
• c.)2 hands, 2 inches for adults
• d.) All of the above
• Answers b,a,d,b,a,d,d

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AIRWAY OBSTRUCTION
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Are you choking?

• 9-1-1
• Find correct hand positions (midline, just above
  navel)
• Give abdominal thrusts
• Inward and upward until obstruction is removed
• Most often obstruction is tongue!

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If pregnant...or too large to get arms around

• Place fist in center, thrusts instead of
  abdominal thrusts.
• Alone..bend over a chair and thrust
• Infant.holding baby turn on their stomach use
  ridge of hand thrusts to their back

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Infant
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Bloodborne Pathogens

• What is true exposure?
• Needlestick
• Blood or bodily fluids
• Mouth to mouth
• Breathing airborne pathogens
• Human Bite

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Hepatitis, HIV, tuberculosis, meningitis,
measles, chicken pox, MRSA!
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MRSA

• MRSA infection is caused by Staphylococcus aureus
  bacteria often called "staph." MRSA stands for
  methicillin-resistant Staphylococcus aureus. It's
  a strain of staph that's resistant to the
  broad-spectrum antibiotics commonly used to treat
  it. MRSA can be fatal. Looks like.

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Hepatitis A

• The hepatitis A virus is found in the stools
  (feces) of people with hepatitis A. It is
  transmitted when a person puts something in his
  or her mouth that has been contaminated with the
  feces of an affected person. This is referred to
  as fecal-oral transmission.
• If food or drinking water becomes contaminated
  with stool from an infected person (usually
  because of inadequate hand washing or poor
  sanitary conditions), the virus can quickly
  spread to anyone who drinks or swallows the
  contaminated food or water.
• The virus can also be spread by eating raw or
  undercooked shellfish collected from water that
  has been contaminated by sewage.
• The hepatitis A virus can be transmitted through
  blood transfusions, although this is extremely
  rare.

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Hepatitis B

• The hepatitis B virus is known as a blood-borne
  virus because it is transmitted from one person
  to another via blood.
• Semen and saliva, which contain small amounts of
  blood, also carry the virus.
• The virus can be transmitted whenever any of
  these bodily fluids come in contact with the
  broken skin or a mucous membrane (in the mouth,
  genital organs, or rectum) of an uninfected
  person.

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Hepatitis C

• HCV is not related to the other viruses that
  cause hepatitis. Like the other hepatitis
  viruses, however, it is contagious. The hepatitis
  C virus is transmitted mainly by contact with
  blood or blood products.
• Sharing of contaminated needles among IV drug
  users is the most common mode of transmission.
  Using a needle to inject recreational drugs, even
  once several years ago, is a risk factor for
  hepatitis C.
• Transfusion with infected blood or blood
  products, hemodialysis, or transplantation of
  organs from infected donors was once a common
  mode of transmission but is now rare.
• In 1992, a test became available for checking
  blood for HCV. Blood and blood products are now
  tested to ensure that they are not contaminated.
  As a result, cases of hepatitis C related to
  transfusion, hemodialysis, or transplantation
  have dropped to almost zero since then.
  Transfusion of blood or blood products before
  1992 is a risk factor for hepatitis C.
• Less common causes of HCV transmission include
  the following  
• From mother to infant at the time of childbirth
• Through sexual intercourse with an infected
  person Having multiple sex partners is a risk
  factor.
• Needle sticks with HCV-contaminated blood This
  is mostly seen in health care workers. The risk
  of developing HCV infection after a needle stick
  is about 5-10.
• You cannot get hepatitis C by living with, being
  near, or touching someone with the disease. You
  can get the disease by sharing a razor, nail
  clippers, or other such items with an infected
  person.

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HIV

• HIV is transmitted when the virus enters the
  body, usually by injecting infected cells or
  semen. There are several possible ways in which
  the virus can enter.
• Most commonly, HIV infection is spread by having
  sex with an infected partner. The virus can enter
  the body through the lining of the vagina, vulva,
  penis, rectum, or mouth during sex.
• HIV frequently spreads among injection-drug users
  who share needles or syringes that are
  contaminated with blood from an infected
  person.
• Women can transmit HIV to their babies during
  pregnancy or birth, when infected maternal cells
  enter the baby's circulation.
• HIV can be spread in health-care settings through
  accidental needle sticks or contact with
  contaminated fluids.
• Very rarely, HIV spreads through transfusion of
  contaminated blood or blood components. Blood
  products are now tested to minimize this risk. If
  tissues or organs from an infected person are
  transplanted, the recipient may acquire HIV.
  Donors are now tested for HIV to minimize this
  risk.

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Personal Protective Equipment

• Gloves
• CPR shields OR masks with one-way valve
• Eye protection
• Respiratory protection
• Proper Hand Washing most effective method to
  prevent spread of germs
• Post exposure follow-up with a physician

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Cleaning up Blood

• 1 part bleach to 10 parts water
• Only use luke warm water or cold water,
• Hot water destroys chlorine
• Bleach will only live in the water for 24 hours.
  Must be fresh mix!
• If you have the Purell gel packs that would work
  if you have nothing else.
• Put all contaminated towels and waste in a Red
  Bag or other appropriate sealed, labeled
  (Biohazard symbol or label), leak-proof container

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Bleeding and Wounds

• Average adult has 10-12 pints of blood
• 1 pint loss- Shock unlikely
• 2 pints loss- symptoms of shock evident
• 3-4 pints of loss- can/will be life threatening
• (FYI) When you give blood you donate 1 unitjust
  under a pint of blood

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Color of blood can help..

• Dark Red, possible bluish, flow is strong and
  steady.VEIN
• Bright Red, spurting.ARTERY
• Oozes.CAPILLARY
• 1 If unconscious A.B.C.s
• 2 Stop open bleeding wounds with direct
  pressure

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Direct Pressure

• Direct pressure from gloved hand. Sterile
  compression to the entire wound-wrap towards the
  heart
• Elevateraise limb above heart
• Ice Ice pack on top of bandage. Never ice
  directly to skin.
• Pressure points brachial artery, femoral artery

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SHOCK

• Shock is inadequate supply of oxygen to vital
  organs/body tissue. May accompany any illness or
  injury
• 1 Check level of consciousness
• 2 A, B, Cs
• 3 Control bleeding
• 4 Treat in position
• 5 DO NOT GIVE FLUID
• 6 Speak calmly see if you can help them through.

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Sprains, and Fractures

• Allow patient to find their natural comfortable
  position
• Keep injured area immobile
• Cold packs

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Head and spine injury

• Immobilize head, back, and neck.
• Do not move patient
• Use head tilt only if airway management is needed

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Concussion

• Violent vomiting, blacking out is severe needs to
  be seen by physician
• Headache, stomach ache, feeling nauseous needs to
  be seen by a physician
• Pupils not same in size
• Do not have the patient go to sleep within two
  hours of injury

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Allergies

• Nuts, bees, aspirin, seafood, medications, etc.
• Swelling of face, eyes, tongue, and/or throat
• Breathing difficulty
• Call 9-1-1
• May need to administer epi-pen (if known they
  use) but still will need to be seen by physician
  within two hours

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Poisoning

• Call 9-1-1
• They will connect with poison control center
• Information from witnesses
• What was it?
• How much was ingested?
• When taken?

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Seizures

• Do not put anything in mouth
• Protect patient, put something soft underneath
  head
• Roll on side, if possible, after seizure
• Call 9-1-1

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Burns

• Provide immediate cooling to burns without broken
  tissue (cold water 25 times faster than air).
  Then dry.
• Bandage burns loosely with clean, lint-free
  cloth.
• Do not use creams, butter, ointments, etc.

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Chemical Burns (to eyes too)

• Flood the affected area with water for minimum of
  15 minutes
• Remove all contaminated clothing, especially
  shoes.
• Dress affected areas with sterile or clean
  dressings

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Asthma

• Determine if they have asthma. If they are
  wheezing, they might be unable to answer.
  Whatever their response, get them to sit down.
  Many times, asthmatics will sit in a "tripod"
  position this is when they place their hands on
  their knees or legs and lean forward in a sitting
  position, creating a tripod. This position helps
  relieve pressure on the diaphragm and allows for
  greater lung expansion. Getting them to answer
  will help you determine the severity of the
  attack. If the person can talk in complete
  sentences, they are not having SEVERE difficulty
  breathing.
• Make them sit down. Standing and laying down are
  bad position for an asthmatic to be in, as it
  puts pressure on the lungs. Make them sit down,
  but be ready to support them if they collapse.
• Find their inhaler. Most asthmatics will have an
  inhaler. This is usually blue, brown or red and
  in the shape of an L.
• Let them administer medication. Give them the
  inhaler don't try to administer it yourself.
  Inhalers have to be timed, and you can make them
  choke if you try it yourself. Let them handle it.
  Do not be alarmed by how many puffs they take. It
  is very difficult to sustain any harm from an
  inhaler overdose, so let the patient do whatever
  they feel is necessary.
• Wait for recovery. Inhalers work almost
  immediately. If their breathing returns to
  normal, relax and call an ambulance. Although
  they may be breathing now, their body will be
  deprived of oxygen. They need medical treatment
  anyway. If their breathing doesn't return to
  normal call an ambulance and stay with them. It
  may be an allergy. Treat it as such.

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Chest pain and heart attacks

• Pain in chest
• Numbness in limbs
• Nausea, weakness, shortness of breath, sweaty,
  cool, and PALE.
• Anxiety, denial
• Toothache (location of heart attack)
• CALL 9-1-1

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Stroke

• Numbness, paralysis of one side of face/body. One
  side of face droops
• Inability to speak normally
• Pupils may be unequal
• CALL 9-1-1

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Diabetes

• Extreme thirst
• Not enough insulin, plenty of sugar
• Insulin Shock
• Hunger, dizziness
• Too much insulin, not enough sugar
• Best to give sugar, under lip

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Tooth falls out

• Save it
• Keep wet and moist
• Keep in cup of MILK

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Hypothermia

• Cooling of the body to a dangerously low level
• 1 Protect from further heat loss, remove wet
• clothes and replace with dry
• 2 Call 9-1-1
• 3 Monitor A,B,Cs

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Frost Bite/Frost Nip

• Freezing of body Tissue
• 1 Protect from further cooling
• 2 DO NOT RUB OR MANIPULATE THE EXTREMETIES. DO
  NOT GIVE COFFEElt ALCOHOLlt OR OTHER DRUGS. DO NOT
  PUT IN BATH OR SHOWER.
• 3 9-1-1.

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Heat Exhaustion

• Excessive loss of body fluid and electrolytes.
• 1 Give fluids if conscious
• 2 Use plain water
• 3 Cool patient as quickly as possible, use cold
• water, cold bath, or blow cold air on
  patient using
• ice and fan.
• 4 Call 9-1-1
• 5 Watch for possible seizures

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So much more

• Snake bites
• Bug bites
• Electrical injuries
• Bullet holes, stabbing, impaled objects
• Drug overdose
• Alcohol poisoning

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Never hesitate to call 9-1-1
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Good Samaritan Law

• is a legal principle that prevents a rescuer
  who has voluntarily helped a victim in distress
  from being successfully sued for 'wrongdoing.'
  Its purpose is to keep people from being so
  reluctant to help a stranger in need for fear of
  legal repercussions if they made some mistake in
  treatment.

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First Aid Quiz

• http//www.firstaidweb.com/firstaid_quiz.html

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El Fin
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What to do next..

• Complete and submit CPR question and your answers
  along with First Aid Quiz answers
• Comments/Suggestions?