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CPR/AED/First AidCPR/AED/First Aid
TrainingTraining
byby
Rob Sundquist, MS ATC LATRob Sundquist, MS ATC LAT
Director of Sports Medicine/Head Athletic TrainerDirector of Sports Medicine/Head Athletic Trainer
Creekview High SchoolCreekview High School
Chain of SurvivalChain of Survival
 The chain of survival are four steps to helpThe chain of survival are four steps to help
increase the chances of an injured personincrease the chances of an injured person
of surviving a cardiac arrest.of surviving a cardiac arrest.
Chain of Survival – step oneChain of Survival – step one
 After determining that there is an injury needingAfter determining that there is an injury needing
advanced care; if unconscious tap and shout.advanced care; if unconscious tap and shout.
 Call 911Call 911
– Questions you will need to answer:Questions you will need to answer:
– Nature of the emergency?Nature of the emergency?
– Where are you?Where are you?
– How many are hurt?How many are hurt?
– Ages of who is/are hurtAges of who is/are hurt
– Who are you?Who are you?
– Has treatment started?Has treatment started?
– Only hang up when instructed to do so by operator.Only hang up when instructed to do so by operator.
Chain of Survival – step twoChain of Survival – step two
 Begin CPRBegin CPR
– Most adult cardiac arrests (CA) victims heart is inMost adult cardiac arrests (CA) victims heart is in
ventricular fibrillation (VF) - Abnormal chaotic heartventricular fibrillation (VF) - Abnormal chaotic heart
rhythm that prevents the heart from pumping blood.rhythm that prevents the heart from pumping blood.
– CPR will not usually stop VF but plays an importantCPR will not usually stop VF but plays an important
part in pushing oxygenated blood to the brain andpart in pushing oxygenated blood to the brain and
heart and prolonging VF so that an AED will beheart and prolonging VF so that an AED will be
useful.useful.
– CPR can double or triple the victims survival rateCPR can double or triple the victims survival rate
– For every passing minute without CPR; rate ofFor every passing minute without CPR; rate of
surviving drops 7-10%.surviving drops 7-10%.
– With CPR there is only a 3-4% drop each minuteWith CPR there is only a 3-4% drop each minute
Chain of Survival – step threeChain of Survival – step three
 Use an AEDUse an AED
– The use of the AED will stun the fibrillatingThe use of the AED will stun the fibrillating
heart, if the heart is still viable the normalheart, if the heart is still viable the normal
pacemakers in the heart will begin firing andpacemakers in the heart will begin firing and
start a normal rhythm.start a normal rhythm.
– If used within 5 min; chances of survival isIf used within 5 min; chances of survival is
49-75%.49-75%.
– Using an AED is simple.Using an AED is simple.
Chain of Survival – step fourChain of Survival – step four
 Advanced Care – EMSAdvanced Care – EMS
– Response time is 7-8 minutes – CPR isResponse time is 7-8 minutes – CPR is
extremely important.extremely important.
How to recognize majorHow to recognize major
emergenciesemergencies
Heart AttackHeart Attack
Myocardial infarctionMyocardial infarction
 Coronary heart disease is the leading cause of deathCoronary heart disease is the leading cause of death
in our nation.in our nation.
 During MI - part of heart muscle is starting to die.During MI - part of heart muscle is starting to die.
 Caused by a blockage of an artery (coronary) due toCaused by a blockage of an artery (coronary) due to
buildup of cholesterol deposits or a blood clot.buildup of cholesterol deposits or a blood clot.
 Victims are usually awake and can talk but feelsVictims are usually awake and can talk but feels
severe painsevere pain
 Most critical time is within the first 30Most critical time is within the first 30
minutes after Sx begin.minutes after Sx begin.
Heart AttackHeart Attack
 Most common symptomsMost common symptoms
– Pain or pressure in the center of the chest – which last more than 3-5 minutes.Pain or pressure in the center of the chest – which last more than 3-5 minutes.
– Pain might feel pressure, fullness, squeezing, or heavinessPain might feel pressure, fullness, squeezing, or heaviness
– Pain might spread to shoulder, neck, lower jaw and down arm (usually the right).Pain might spread to shoulder, neck, lower jaw and down arm (usually the right).
– Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then begin again.Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then begin again.
 Other Sx – lightheadedness, fainting, sweating without fever, nausea, shortness ofOther Sx – lightheadedness, fainting, sweating without fever, nausea, shortness of
breathbreath
– Most victims will downplay symptoms, you must take action!!!Most victims will downplay symptoms, you must take action!!!
– Call 911, get the nearest AED, and have the person rest in a position that is comfortableCall 911, get the nearest AED, and have the person rest in a position that is comfortable
where they can breathe easily.where they can breathe easily.
 Put them in an area that you can get them to the floor easily and paramedics can get inPut them in an area that you can get them to the floor easily and paramedics can get in..
Cardiac ArrestCardiac Arrest
 When the heart stops beating. UsuallyWhen the heart stops beating. Usually
caused by VF, which begins where the heartcaused by VF, which begins where the heart
muscle is injured.muscle is injured.
 Without blood flow and no pulse the personWithout blood flow and no pulse the person
becomes unconscious and stops breathingbecomes unconscious and stops breathing
and collapses.and collapses.
 VF and cardiac arrest may be the onlyVF and cardiac arrest may be the only
symptom of a heart attack.symptom of a heart attack.
 AED is only thing that will stop a VFAED is only thing that will stop a VF
StrokeStroke
 Its is a rapid onset of neurological problemsIts is a rapid onset of neurological problems
like weakness, paralysis in one or morelike weakness, paralysis in one or more
limbs, difficulty speaking, visual problems,limbs, difficulty speaking, visual problems,
intense dizziness, facial weakness, alteredintense dizziness, facial weakness, altered
consciousness, and severe headache.consciousness, and severe headache.
 Two causesTwo causes
– blood vessel to brain is blocked by a blood clotblood vessel to brain is blocked by a blood clot
– blood vessel to brain breaksblood vessel to brain breaks
 #3 cause of death and #1 cause of serious#3 cause of death and #1 cause of serious
disability among Americansdisability among Americans
StrokeStroke
 Most signs overlooked;Most signs overlooked;
three major signs tothree major signs to
observeobserve
– facial droopfacial droop
– arm weakness – mostarm weakness – most
obvious when victimobvious when victim
attempts to extend armsattempts to extend arms
with eyes closed – one orwith eyes closed – one or
both may not move veryboth may not move very
wellwell
– speech difficulties –speech difficulties –
slurring of words andslurring of words and
sentencessentences
– Call 911 immediately ifCall 911 immediately if
see signs of strokesee signs of stroke
 Provide CPR if neededProvide CPR if needed
Foreign body obstructionForeign body obstruction
 Usually caused by food, but can be caused by manyUsually caused by food, but can be caused by many
objectsobjects
 Major signsMajor signs
– Universal choking signalUniversal choking signal
– poor ineffective coughspoor ineffective coughs
– inability to speakinability to speak
– high pitched sounds while inhalinghigh pitched sounds while inhaling
– increased difficulty breathingincreased difficulty breathing
– Blue lips or skin (cyanosis)Blue lips or skin (cyanosis)
– Loss of consciousness and responsivenessLoss of consciousness and responsiveness
 Heimlich maneuver in conscious victimHeimlich maneuver in conscious victim
 CPR in unconscious victimCPR in unconscious victim
CPR - adultCPR - adult
Step oneStep one
 Make sure area is safeMake sure area is safe
 Check unresponsiveness – tap andCheck unresponsiveness – tap and
shout – “Are you alright”shout – “Are you alright”
– If no response – call 911 or send someoneIf no response – call 911 or send someone
directly to calldirectly to call
 Grab AED if one present or sendGrab AED if one present or send
someone to get one.someone to get one.
Step twoStep two
 If possible placeIf possible place
victim supine andvictim supine and
on a hard surface.on a hard surface.
– If victim is prone –If victim is prone –
roll overroll over
– Try protecting theTry protecting the
neck as much asneck as much as
possible if youpossible if you
suspect neck injurysuspect neck injury
Begin CAB’sBegin CAB’s
– C = CirculationC = Circulation
 If not breathing or see abnormal breathing begin chestIf not breathing or see abnormal breathing begin chest
compressionscompressions
– Agnal breathingAgnal breathing – gasps that occur at the beginning of CA – not efficient– gasps that occur at the beginning of CA – not efficient
– act as they are not breathing– act as they are not breathing
– No checking for pulse or signs of circulation just go straightNo checking for pulse or signs of circulation just go straight
to CPRto CPR
– Place one palm on the chest between the nipple linePlace one palm on the chest between the nipple line
– Interlock your other hand on top of the hand on the chestInterlock your other hand on top of the hand on the chest
– Bring your shoulder over the topBring your shoulder over the top
– Make sure you have a wide base (knees spread just outside yourMake sure you have a wide base (knees spread just outside your
shoulders)shoulders)
– Press down 1 ½ -2 inches at a rate of 100 compressions per minute –Press down 1 ½ -2 inches at a rate of 100 compressions per minute –
hard and fasthard and fast
– Make sure chest recoils completelyMake sure chest recoils completely
– Complete 30 compressions and then give two breaths.Complete 30 compressions and then give two breaths.
– Do not stop unless and AED is available, victim moves, or youDo not stop unless and AED is available, victim moves, or you
substituted out (if two rescuers are available – switch every five cyclessubstituted out (if two rescuers are available – switch every five cycles
of 30:2 – approx two minutes) – reduces fatigueof 30:2 – approx two minutes) – reduces fatigue
– A = AirwayA = Airway
 Head tilt and Chin liftHead tilt and Chin lift
– B = BreathingB = Breathing
 If you do not detect normal breathing – give twoIf you do not detect normal breathing – give two
breaths lasting 1 second each (may use barrier)breaths lasting 1 second each (may use barrier)
 Watch chest rise, allow exhalation before nextWatch chest rise, allow exhalation before next
breath.breath.
 If breaths do not go in – reposition head and tryIf breaths do not go in – reposition head and try
again.again.
 PracticePractice
CPR/AED/First Aid Training by Creekview High School
 PracticePractice
– Practice compressions 30 times twice –Practice compressions 30 times twice –
alternate with partner – no breathsalternate with partner – no breaths
– 60 sec test – just compressions – try to get60 sec test – just compressions – try to get
95-105 compressions – allows to learn95-105 compressions – allows to learn
rhythm. Perform 1-2 times or as neededrhythm. Perform 1-2 times or as needed
– Two minute test – performing 30:2 (includesTwo minute test – performing 30:2 (includes
breath) - should complete five cycles in thatbreath) - should complete five cycles in that
time.time.
 During the beginning stages of CA – chest compressionsDuring the beginning stages of CA – chest compressions
are more important than breaths. Oxygen level will stayare more important than breaths. Oxygen level will stay
high for the first few minutes but blood is not moving tohigh for the first few minutes but blood is not moving to
due to the heart not pumping.due to the heart not pumping.
– Breathing becomes as important as the length of CPR continuesBreathing becomes as important as the length of CPR continues
 Very important to limit interruptions of chestVery important to limit interruptions of chest
compressions.compressions.
 Be mindful not to give to many breaths, too much breathBe mindful not to give to many breaths, too much breath
or too forceful – may cause gastric filling and theor too forceful – may cause gastric filling and the
resultant complications, and/or cause diminished bloodresultant complications, and/or cause diminished blood
flow and reduce survival.flow and reduce survival.
Vomiting/other breathingVomiting/other breathing
 If someone does throw up – do not panic.If someone does throw up – do not panic.
– Roll victim towards you. Use your body to hold them.Roll victim towards you. Use your body to hold them.
– Clean out the mouth – roll back and continue.Clean out the mouth – roll back and continue.
 Mouth to noseMouth to nose
– Use when it is impossible to use the mouth due toUse when it is impossible to use the mouth due to
injury.injury.
 Face shields and masks – may be used -Face shields and masks – may be used -
– Very little chance of transfer of bodily fluids if performVery little chance of transfer of bodily fluids if perform
mouth to mouth without mask.mouth to mouth without mask.
– Using shield or mask can slow down the CPR processUsing shield or mask can slow down the CPR process
– ““Chest compression only” CPR is more beneficialChest compression only” CPR is more beneficial
than no CPR at all.than no CPR at all.
Recovery positionRecovery position
 If victim begins breathing and having aIf victim begins breathing and having a
pulse then turn victim to their side withpulse then turn victim to their side with
lower arm in front.lower arm in front.
 No position is perfect- just make sure theyNo position is perfect- just make sure they
are stable, near a true lateral position, andare stable, near a true lateral position, and
there is no pressure on the chest to impairthere is no pressure on the chest to impair
breathingbreathing
Potential neck injuryPotential neck injury
 If two or more respondersIf two or more responders
– One stabilizes the neck – they will be in charge ifOne stabilizes the neck – they will be in charge if
victim needs to be movedvictim needs to be moved
– Place hands on the sides of the head and neck, usingPlace hands on the sides of the head and neck, using
your hands to cup around the neck.your hands to cup around the neck.
– Place pressure on head with forearms near the earsPlace pressure on head with forearms near the ears
– Elbows should be on the ground, wrists in ulnarElbows should be on the ground, wrists in ulnar
deviation so that they come in contact with the head.deviation so that they come in contact with the head.
 This will limit the amount of movement that will occur if youThis will limit the amount of movement that will occur if you
have to move your body, for example moving so that CPRhave to move your body, for example moving so that CPR
can be administered or when EMS puts on a neck brace.can be administered or when EMS puts on a neck brace.
– If movement is necessary then move body as one.If movement is necessary then move body as one.
CPR – Child and infantCPR – Child and infant
Child CPR (ages 1-8)Child CPR (ages 1-8)
 Similarities with Adult CPRSimilarities with Adult CPR
– Location on chest for compressions is the same – nipple lineLocation on chest for compressions is the same – nipple line
– Ratio of compressions to breaths the same – 30:2Ratio of compressions to breaths the same – 30:2
 Differences with Adult CPRDifferences with Adult CPR
– In the chain of survival you will perform CPRIn the chain of survival you will perform CPR firstfirst for two minutesfor two minutes
performing five cycles of 30:2 – then call 911 (if you are alone)performing five cycles of 30:2 – then call 911 (if you are alone)
 Reason is that most child and infant cardiac arrests are due fromReason is that most child and infant cardiac arrests are due from
asphyxiation, so they will benefit more from the CPR.asphyxiation, so they will benefit more from the CPR.
– The depth you use for compression is 1/3 to ½ depth of theThe depth you use for compression is 1/3 to ½ depth of the
chest. Use one or two hands – which ever is more comfortable.chest. Use one or two hands – which ever is more comfortable.
Infant CPRInfant CPR
 Similarities with adult CPRSimilarities with adult CPR
– 30:2 ratio of compressions to breaths30:2 ratio of compressions to breaths
 Similarities with ChildSimilarities with Child
– Perform CPR first in the Chain of Survival, for the same reasons.Perform CPR first in the Chain of Survival, for the same reasons.
 If small enough you may carry to phone with you after completing the fiveIf small enough you may carry to phone with you after completing the five
cycles – use speaker phonecycles – use speaker phone
– Depth of compressions.Depth of compressions.
 Differences with CPRDifferences with CPR
– You will perform chest compressions one finger below nipple lineYou will perform chest compressions one finger below nipple line
– You will place your mouth over mouth and nose of infantYou will place your mouth over mouth and nose of infant
– You will only puff air inYou will only puff air in
– If unsure if it is a child or not, if it can fit on your arm, then treat as anIf unsure if it is a child or not, if it can fit on your arm, then treat as an
infantinfant
 PracticePractice
CPR/AED/First Aid Training by Creekview High School
Foreign Body AirwayForeign Body Airway
Obstruction (FBAO)Obstruction (FBAO)
Heimlich ManeuverHeimlich Maneuver
ChokingChoking
 Universal sign of choking – handUniversal sign of choking – hand
around throataround throat
 Ask questionsAsk questions
– Are you choking? Can you speak? May IAre you choking? Can you speak? May I
help you? – Very important.help you? – Very important.
 If they say no leave them alone until they passIf they say no leave them alone until they pass
out – then it is assumed they want help.out – then it is assumed they want help.
 If a person can speak or can cough -If a person can speak or can cough -
do not helpdo not help
Abdominal thrustsAbdominal thrusts
 Place yourself behind victim scissor you legsPlace yourself behind victim scissor you legs
 Front leg between victims legsFront leg between victims legs
 Slightly bend kneesSlightly bend knees
 Place hands on navelPlace hands on navel
 place hands on chest if woman is pregnant or victim is severelyplace hands on chest if woman is pregnant or victim is severely
overweightoverweight
 Pull in and upPull in and up
 continue until object is out or they pass outcontinue until object is out or they pass out
 Use chest thrusts if you are unable to circumvent the abdomenUse chest thrusts if you are unable to circumvent the abdomen
 If pass out lower them carefully to the floor begin CPRIf pass out lower them carefully to the floor begin CPR
 Only difference with CPR is you check mouth for object beforeOnly difference with CPR is you check mouth for object before
breaths.breaths.
 Finger sweep only if you see objectFinger sweep only if you see object..
 PracticePractice
Infant FBAOInfant FBAO
 Infant –Infant –
– Conscious – place infant on forearm with babiesConscious – place infant on forearm with babies
mouth between fingers – back blows to upper backmouth between fingers – back blows to upper back
– Unconscious –Unconscious –
 after back blows - five compressions –after back blows - five compressions –
 look for objectlook for object
 give breathgive breath
 repeat cycle – back blows, compressions, look andrepeat cycle – back blows, compressions, look and
breathsbreaths
 Finger sweep if see objectFinger sweep if see object
 PracticePractice
Automated ExternalAutomated External
DefibrillatorDefibrillator
AEDAED
What is an AED?What is an AED?
 Automated external defibrillator – is an computerizedAutomated external defibrillator – is an computerized
defibrillatordefibrillator
 it can analyze heart rhythmit can analyze heart rhythm
 recognize shockable rhythmrecognize shockable rhythm
 advise the operator whether the rhythm should be shockedadvise the operator whether the rhythm should be shocked
 very easy to usevery easy to use
 AED’s computer chips analyze the rate, size and waveAED’s computer chips analyze the rate, size and wave
shape of human cardiac rhythm.shape of human cardiac rhythm.
 will not shock a properly functioning heartwill not shock a properly functioning heart
 will not shock a heart that has stopped – VF is not presentwill not shock a heart that has stopped – VF is not present
Universal steps of AED useUniversal steps of AED use
 Place AED parallel to patients left earPlace AED parallel to patients left ear
 Power on the AED firstPower on the AED first
 Some automatically turn on when openedSome automatically turn on when opened
 Attach the AED to the patients chest with electrode padsAttach the AED to the patients chest with electrode pads
 Remove clothing – to bear chestRemove clothing – to bear chest
 Be kind to femalesBe kind to females
 Dry patient or shave chest in area of electrode placement if neededDry patient or shave chest in area of electrode placement if needed
 Place one pad above right nipple and one to the side and below the leftPlace one pad above right nipple and one to the side and below the left
nipple.nipple. (CPR is continued up to the point of placing the pads(CPR is continued up to the point of placing the pads
on)on)
 Analyze rhythmAnalyze rhythm
 Make sure everyone is clear (must say “stand clear of the victim”). NoMake sure everyone is clear (must say “stand clear of the victim”). No
contactcontact
 Push analyzePush analyze
 Charge AED if shock is required (some machine charge automatically)Charge AED if shock is required (some machine charge automatically)
 Shock if indicated – (after checking everyone is clearShock if indicated – (after checking everyone is clear
again)again)
 Begin CPR for five cycles then analyze againBegin CPR for five cycles then analyze again
 If shock is advisable again you clear everyone and shockIf shock is advisable again you clear everyone and shock
 If shock is not advisable – continue with CPRIf shock is not advisable – continue with CPR
 If victim has pulse and is breathing put into recoveryIf victim has pulse and is breathing put into recovery
position.position.
 DO NOT take off pads or turn off AED until prompted by EMSDO NOT take off pads or turn off AED until prompted by EMS
Special ConsiderationsSpecial Considerations
 WaterWater
 Must remove victim from water or wet surfaceMust remove victim from water or wet surface
 Dry before attaching padsDry before attaching pads
 Metal surfacesMetal surfaces
 Is victim lying on metal surface? – if so move victimIs victim lying on metal surface? – if so move victim
 The metal surface may cause the shock form the AED to hit you.The metal surface may cause the shock form the AED to hit you.
 ChildrenChildren
 Children 8 and older use as soon as possibleChildren 8 and older use as soon as possible
 Children 1-8 – CPR for two minutes before using AEDChildren 1-8 – CPR for two minutes before using AED
 Transdermal medicationsTransdermal medications
 Remove patch and wipe clean before attaching AED padsRemove patch and wipe clean before attaching AED pads
 Implanted pacemakers and defibrillatorsImplanted pacemakers and defibrillators
 Do not place an AED electrode directly over implanted device.Do not place an AED electrode directly over implanted device.
 Move at least one inch to the side of deviceMove at least one inch to the side of device
 PracticePractice
First AidFirst Aid
Medical emergenciesMedical emergencies
 Breathing difficultiesBreathing difficulties
 Asthma problems are increasingAsthma problems are increasing
 Most have medicinesMost have medicines
 May need assist victim is administratingMay need assist victim is administrating
 If symptoms continue to get worse call 911If symptoms continue to get worse call 911
 AnaphylaxisisAnaphylaxisis
 Severe reaction to allergenSevere reaction to allergen
 Victim may have epinephrine injectorVictim may have epinephrine injector
 May need to administerMay need to administer
 Call 911 if medicine is not administeredCall 911 if medicine is not administered
 SeizuresSeizures
 General rules – 1) Prevent injury 2) ensure open airway 3) maintain openGeneral rules – 1) Prevent injury 2) ensure open airway 3) maintain open
airway after seizure is completed – place in recovery positionairway after seizure is completed – place in recovery position
 Never try to restrain victim, place anything in the mouth.Never try to restrain victim, place anything in the mouth.
Injury emergenciesInjury emergencies
 BleedingBleeding
 Direct pressure best wayDirect pressure best way
 If bleeding continues add more gauze or cloth; do notIf bleeding continues add more gauze or cloth; do not
remove gauze or clothremove gauze or cloth
 Use elastic bandage to apply pressure to gauze and hold it inUse elastic bandage to apply pressure to gauze and hold it in
place.place.
 The use of tourniquets should be avoided unless in extremeThe use of tourniquets should be avoided unless in extreme
mattersmatters
 The efficacy of elevation and pressure points is inconclusive;The efficacy of elevation and pressure points is inconclusive;
if used, use only in conjunction with direct pressure andif used, use only in conjunction with direct pressure and
when there is no apparent fracture or other underlying injury.when there is no apparent fracture or other underlying injury.
 Wounds and abrasionsWounds and abrasions
 Irrigate wounds until free of any foreign matter.Irrigate wounds until free of any foreign matter.
 Small wounds and abrasions should be cleanedSmall wounds and abrasions should be cleaned
thoroughly then have triple antibiotic ointmentthoroughly then have triple antibiotic ointment
placed on it and covered.placed on it and covered.
 Larger wounds need to also be cleaned then coveredLarger wounds need to also be cleaned then covered
and taken to doctor for possible stitchesand taken to doctor for possible stitches
 BurnsBurns
 Thermal burnsThermal burns
 Cool burn with cold water until pain ceasesCool burn with cold water until pain ceases
 Do not cool for more than 10 min. Can lead to further damageDo not cool for more than 10 min. Can lead to further damage
 Burn blisters cover with loose gauze, but keep intact – breaking themBurn blisters cover with loose gauze, but keep intact – breaking them
can lead to infectioncan lead to infection
 Electrical burnsElectrical burns
 Make sure electrical current is shut off before trying to help victim.Make sure electrical current is shut off before trying to help victim.
 CPR and defibrillation may be needed as well as burn treatmentCPR and defibrillation may be needed as well as burn treatment
 All electrocution injuries should be checked out by a physicianAll electrocution injuries should be checked out by a physician
 Spine stabilizationSpine stabilization
 Suspect possible spinal injury if…Suspect possible spinal injury if…
 Car accidentCar accident
 Injured from fall greater than their heightInjured from fall greater than their height
 Complains of neck pain, tingling, or extremity weaknessComplains of neck pain, tingling, or extremity weakness
 Is not fully alertIs not fully alert
 Appears to be intoxicatedAppears to be intoxicated
 Appears frail or is >65 yrs oldAppears frail or is >65 yrs old
 Has sustained a head injuryHas sustained a head injury
- Manually stabilize the neck until help arrives.- Manually stabilize the neck until help arrives.
 Musculoskeletal trauma – sprains, strains, contusions,Musculoskeletal trauma – sprains, strains, contusions,
fracturesfractures
 For sprains, strains, contusions – apply ice for 20.For sprains, strains, contusions – apply ice for 20.
 Sprains elevate and place compression bandageSprains elevate and place compression bandage
 R.I.C.E. – rest, ice, compression, elevationR.I.C.E. – rest, ice, compression, elevation
 If victim has aversion to cold – place wet cloth between ice and skinIf victim has aversion to cold – place wet cloth between ice and skin
 Young kids and elderly especially susceptibleYoung kids and elderly especially susceptible
 Contusion you want to stretch the injury as well as iceContusion you want to stretch the injury as well as ice
 If you are unsure of the injury suspect fracture – do notIf you are unsure of the injury suspect fracture – do not
move or straighten injury. Place ice on area and splint inmove or straighten injury. Place ice on area and splint in
position, send to ER.position, send to ER.
 If suspect dislocation – splint as is and send to ER.If suspect dislocation – splint as is and send to ER.
 Dental injuriesDental injuries
 Avulsed toothAvulsed tooth
 Hold onto by the crown not the root (part embedded intoHold onto by the crown not the root (part embedded into
gumgum
 Rinse off with water (do not scrub)Rinse off with water (do not scrub)
 Either place back into socket or place in glass of milk andEither place back into socket or place in glass of milk and
see a dentist immediatelysee a dentist immediately
 Clean bleeding wound with saline solution or tapClean bleeding wound with saline solution or tap
waterwater
 Use cotton to apply pressure to stop bleedingUse cotton to apply pressure to stop bleeding
Environmental injuriesEnvironmental injuries
 SnakebiteSnakebite
 Do not suck wound, it will only exasperate the problemDo not suck wound, it will only exasperate the problem
 In case of Coral snake – wrap a bandage around the extremity of the bite – it will help slowIn case of Coral snake – wrap a bandage around the extremity of the bite – it will help slow
the poison – then get to medical facility immediately.the poison – then get to medical facility immediately.
 Coral snake bites and sucksCoral snake bites and sucks
 Other snake bites, wash area with soap and water, try not to move extremity very much andOther snake bites, wash area with soap and water, try not to move extremity very much and
get to medical facility.get to medical facility.
 Cold injuriesCold injuries
 HypothermiaHypothermia
 Immediately begin re-warming – remove wet clothes and wrap body surface with anything at hand;Immediately begin re-warming – remove wet clothes and wrap body surface with anything at hand;
get to medical facility immediatelyget to medical facility immediately
 If far from medical facility you begin active warming – placing near heat source, placing in warmIf far from medical facility you begin active warming – placing near heat source, placing in warm
(not hot) water.(not hot) water.
 FrostbiteFrostbite
 Remove wet clothing, usually occurs on extremities, do not re-warm if there is any chance it couldRemove wet clothing, usually occurs on extremities, do not re-warm if there is any chance it could
freeze again or you are close to a medical facility.freeze again or you are close to a medical facility.
 Use luke-warm water if you are far from medical facilityUse luke-warm water if you are far from medical facility
 Heat InjuriesHeat Injuries
 Heat cramps – muscle cramping, usually due to extreme loss of fluidsHeat cramps – muscle cramping, usually due to extreme loss of fluids
 Get to cooler areaGet to cooler area
 Replace fluidsReplace fluids
 Ice and stretch areaIce and stretch area
 Heat exhaustionHeat exhaustion
 Dizziness, could have flushed skin or cool and clammy, disoriented, nausea,Dizziness, could have flushed skin or cool and clammy, disoriented, nausea,
headacheheadache
 Get victim to cool area immediatelyGet victim to cool area immediately
 Place ice on side of neck (carotid artery), arm pits, and groin areaPlace ice on side of neck (carotid artery), arm pits, and groin area
 Replace fluidsReplace fluids
 Watch for shock; could lead into heat strokeWatch for shock; could lead into heat stroke
 Heat Stroke – medical emergency – call 911 immediatelyHeat Stroke – medical emergency – call 911 immediately
 Extreme disorientation, possible unconsciousness, very little sweating,Extreme disorientation, possible unconsciousness, very little sweating,
internal temperature of >105.internal temperature of >105.
 Cool down by any meansCool down by any means
 DrowningDrowning
 Get victim out of water as soon as possibleGet victim out of water as soon as possible
 Begin CPR immediatelyBegin CPR immediately
 If you are alone – finish five cycles of CPR before calling 911If you are alone – finish five cycles of CPR before calling 911
PoisonsPoisons
 Poison control center – 1-800-222-1222Poison control center – 1-800-222-1222
 Chemical BurnsChemical Burns
 Brush off any powder and remove all contaminated clothingBrush off any powder and remove all contaminated clothing
 Alki or acid exposure – rinse with copious amounts of water.Alki or acid exposure – rinse with copious amounts of water.
 Ingested poisonsIngested poisons
 Do not ingest any medication; milk, activated charcoal, syrupDo not ingest any medication; milk, activated charcoal, syrup
of ipecac unless instructed by poison controlof ipecac unless instructed by poison control
ShockShock
 Develops when there is not enough blood flowing to the cells of the bodyDevelops when there is not enough blood flowing to the cells of the body
 Causes in adults;Causes in adults;
 loss of bloodloss of blood
 heart attack,heart attack,
 allergic reactionallergic reaction
 SymptomsSymptoms
 feel cold and shiver,feel cold and shiver,
 feel weak, faint, or dizzy,feel weak, faint, or dizzy,
 restless,restless,
 vomit,vomit,
 feel thirstyfeel thirsty
 TreatmentTreatment
 Call 911Call 911
 Put victim on their backPut victim on their back
 If not leg injury or pain raise legs 12 inchesIf not leg injury or pain raise legs 12 inches
 Cover victim with blanketCover victim with blanket
 If bleeding is visible – use direct pressureIf bleeding is visible – use direct pressure

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CPR/AED/First Aid Training by Creekview High School

  • 1. CPR/AED/First AidCPR/AED/First Aid TrainingTraining byby Rob Sundquist, MS ATC LATRob Sundquist, MS ATC LAT Director of Sports Medicine/Head Athletic TrainerDirector of Sports Medicine/Head Athletic Trainer Creekview High SchoolCreekview High School
  • 2. Chain of SurvivalChain of Survival  The chain of survival are four steps to helpThe chain of survival are four steps to help increase the chances of an injured personincrease the chances of an injured person of surviving a cardiac arrest.of surviving a cardiac arrest.
  • 3. Chain of Survival – step oneChain of Survival – step one  After determining that there is an injury needingAfter determining that there is an injury needing advanced care; if unconscious tap and shout.advanced care; if unconscious tap and shout.  Call 911Call 911 – Questions you will need to answer:Questions you will need to answer: – Nature of the emergency?Nature of the emergency? – Where are you?Where are you? – How many are hurt?How many are hurt? – Ages of who is/are hurtAges of who is/are hurt – Who are you?Who are you? – Has treatment started?Has treatment started? – Only hang up when instructed to do so by operator.Only hang up when instructed to do so by operator.
  • 4. Chain of Survival – step twoChain of Survival – step two  Begin CPRBegin CPR – Most adult cardiac arrests (CA) victims heart is inMost adult cardiac arrests (CA) victims heart is in ventricular fibrillation (VF) - Abnormal chaotic heartventricular fibrillation (VF) - Abnormal chaotic heart rhythm that prevents the heart from pumping blood.rhythm that prevents the heart from pumping blood. – CPR will not usually stop VF but plays an importantCPR will not usually stop VF but plays an important part in pushing oxygenated blood to the brain andpart in pushing oxygenated blood to the brain and heart and prolonging VF so that an AED will beheart and prolonging VF so that an AED will be useful.useful. – CPR can double or triple the victims survival rateCPR can double or triple the victims survival rate – For every passing minute without CPR; rate ofFor every passing minute without CPR; rate of surviving drops 7-10%.surviving drops 7-10%. – With CPR there is only a 3-4% drop each minuteWith CPR there is only a 3-4% drop each minute
  • 5. Chain of Survival – step threeChain of Survival – step three  Use an AEDUse an AED – The use of the AED will stun the fibrillatingThe use of the AED will stun the fibrillating heart, if the heart is still viable the normalheart, if the heart is still viable the normal pacemakers in the heart will begin firing andpacemakers in the heart will begin firing and start a normal rhythm.start a normal rhythm. – If used within 5 min; chances of survival isIf used within 5 min; chances of survival is 49-75%.49-75%. – Using an AED is simple.Using an AED is simple.
  • 6. Chain of Survival – step fourChain of Survival – step four  Advanced Care – EMSAdvanced Care – EMS – Response time is 7-8 minutes – CPR isResponse time is 7-8 minutes – CPR is extremely important.extremely important.
  • 7. How to recognize majorHow to recognize major emergenciesemergencies
  • 8. Heart AttackHeart Attack Myocardial infarctionMyocardial infarction  Coronary heart disease is the leading cause of deathCoronary heart disease is the leading cause of death in our nation.in our nation.  During MI - part of heart muscle is starting to die.During MI - part of heart muscle is starting to die.  Caused by a blockage of an artery (coronary) due toCaused by a blockage of an artery (coronary) due to buildup of cholesterol deposits or a blood clot.buildup of cholesterol deposits or a blood clot.  Victims are usually awake and can talk but feelsVictims are usually awake and can talk but feels severe painsevere pain  Most critical time is within the first 30Most critical time is within the first 30 minutes after Sx begin.minutes after Sx begin.
  • 9. Heart AttackHeart Attack  Most common symptomsMost common symptoms – Pain or pressure in the center of the chest – which last more than 3-5 minutes.Pain or pressure in the center of the chest – which last more than 3-5 minutes. – Pain might feel pressure, fullness, squeezing, or heavinessPain might feel pressure, fullness, squeezing, or heaviness – Pain might spread to shoulder, neck, lower jaw and down arm (usually the right).Pain might spread to shoulder, neck, lower jaw and down arm (usually the right). – Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then begin again.Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then begin again.  Other Sx – lightheadedness, fainting, sweating without fever, nausea, shortness ofOther Sx – lightheadedness, fainting, sweating without fever, nausea, shortness of breathbreath – Most victims will downplay symptoms, you must take action!!!Most victims will downplay symptoms, you must take action!!! – Call 911, get the nearest AED, and have the person rest in a position that is comfortableCall 911, get the nearest AED, and have the person rest in a position that is comfortable where they can breathe easily.where they can breathe easily.  Put them in an area that you can get them to the floor easily and paramedics can get inPut them in an area that you can get them to the floor easily and paramedics can get in..
  • 10. Cardiac ArrestCardiac Arrest  When the heart stops beating. UsuallyWhen the heart stops beating. Usually caused by VF, which begins where the heartcaused by VF, which begins where the heart muscle is injured.muscle is injured.  Without blood flow and no pulse the personWithout blood flow and no pulse the person becomes unconscious and stops breathingbecomes unconscious and stops breathing and collapses.and collapses.  VF and cardiac arrest may be the onlyVF and cardiac arrest may be the only symptom of a heart attack.symptom of a heart attack.  AED is only thing that will stop a VFAED is only thing that will stop a VF
  • 11. StrokeStroke  Its is a rapid onset of neurological problemsIts is a rapid onset of neurological problems like weakness, paralysis in one or morelike weakness, paralysis in one or more limbs, difficulty speaking, visual problems,limbs, difficulty speaking, visual problems, intense dizziness, facial weakness, alteredintense dizziness, facial weakness, altered consciousness, and severe headache.consciousness, and severe headache.  Two causesTwo causes – blood vessel to brain is blocked by a blood clotblood vessel to brain is blocked by a blood clot – blood vessel to brain breaksblood vessel to brain breaks  #3 cause of death and #1 cause of serious#3 cause of death and #1 cause of serious disability among Americansdisability among Americans
  • 12. StrokeStroke  Most signs overlooked;Most signs overlooked; three major signs tothree major signs to observeobserve – facial droopfacial droop – arm weakness – mostarm weakness – most obvious when victimobvious when victim attempts to extend armsattempts to extend arms with eyes closed – one orwith eyes closed – one or both may not move veryboth may not move very wellwell – speech difficulties –speech difficulties – slurring of words andslurring of words and sentencessentences – Call 911 immediately ifCall 911 immediately if see signs of strokesee signs of stroke  Provide CPR if neededProvide CPR if needed
  • 13. Foreign body obstructionForeign body obstruction  Usually caused by food, but can be caused by manyUsually caused by food, but can be caused by many objectsobjects  Major signsMajor signs – Universal choking signalUniversal choking signal – poor ineffective coughspoor ineffective coughs – inability to speakinability to speak – high pitched sounds while inhalinghigh pitched sounds while inhaling – increased difficulty breathingincreased difficulty breathing – Blue lips or skin (cyanosis)Blue lips or skin (cyanosis) – Loss of consciousness and responsivenessLoss of consciousness and responsiveness  Heimlich maneuver in conscious victimHeimlich maneuver in conscious victim  CPR in unconscious victimCPR in unconscious victim
  • 14. CPR - adultCPR - adult
  • 15. Step oneStep one  Make sure area is safeMake sure area is safe  Check unresponsiveness – tap andCheck unresponsiveness – tap and shout – “Are you alright”shout – “Are you alright” – If no response – call 911 or send someoneIf no response – call 911 or send someone directly to calldirectly to call  Grab AED if one present or sendGrab AED if one present or send someone to get one.someone to get one.
  • 16. Step twoStep two  If possible placeIf possible place victim supine andvictim supine and on a hard surface.on a hard surface. – If victim is prone –If victim is prone – roll overroll over – Try protecting theTry protecting the neck as much asneck as much as possible if youpossible if you suspect neck injurysuspect neck injury
  • 17. Begin CAB’sBegin CAB’s – C = CirculationC = Circulation  If not breathing or see abnormal breathing begin chestIf not breathing or see abnormal breathing begin chest compressionscompressions – Agnal breathingAgnal breathing – gasps that occur at the beginning of CA – not efficient– gasps that occur at the beginning of CA – not efficient – act as they are not breathing– act as they are not breathing – No checking for pulse or signs of circulation just go straightNo checking for pulse or signs of circulation just go straight to CPRto CPR – Place one palm on the chest between the nipple linePlace one palm on the chest between the nipple line – Interlock your other hand on top of the hand on the chestInterlock your other hand on top of the hand on the chest – Bring your shoulder over the topBring your shoulder over the top – Make sure you have a wide base (knees spread just outside yourMake sure you have a wide base (knees spread just outside your shoulders)shoulders) – Press down 1 ½ -2 inches at a rate of 100 compressions per minute –Press down 1 ½ -2 inches at a rate of 100 compressions per minute – hard and fasthard and fast – Make sure chest recoils completelyMake sure chest recoils completely – Complete 30 compressions and then give two breaths.Complete 30 compressions and then give two breaths. – Do not stop unless and AED is available, victim moves, or youDo not stop unless and AED is available, victim moves, or you substituted out (if two rescuers are available – switch every five cyclessubstituted out (if two rescuers are available – switch every five cycles of 30:2 – approx two minutes) – reduces fatigueof 30:2 – approx two minutes) – reduces fatigue
  • 18. – A = AirwayA = Airway  Head tilt and Chin liftHead tilt and Chin lift – B = BreathingB = Breathing  If you do not detect normal breathing – give twoIf you do not detect normal breathing – give two breaths lasting 1 second each (may use barrier)breaths lasting 1 second each (may use barrier)  Watch chest rise, allow exhalation before nextWatch chest rise, allow exhalation before next breath.breath.  If breaths do not go in – reposition head and tryIf breaths do not go in – reposition head and try again.again.  PracticePractice
  • 20.  PracticePractice – Practice compressions 30 times twice –Practice compressions 30 times twice – alternate with partner – no breathsalternate with partner – no breaths – 60 sec test – just compressions – try to get60 sec test – just compressions – try to get 95-105 compressions – allows to learn95-105 compressions – allows to learn rhythm. Perform 1-2 times or as neededrhythm. Perform 1-2 times or as needed – Two minute test – performing 30:2 (includesTwo minute test – performing 30:2 (includes breath) - should complete five cycles in thatbreath) - should complete five cycles in that time.time.
  • 21.  During the beginning stages of CA – chest compressionsDuring the beginning stages of CA – chest compressions are more important than breaths. Oxygen level will stayare more important than breaths. Oxygen level will stay high for the first few minutes but blood is not moving tohigh for the first few minutes but blood is not moving to due to the heart not pumping.due to the heart not pumping. – Breathing becomes as important as the length of CPR continuesBreathing becomes as important as the length of CPR continues  Very important to limit interruptions of chestVery important to limit interruptions of chest compressions.compressions.  Be mindful not to give to many breaths, too much breathBe mindful not to give to many breaths, too much breath or too forceful – may cause gastric filling and theor too forceful – may cause gastric filling and the resultant complications, and/or cause diminished bloodresultant complications, and/or cause diminished blood flow and reduce survival.flow and reduce survival.
  • 22. Vomiting/other breathingVomiting/other breathing  If someone does throw up – do not panic.If someone does throw up – do not panic. – Roll victim towards you. Use your body to hold them.Roll victim towards you. Use your body to hold them. – Clean out the mouth – roll back and continue.Clean out the mouth – roll back and continue.  Mouth to noseMouth to nose – Use when it is impossible to use the mouth due toUse when it is impossible to use the mouth due to injury.injury.  Face shields and masks – may be used -Face shields and masks – may be used - – Very little chance of transfer of bodily fluids if performVery little chance of transfer of bodily fluids if perform mouth to mouth without mask.mouth to mouth without mask. – Using shield or mask can slow down the CPR processUsing shield or mask can slow down the CPR process – ““Chest compression only” CPR is more beneficialChest compression only” CPR is more beneficial than no CPR at all.than no CPR at all.
  • 23. Recovery positionRecovery position  If victim begins breathing and having aIf victim begins breathing and having a pulse then turn victim to their side withpulse then turn victim to their side with lower arm in front.lower arm in front.  No position is perfect- just make sure theyNo position is perfect- just make sure they are stable, near a true lateral position, andare stable, near a true lateral position, and there is no pressure on the chest to impairthere is no pressure on the chest to impair breathingbreathing
  • 24. Potential neck injuryPotential neck injury  If two or more respondersIf two or more responders – One stabilizes the neck – they will be in charge ifOne stabilizes the neck – they will be in charge if victim needs to be movedvictim needs to be moved – Place hands on the sides of the head and neck, usingPlace hands on the sides of the head and neck, using your hands to cup around the neck.your hands to cup around the neck. – Place pressure on head with forearms near the earsPlace pressure on head with forearms near the ears – Elbows should be on the ground, wrists in ulnarElbows should be on the ground, wrists in ulnar deviation so that they come in contact with the head.deviation so that they come in contact with the head.  This will limit the amount of movement that will occur if youThis will limit the amount of movement that will occur if you have to move your body, for example moving so that CPRhave to move your body, for example moving so that CPR can be administered or when EMS puts on a neck brace.can be administered or when EMS puts on a neck brace. – If movement is necessary then move body as one.If movement is necessary then move body as one.
  • 25. CPR – Child and infantCPR – Child and infant
  • 26. Child CPR (ages 1-8)Child CPR (ages 1-8)  Similarities with Adult CPRSimilarities with Adult CPR – Location on chest for compressions is the same – nipple lineLocation on chest for compressions is the same – nipple line – Ratio of compressions to breaths the same – 30:2Ratio of compressions to breaths the same – 30:2  Differences with Adult CPRDifferences with Adult CPR – In the chain of survival you will perform CPRIn the chain of survival you will perform CPR firstfirst for two minutesfor two minutes performing five cycles of 30:2 – then call 911 (if you are alone)performing five cycles of 30:2 – then call 911 (if you are alone)  Reason is that most child and infant cardiac arrests are due fromReason is that most child and infant cardiac arrests are due from asphyxiation, so they will benefit more from the CPR.asphyxiation, so they will benefit more from the CPR. – The depth you use for compression is 1/3 to ½ depth of theThe depth you use for compression is 1/3 to ½ depth of the chest. Use one or two hands – which ever is more comfortable.chest. Use one or two hands – which ever is more comfortable.
  • 27. Infant CPRInfant CPR  Similarities with adult CPRSimilarities with adult CPR – 30:2 ratio of compressions to breaths30:2 ratio of compressions to breaths  Similarities with ChildSimilarities with Child – Perform CPR first in the Chain of Survival, for the same reasons.Perform CPR first in the Chain of Survival, for the same reasons.  If small enough you may carry to phone with you after completing the fiveIf small enough you may carry to phone with you after completing the five cycles – use speaker phonecycles – use speaker phone – Depth of compressions.Depth of compressions.  Differences with CPRDifferences with CPR – You will perform chest compressions one finger below nipple lineYou will perform chest compressions one finger below nipple line – You will place your mouth over mouth and nose of infantYou will place your mouth over mouth and nose of infant – You will only puff air inYou will only puff air in – If unsure if it is a child or not, if it can fit on your arm, then treat as anIf unsure if it is a child or not, if it can fit on your arm, then treat as an infantinfant  PracticePractice
  • 29. Foreign Body AirwayForeign Body Airway Obstruction (FBAO)Obstruction (FBAO) Heimlich ManeuverHeimlich Maneuver
  • 30. ChokingChoking  Universal sign of choking – handUniversal sign of choking – hand around throataround throat  Ask questionsAsk questions – Are you choking? Can you speak? May IAre you choking? Can you speak? May I help you? – Very important.help you? – Very important.  If they say no leave them alone until they passIf they say no leave them alone until they pass out – then it is assumed they want help.out – then it is assumed they want help.  If a person can speak or can cough -If a person can speak or can cough - do not helpdo not help
  • 31. Abdominal thrustsAbdominal thrusts  Place yourself behind victim scissor you legsPlace yourself behind victim scissor you legs  Front leg between victims legsFront leg between victims legs  Slightly bend kneesSlightly bend knees  Place hands on navelPlace hands on navel  place hands on chest if woman is pregnant or victim is severelyplace hands on chest if woman is pregnant or victim is severely overweightoverweight  Pull in and upPull in and up  continue until object is out or they pass outcontinue until object is out or they pass out  Use chest thrusts if you are unable to circumvent the abdomenUse chest thrusts if you are unable to circumvent the abdomen  If pass out lower them carefully to the floor begin CPRIf pass out lower them carefully to the floor begin CPR  Only difference with CPR is you check mouth for object beforeOnly difference with CPR is you check mouth for object before breaths.breaths.  Finger sweep only if you see objectFinger sweep only if you see object..  PracticePractice
  • 32. Infant FBAOInfant FBAO  Infant –Infant – – Conscious – place infant on forearm with babiesConscious – place infant on forearm with babies mouth between fingers – back blows to upper backmouth between fingers – back blows to upper back – Unconscious –Unconscious –  after back blows - five compressions –after back blows - five compressions –  look for objectlook for object  give breathgive breath  repeat cycle – back blows, compressions, look andrepeat cycle – back blows, compressions, look and breathsbreaths  Finger sweep if see objectFinger sweep if see object  PracticePractice
  • 34. What is an AED?What is an AED?  Automated external defibrillator – is an computerizedAutomated external defibrillator – is an computerized defibrillatordefibrillator  it can analyze heart rhythmit can analyze heart rhythm  recognize shockable rhythmrecognize shockable rhythm  advise the operator whether the rhythm should be shockedadvise the operator whether the rhythm should be shocked  very easy to usevery easy to use  AED’s computer chips analyze the rate, size and waveAED’s computer chips analyze the rate, size and wave shape of human cardiac rhythm.shape of human cardiac rhythm.  will not shock a properly functioning heartwill not shock a properly functioning heart  will not shock a heart that has stopped – VF is not presentwill not shock a heart that has stopped – VF is not present
  • 35. Universal steps of AED useUniversal steps of AED use  Place AED parallel to patients left earPlace AED parallel to patients left ear  Power on the AED firstPower on the AED first  Some automatically turn on when openedSome automatically turn on when opened  Attach the AED to the patients chest with electrode padsAttach the AED to the patients chest with electrode pads  Remove clothing – to bear chestRemove clothing – to bear chest  Be kind to femalesBe kind to females  Dry patient or shave chest in area of electrode placement if neededDry patient or shave chest in area of electrode placement if needed  Place one pad above right nipple and one to the side and below the leftPlace one pad above right nipple and one to the side and below the left nipple.nipple. (CPR is continued up to the point of placing the pads(CPR is continued up to the point of placing the pads on)on)  Analyze rhythmAnalyze rhythm  Make sure everyone is clear (must say “stand clear of the victim”). NoMake sure everyone is clear (must say “stand clear of the victim”). No contactcontact  Push analyzePush analyze  Charge AED if shock is required (some machine charge automatically)Charge AED if shock is required (some machine charge automatically)
  • 36.  Shock if indicated – (after checking everyone is clearShock if indicated – (after checking everyone is clear again)again)  Begin CPR for five cycles then analyze againBegin CPR for five cycles then analyze again  If shock is advisable again you clear everyone and shockIf shock is advisable again you clear everyone and shock  If shock is not advisable – continue with CPRIf shock is not advisable – continue with CPR  If victim has pulse and is breathing put into recoveryIf victim has pulse and is breathing put into recovery position.position.  DO NOT take off pads or turn off AED until prompted by EMSDO NOT take off pads or turn off AED until prompted by EMS
  • 37. Special ConsiderationsSpecial Considerations  WaterWater  Must remove victim from water or wet surfaceMust remove victim from water or wet surface  Dry before attaching padsDry before attaching pads  Metal surfacesMetal surfaces  Is victim lying on metal surface? – if so move victimIs victim lying on metal surface? – if so move victim  The metal surface may cause the shock form the AED to hit you.The metal surface may cause the shock form the AED to hit you.  ChildrenChildren  Children 8 and older use as soon as possibleChildren 8 and older use as soon as possible  Children 1-8 – CPR for two minutes before using AEDChildren 1-8 – CPR for two minutes before using AED  Transdermal medicationsTransdermal medications  Remove patch and wipe clean before attaching AED padsRemove patch and wipe clean before attaching AED pads  Implanted pacemakers and defibrillatorsImplanted pacemakers and defibrillators  Do not place an AED electrode directly over implanted device.Do not place an AED electrode directly over implanted device.  Move at least one inch to the side of deviceMove at least one inch to the side of device  PracticePractice
  • 39. Medical emergenciesMedical emergencies  Breathing difficultiesBreathing difficulties  Asthma problems are increasingAsthma problems are increasing  Most have medicinesMost have medicines  May need assist victim is administratingMay need assist victim is administrating  If symptoms continue to get worse call 911If symptoms continue to get worse call 911  AnaphylaxisisAnaphylaxisis  Severe reaction to allergenSevere reaction to allergen  Victim may have epinephrine injectorVictim may have epinephrine injector  May need to administerMay need to administer  Call 911 if medicine is not administeredCall 911 if medicine is not administered  SeizuresSeizures  General rules – 1) Prevent injury 2) ensure open airway 3) maintain openGeneral rules – 1) Prevent injury 2) ensure open airway 3) maintain open airway after seizure is completed – place in recovery positionairway after seizure is completed – place in recovery position  Never try to restrain victim, place anything in the mouth.Never try to restrain victim, place anything in the mouth.
  • 40. Injury emergenciesInjury emergencies  BleedingBleeding  Direct pressure best wayDirect pressure best way  If bleeding continues add more gauze or cloth; do notIf bleeding continues add more gauze or cloth; do not remove gauze or clothremove gauze or cloth  Use elastic bandage to apply pressure to gauze and hold it inUse elastic bandage to apply pressure to gauze and hold it in place.place.  The use of tourniquets should be avoided unless in extremeThe use of tourniquets should be avoided unless in extreme mattersmatters  The efficacy of elevation and pressure points is inconclusive;The efficacy of elevation and pressure points is inconclusive; if used, use only in conjunction with direct pressure andif used, use only in conjunction with direct pressure and when there is no apparent fracture or other underlying injury.when there is no apparent fracture or other underlying injury.
  • 41.  Wounds and abrasionsWounds and abrasions  Irrigate wounds until free of any foreign matter.Irrigate wounds until free of any foreign matter.  Small wounds and abrasions should be cleanedSmall wounds and abrasions should be cleaned thoroughly then have triple antibiotic ointmentthoroughly then have triple antibiotic ointment placed on it and covered.placed on it and covered.  Larger wounds need to also be cleaned then coveredLarger wounds need to also be cleaned then covered and taken to doctor for possible stitchesand taken to doctor for possible stitches
  • 42.  BurnsBurns  Thermal burnsThermal burns  Cool burn with cold water until pain ceasesCool burn with cold water until pain ceases  Do not cool for more than 10 min. Can lead to further damageDo not cool for more than 10 min. Can lead to further damage  Burn blisters cover with loose gauze, but keep intact – breaking themBurn blisters cover with loose gauze, but keep intact – breaking them can lead to infectioncan lead to infection  Electrical burnsElectrical burns  Make sure electrical current is shut off before trying to help victim.Make sure electrical current is shut off before trying to help victim.  CPR and defibrillation may be needed as well as burn treatmentCPR and defibrillation may be needed as well as burn treatment  All electrocution injuries should be checked out by a physicianAll electrocution injuries should be checked out by a physician
  • 43.  Spine stabilizationSpine stabilization  Suspect possible spinal injury if…Suspect possible spinal injury if…  Car accidentCar accident  Injured from fall greater than their heightInjured from fall greater than their height  Complains of neck pain, tingling, or extremity weaknessComplains of neck pain, tingling, or extremity weakness  Is not fully alertIs not fully alert  Appears to be intoxicatedAppears to be intoxicated  Appears frail or is >65 yrs oldAppears frail or is >65 yrs old  Has sustained a head injuryHas sustained a head injury - Manually stabilize the neck until help arrives.- Manually stabilize the neck until help arrives.
  • 44.  Musculoskeletal trauma – sprains, strains, contusions,Musculoskeletal trauma – sprains, strains, contusions, fracturesfractures  For sprains, strains, contusions – apply ice for 20.For sprains, strains, contusions – apply ice for 20.  Sprains elevate and place compression bandageSprains elevate and place compression bandage  R.I.C.E. – rest, ice, compression, elevationR.I.C.E. – rest, ice, compression, elevation  If victim has aversion to cold – place wet cloth between ice and skinIf victim has aversion to cold – place wet cloth between ice and skin  Young kids and elderly especially susceptibleYoung kids and elderly especially susceptible  Contusion you want to stretch the injury as well as iceContusion you want to stretch the injury as well as ice  If you are unsure of the injury suspect fracture – do notIf you are unsure of the injury suspect fracture – do not move or straighten injury. Place ice on area and splint inmove or straighten injury. Place ice on area and splint in position, send to ER.position, send to ER.  If suspect dislocation – splint as is and send to ER.If suspect dislocation – splint as is and send to ER.
  • 45.  Dental injuriesDental injuries  Avulsed toothAvulsed tooth  Hold onto by the crown not the root (part embedded intoHold onto by the crown not the root (part embedded into gumgum  Rinse off with water (do not scrub)Rinse off with water (do not scrub)  Either place back into socket or place in glass of milk andEither place back into socket or place in glass of milk and see a dentist immediatelysee a dentist immediately  Clean bleeding wound with saline solution or tapClean bleeding wound with saline solution or tap waterwater  Use cotton to apply pressure to stop bleedingUse cotton to apply pressure to stop bleeding
  • 46. Environmental injuriesEnvironmental injuries  SnakebiteSnakebite  Do not suck wound, it will only exasperate the problemDo not suck wound, it will only exasperate the problem  In case of Coral snake – wrap a bandage around the extremity of the bite – it will help slowIn case of Coral snake – wrap a bandage around the extremity of the bite – it will help slow the poison – then get to medical facility immediately.the poison – then get to medical facility immediately.  Coral snake bites and sucksCoral snake bites and sucks  Other snake bites, wash area with soap and water, try not to move extremity very much andOther snake bites, wash area with soap and water, try not to move extremity very much and get to medical facility.get to medical facility.  Cold injuriesCold injuries  HypothermiaHypothermia  Immediately begin re-warming – remove wet clothes and wrap body surface with anything at hand;Immediately begin re-warming – remove wet clothes and wrap body surface with anything at hand; get to medical facility immediatelyget to medical facility immediately  If far from medical facility you begin active warming – placing near heat source, placing in warmIf far from medical facility you begin active warming – placing near heat source, placing in warm (not hot) water.(not hot) water.  FrostbiteFrostbite  Remove wet clothing, usually occurs on extremities, do not re-warm if there is any chance it couldRemove wet clothing, usually occurs on extremities, do not re-warm if there is any chance it could freeze again or you are close to a medical facility.freeze again or you are close to a medical facility.  Use luke-warm water if you are far from medical facilityUse luke-warm water if you are far from medical facility
  • 47.  Heat InjuriesHeat Injuries  Heat cramps – muscle cramping, usually due to extreme loss of fluidsHeat cramps – muscle cramping, usually due to extreme loss of fluids  Get to cooler areaGet to cooler area  Replace fluidsReplace fluids  Ice and stretch areaIce and stretch area  Heat exhaustionHeat exhaustion  Dizziness, could have flushed skin or cool and clammy, disoriented, nausea,Dizziness, could have flushed skin or cool and clammy, disoriented, nausea, headacheheadache  Get victim to cool area immediatelyGet victim to cool area immediately  Place ice on side of neck (carotid artery), arm pits, and groin areaPlace ice on side of neck (carotid artery), arm pits, and groin area  Replace fluidsReplace fluids  Watch for shock; could lead into heat strokeWatch for shock; could lead into heat stroke  Heat Stroke – medical emergency – call 911 immediatelyHeat Stroke – medical emergency – call 911 immediately  Extreme disorientation, possible unconsciousness, very little sweating,Extreme disorientation, possible unconsciousness, very little sweating, internal temperature of >105.internal temperature of >105.  Cool down by any meansCool down by any means
  • 48.  DrowningDrowning  Get victim out of water as soon as possibleGet victim out of water as soon as possible  Begin CPR immediatelyBegin CPR immediately  If you are alone – finish five cycles of CPR before calling 911If you are alone – finish five cycles of CPR before calling 911
  • 49. PoisonsPoisons  Poison control center – 1-800-222-1222Poison control center – 1-800-222-1222  Chemical BurnsChemical Burns  Brush off any powder and remove all contaminated clothingBrush off any powder and remove all contaminated clothing  Alki or acid exposure – rinse with copious amounts of water.Alki or acid exposure – rinse with copious amounts of water.  Ingested poisonsIngested poisons  Do not ingest any medication; milk, activated charcoal, syrupDo not ingest any medication; milk, activated charcoal, syrup of ipecac unless instructed by poison controlof ipecac unless instructed by poison control
  • 50. ShockShock  Develops when there is not enough blood flowing to the cells of the bodyDevelops when there is not enough blood flowing to the cells of the body  Causes in adults;Causes in adults;  loss of bloodloss of blood  heart attack,heart attack,  allergic reactionallergic reaction  SymptomsSymptoms  feel cold and shiver,feel cold and shiver,  feel weak, faint, or dizzy,feel weak, faint, or dizzy,  restless,restless,  vomit,vomit,  feel thirstyfeel thirsty  TreatmentTreatment  Call 911Call 911  Put victim on their backPut victim on their back  If not leg injury or pain raise legs 12 inchesIf not leg injury or pain raise legs 12 inches  Cover victim with blanketCover victim with blanket  If bleeding is visible – use direct pressureIf bleeding is visible – use direct pressure