Emergency Lifesaver Workshop Objectives of First AidPreserve Life ・ Prevent Worsening ・ Pain Relief Necessity of First Aid Importance of the first 5 minutesNecessity of independent aiders - the courage to help In saving others, society saves us Casualty (person injured or taken ill) Responder （ passer-by)
The Chain of Survival Early Access Early CPR Quick Emergency Early MedicalCalmly and quickly Perform CPR or Measures Care call 102 / 108 and other first aid as Ambulance team Professional care atexplain the situation necessary until provides further medical institution ambulance arrives expert care
Is Resuscitation Possible? １００ １ ２ ３ ７５Death rate ５０ ２５ ０ ２ ３ ５ １０ １５ ３０ １ hour 30s １ min time ① 50% die within 3min after circulatory arrest ② 50% die within 10min after pulmonary arrest ③ 50% die within 30min of major bleeding * Average ambulance arrival assumed time is 10min from call
Emergency Aid If unconscious Preserve airwayFirst Aid If not breathing Artificially ventilate If no heartbeat Chest compressions If airway blocked Remove obstruction If bleeding heavily Stop bleeding Make comfortable. Other Treat fractures, wounds, injuries, Aid burns, drowning. Transportation.
Age 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
Observation 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 When Signs ofventilating Any coughing? circulation Give two breaths Any movement?
Signs of Circulation: Checking the PulseAdults, children （ carotid artery ）Infants, newborns （ brachial or femoral artery ）
No ①Conscious? Yes ②Get help Insufficient ④Breathing? ③Open airway Sufficient ④Breathing? Sufficient Put in recovery position and observe ⑤Ventilate (2 times) Yes ⑥Circulation signs? If breathing still insufficient (breathing, coughing, movement) continue ventilating (one breath every 5 seconds)⑦⑧ CPR (30 compressions: 2 breaths) Yes for 5 cycles If breathing recovers or casualty protests, stop ventilating ⑥Circulation signs? ⑧ Continue CPR (30 compressions: 2 breaths)
Observation: ConsciousnessCall “Are you alright? Can you hear me?” intocasualty’s ear while tapping their shoulder. See if theycan talk or respond. If no response, get progressivelylouder/harder (no more than 3 times!) Judge whether casualty Can you is conscious or hear me? unconscious Do not move or slide the casualty For infant/newborn casualty, scrape the sole of the foot
Get HelpChoose someone and request their help. Please call 102 for an ambulance
The Airway The airway is the path taken by air through the mouth and nose to the lungs. （ Consciousness problems/ not breathing/ airway obstruction ）
Opening 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.
Opening the Airway (2): neck injuriesGrasp the jawbone with both hands and gently easeupwards, applying pressure with all 4 fingers on bothsides.
Observe BreathingPlace your ear above the casualty’s mouth and nose. Look along thechest and abdomen. If she is breathing you will hear and feel thebreath 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”
The Recovery PositionFor the casualty who is breathing sufficiently but is notfully conscious. Use the casualty’s own hand undertheir jaw to keep the airway open.
Artificial VentilationKeeping the airway open, pinch the nostrils so that aircannot escape through the nose but is forced into the lungs. Mouth-to- -Mouth -Nose -Mouth & nose -Mask -Tracheostomy etc.
Breathe for the Casualty Open your mouth wide, take a deep breath, and seal your lips aroundthe casualty’s mouth. Blow into the lungs, looking along the chestuntil you see the chest rise slightly.Blow about 10cc per kg of casualty’s weight. (e.g. 500-800cc) Problems: Open airway? Nostrils? Seal? Airway obstructions?
Remove your mouth and watch the chest fall Pros and cons of Mouth-to-Mouth VentilationRequires no special tools Risk of infectionCan be done by one person,even a child Risk of secondary poisoning May feel unpleasantEasy to see if it’s working
Preventing InfectionA non-return valve resuscitation mask can be used.If you’re worried about infection you can perform chest compressions only.
Ventilating when circulation signs are present １ ２ １ ２ １ ２ ３ ４ ５ ６ ７ ８ ９ １０ １“No breathing” Breathe gently for two seconds Breathe gently for two seconds Breathe gently for two seconds “Circulation Signs present” Check signs for no more than Ventilate Ventilate Ventilate ten seconds. Look for autonomous breathing, coughing or movement. Breathing may still be insufficient.
Breathing: Age groups Frequency Amount Duration MethodAdult Every 3-5 sec. 500-800cc 2 sec. （ 10cc/kg ） Mouth-to-mouthChild Every 2-3 sec. 1 - 1.5 sec.Infant Until chest Mouth-to-nose rises gently.Newborn Every 1 - 2 sec. 1 sec. Mouth-to-mouth- and-nose
Chest Compressions: Correct Hand PositionThe heart is located within the ribcage, slightly to left of centre.An incorrect hand position will make compressions less effective,and break the casualty’s ribs. Heart Hand position
Hand 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-spaceLower limit for compression Xiphoid process
Finding the correct hand positionTrace the underside of the ribs with your index and middlefingers. ribs
Place the middle finger in the sternal notch, and the index finger on the sternumUsing 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
Now rest the heel of the other hand on the sternum next tothe extended index finger. This is the correct hand positionfor compressions.
Cardiac Compressions - Essential Points① Sit level with the casualty’s chest② Correct hand position, with the heel of the hand③ Lock your elbows④ Position your shoulders over the chest⑤ Using your body weight, compress straight down towards the ground Adult casualty: Compress 3.5 〜 5cm Rhythm of 100 per min.
Compression techniqueAvoiding pressure on the casualty’s ribs, compress onlythe narrow sternum. This maximises the safety andeffectiveness of the compressions. Use this part (the heel of the hand) to compress the chest
Compress VerticallyWith elbows straight, push straight down. Release pressurepromptly. Take care not to lose your position.
Cardiac CompressionsCompressing the heart between the sternum and spinecauses blood to circulate.Compress 30 times at a rate of 100 compressions/minute.heart sternum spine downstroke upstroke
How NOT to do it!Don’t push at an angle Don’t bend your elbows
Cardio-pulmonary Resuscitation(CPR)Repeat cycles of 15 compressions to two breaths (ratio 15:2)After the first four cycles, check again for signs of circulation - for no morethan 10 seconds 30:2
2 breaths 30 compressions : 2 breaths One cycle compressions 30 chest “Starting CPR”signs of life 10 second check for “No signs of life” “Checking signs”2 breaths “No breathing. Ventilate.”
Removing Obstructions (1)Open the casualty’s mouth with the “crossed finger” technique.Cross the thumb and index finger. Place the thumb on the upper teeth, the indexfinger on the lower teeth, and twist to open the mouth.Don’t move the headwhen inspecting themouth.Do you need to removedentures?
Removing Obstructions (2)Turn casualty’s head to one side.Wrap your finger with a handkerchief or cloth, and wipe outany obstructions.Make sure to clean away all blood or body fluids.
Back Slaps Slap sharply and strongly 4 or 5 times between the casualty’s shoulder blades using the heel of your hand.
Heimlich Maneuver (Sitting) Only on conscious casualties aged > 8 yearsPut the ball of the thumb against the upper stomach areaPut your chest against the casualty’s back.Put both arms under the casualty’s armpits.Squeeze inward and upward.
Heimlich Maneuver (Astride)With the heel of one hand on the upper stomach area, support with the other hand and push sharply upwards and inwards.
Compression from BehindWith one knee raised, put open hands on the lower trunkbeneath the ribs on either side of the spine. Squeezestrongly, inwards and upwards.
No ① Conscious? Yes ② Call for help Not enough ④ Breathing? ③ Open airway Enough ④ Breathing? Enough Recovery position (continue to monitor) ⑤ Two breaths Yes⑥ Check signs of life If breathing sufficient, continue Breathing? Coughing? Moving? ventilations (1 every 2 to 3 sec.) ⑦⑧ Perform CPR (30:2) Yes If breathing recovers or casualty objects, stop ⑥ Check signs of life ventilations ⑧ Perform CPR (30:2)
CPR for Children, Babies and NewbornsMouth-to-Mouth Mouth-to-Nose & MouthTwo breaths. Two breaths.1 ～ 1.5 seconds apart.Chest should rise gently. Breathe for 1 sec.Child Baby & Newborn
Casualty Hand Position Technique Extent RateChild Lower half of Heel of one(1-8 yrs) sternum hand 100/minute About 1/3Baby depth of(1-12 month) One finger Middle & At least 100/minute chest width below ring fingersNewborn (less line joining the onlythan 28 days) nipples About 120/minute Child Baby & Newborn
Removing Obstructions: Baby & ChildBack Slaps Thoracic Compressions Turn over, facing Face upward. downwards Compress lower sternum as Support chin with fingers for CPR, 5 times. Slap 5 times with heel of hand Cycle both techniques. If becomes unconscious start CPR!
Bleeding Control: Direct PressureConsider the cleanliness, thickness and position.Apply direct pressure to the wound.Use a plastic bag or rubber gloves to avoid infection. Gauze pad wound bone
Bleeding Control: TourniquetPosition 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.
1. Prepare the tourniquet. 4. Turn the stick until bleeding stops.2. Tie loosely. Insert a pad. 5. Secure the stick so it won’t move.3. Insert the stick. Steady the pad. 6. Record the time.
Legal Protection for First Aiders INDIA : Good Samaritan Law. If emergency aid is given with sincere spirit there will be no retribution even in the event of a mistake. “Regarding actions made in good faith, in the absence of malice or negligence, there shall be no civil or legal liability.”