1. Bls basic life support
EMS – Emergency Medical Services
Accidental Death and Disability
Neglected Disease of the Modern Society
1971 First Edition of Text
USA Act of 1973 – to provide the best possible Emergency Medical Care in the shortest
practical time to the sick and injured.
Rescuer / First Aider – have the greatest opportunity of any group of the society to
relieved suffering at the scene of accident or sudden illness and during transportation to
medical facilities.
Every gestures of the first responder means the difference between life and death, since
the time interval before death or brain damage that is irreparable in
Cardiac arrest
Respiratory arrest
Severe hemorrhage – only 4 – 6 min
is needed to drain blood in the body
The Term First Responder – is the first person present at the scene of sudden illness or
injury.
Example:
RTA – CW
Sports Accident – S
Drown Victim – SP – OS
Industrial Accident – limbs Amputated
Poison bites –S – S- D
Rescuers have little or no equipment to hold back death until medical professionals
arrived. A pair of Hands, a mouth, and a brain to direct rescuer, all that are needed to
provide air for the lungs or blood to the brain and to control dangerous bleeding from
accessible areas by pressure.
DIAGNOSTIC SIGN:
1. Pulse
2. Respiration
3. Blood pressure
4. Body temperature
5. Condition of the skin
2. 6. Status of Pupils
7. State of Consciousness
8. Ability to move
9. Reaction to pain
Heart - is a hallow muscular organ approximately the size of man’s first.
Normal H/B is – 5 to as high as 95 beat per min.
70 – 70 milliliters of blood are injected to the heart in one min.
The entire six (6) lts. Of blood is circulated through the vessel.
Pulse – is a pressure wave travelling along the arteries caused by the contraction of the
heart.
The usual pulse rate in adult is 50 – 95 mins.
Pulse can be palpated “felt by touch” at any area (where)
Temporal
External Maxillary
Brachial
Ulna
Radial
Femoral
Carotid
Dorsalis pedis – top
Tibialis Posterior – side
Note
1. Unconscious patient should be considered pulse less.
2. The pulse rate should be described and the character should be describe ( weak
or strong.)
Respiration – Normal breathing is easy, without pain and without effort. The rate can
vary widely.
Usual breath 12 – 20 B/min
Trained Athletes may breath only 6 – 8 min
Rapid, shallow respiration are seen in shock Deep, gaspin, labored breathing may
indicate partial airway obstruction and or pulmonary disease.
Hyperventilation – hypoventilation 20% or O2
Blood pressure – is a pressure of circulating blood against the wall of arteries
B/P – can fall markedly in state of shock after severe bleeding or after heart attack.
3. Lowered B/P means that there is insufficient pressure in the arterial system to supply
oxygenated blood to all the organs of the body.
B/P is determined with Sphygmomanometer and stethoscope.
With the absence of stethoscope – could be visual or using radial pulse.
B/P levels vary with the age and sex
“Demonstrate “ B/P apparatus – the point with the first sound of pulse is heard through
the stethoscope is the systolic pressure is the point at which the sound disappear is the
diastolic pressure S/D
Temperature – Normal body temperature is 98.6o
F or 37o
C
The skin is largely responsible for the regulation of body temperature. Skin said to be
1700 square foot.
Changes in body temperature occur as a result of illness or injury.
Temperature is usually taken by mouth with the bulb of the thermometer place beneath
the tongues.
Mouth should be closed for 3 min
In a child or uncooperative, patient, the thermometer can be placed in the AXILLA.
However axillary temperatures are notoriously inaccurate. It takes long time to register
accurately. 10 min at least and should be used as a last resort.
Rectal temperature is very accurate – ½ -10 higher above oral. Taken with special
thermometer left in the place for one min.
Anew digital thermometer with plastic disposable tip.
Condition of the skin – skin color depend primarily on the presence of circulating blood
in the blood vessels.
Status of the Pupils – when normal are regular in outline is usually of the same size.
State of Consciousness – Normal is Alert
Ability to move – the inability o conscious patient to move voluntarily is known as
paralysis
Example: Wrong move in RTA victim and wrong mobilization could result to permanent
paralysis.
Reaction to pain – Reaction by vocal response or body movement to painful physical
stimulation is a normal function of the body.
Example: Unconscious
Basic Life Support / First Aid
Human Skeleton form – skeletal section
4. The frame of the body.
Obstructed Airway: Dysprea – state of difficult or labored breathing. There may be
obstruction to the flow of air
Foreign bodies in the throat or windpipe.
Eta – Open airway
It may be conscious when discovered but become unconscious
It is unconscious when discovered
Conscious patient
3 Maneuvers to relieve upper airway obstruction
1. Back blows – up to 4 thrust
2. Manual thrust
3. Finger sweeps
B/B – sharp blows delivered over the pt’s spine between scapulae. These could be
applied whether the pt is sitting, standing, or laying down.
Abdominal Thrust – up to 4 chest thrust
Conscious / unconscious rate
SELF EMERGENCY – DEMO CHAIR
However – those who suffered labored breathing like “Hika”
Hapo – Hepoventelation
Haperventalation Hingal – Sapot = 21% of 02
Same approach in children however the power is reduced.
Bleeding and Control of Bleeding
An average adult has six 6 letters if blood inside, loss of 1 liter of blood in adult and loss
of 500 milliliters of blood in child is very dangerous loss of 25 – 30 milliliters in infant
may coz of shock.
The average adult may comfortably loss 500ml of blood in the blood center or blood
bank. – 15 – 20 min.
Ex case – nataga, nsugatan, nasaksak, naputulan or amputated parts
ETa – local pressure
Pressure point
Tourniquet
5. 1. Bleeding in nearby always stopped when pressure is applied directly over the
wound (DP)
2. In instance where pressure dressing are not available, all proximal arterial
pressure can be used (DEMO)
3. Tourniquet – Amputation of limb – T may also be used if were necessary but
should not be used in other case because sometimes it caused more damage to
injured extremities.
Demo – correct application of Spanish windlass
- B/P cup can also be used.
Basic life support – is an emergency life saving procedure that consist of recognizing
and correcting failure of respiratory cardiovascular system.
Oxygen (O2) Most important in person’s life which is present in the atmosphere.
In concentration of about 21% of O2 – essential for conscious living person.
4 min without O2 person will die
In the delivery of O2 from atmosphere to the brain cell.
There are 2 necessary actions
1. Breathing
2. Circulation
Basic Life Support include ABC steps – “revised” CAB
A – Airway
B – Breathing “Respiratory 16% O2
C – Circulation – Circulatory or Cardiac (heart)
No instrument or supplies needed
Hands
Mouth
A – Check for obstruction / tilt the head to open airway
B – Give 3 Quick breath / for the lungs
C – Compress heart to reactivate function
Recall the mechanics of heart/how it works
In the Middle East – Professional trained medics – inject epinephrine – direct to the
heart.
CPR 5 is to 1 ratio for 60 sec 60 / min and or 100C – 2B
Mouth to nose ventilation – 16% O2
Mouth to Stoma “close mouth and nose “laryngectomy”
6. One man and two men CPR will be practiced with other resource persons.
The Soft tissue
Skin is the largest organ in the body, one of the most important organ and not just
cover for the viscera underneath, also tough tissue which cover the entire body.
Over 70% of the body contain H2O including the six its of blood and skin is watertight
serve to keep the internal solutions intact.
Layers – Epidermis – outer layer
- Dermis – deeper layer
5 Classification of wound
1. Contusion – direct blow
2. Abrasion – rubbing/scraping
3. Laceration – cut until subcutaneous tissue
4. Avulsion – torn loose completely, skin left hanging
5. Puncture – nailed, fishing hook – ti give the Doctor idea to the extent of the
damage.
“STABILIZED APPROACH”
FRACTURES – DISLOCATIONS AND SPRAIN
The human skeleton form the frame of the body
In RTA always assume PT has fractures and Dislocation.
Fracture – is any break in the continuity of the bone or angulated extremities “lower and
upper”
Dislocation – is injury means disruption of join such that the bone ends are no longer in
contact.
Sprain – when the join or supporting ligaments are stretch or turn.
Eta all approach – stabilized
Demo – splints, triangular bondage, pillow same as dislocation of scapula and clavicle
Demo – using long spine boards
Short spine board, splint
The Eye – is an organ of special sense, develop for vision, with sensory cell in the retina
change into electrical message that carried optic nerve to the part of the brain. The
brain received sensory message and interpret it. The entire process is called “SEEING”
Case. FOREIGN BODIES – Ex. Pawning of any size and shape
Eta – wash out automatically by tears “when irritated”
- Flush out by running H2O or saline as irrigation fluid.
- If conjunctive area has FB – use cotton buds and flush H2O never rub
7. Cover with pieces of clean cloth – both eyes (Explain) in children – same approach, but
explain what is happening and what you are going to do. Have one relative to go during
transportation as assurance.
Impaled object to the eyes – stabilized using disposable cup never remove the impaled
SURVIVAL FOR FAMILY and OR INDIVIDUAL
Go BAG – Emergency bag
Important documents
Money for a Day or more
Can goods for at least 3 days
Dry clothes at least 2 each
List of contact numbers
Battery operated radio (local /national stations)
Battery operated flashlights
Whistle
Rope / lifetime at least 5 mts
PERSONAL SURVIVAL
Condoms
Sanitary Napkins
Diapers
SIMPLE / BASIC (WASAR) Water Rescue
“What important in H2O Rescue is one should be knowledgeable in swimming”
If the victim is conscious – never attempt to approach if victim can’t hear your
instructions.
The rescuer will surely die the victim will surely grab whoever approach him.
Different maneuvers
Front approach rescue – the rescuer will give the victim instructions on what to do.
Back approach rescue – hold the head with both hands – swim frog kick.
Swim at the side – hold / grab victim chest either left or right arms and swim sideways.
If the rescuer is really a good swimmer – use underwater approach – hold both feet and
swim ashore.
For rescuer who also does not knew the art of swimming.
Ask / sick to help – throw stick rope or any floater.
Other personal survival
8. Plastic bottle like 1.5 – remove some 50% of its content, put inside the pack bag wear in
front instead of wearing at the back.
Other idea – Pants – talian ang paa at higpitan ang belt, this will float for sometimes
until you find another floating materials.
To avoid Hepothermia – or low body temperature, unless otherwise suspecting,
fractures, agitate victim to move lower and upper extremities.
If in a bigger boat – jog
Both armpit – kili-kili
Note: Rule of Thumb. Only trained water safety personnel should never try to attempt
swimming or water rescue.
Life line is a must. Throw – raw only them go
Blanket drag
Clothes drag
Fire fighter’s drag
Fireman’s carry
Four men log roll Techniques – long spine boards.
Splints Cervical collars
Chair lift two approach
RADIO COMMUNICATION – Communication is powerful – very strong and important
Phonetic Alphabet A-Z
For me good communication is the most effective arm in a successful disaster
management.
Morsecode
Sempahore
Latest in mobile phones – during calamity, signal maybe bag down the best is Radio “2
way radio” – if power is cut off. If the signal radios is 5 klm. It is enhance by a repeater
base.
Old way is using 10 codes – it is a big disadvantage for other station in monitor can’t
understand the message. OCD disregard utilizing these.
Each station should have call sign.
Different between radio and telephone.
May day, May day
TRIAGE – all victim should be brought first to triage area (holding area)
Life threatened level – Critical
9. Urgent Less critical 2nd
Priority
Delayed Ambulatory
Dead will be the last
LACERATION OF ABDOMEN – EX STAB WOUNDS
Eta – never return back the
Cover with sterile moisture dressing
If available – sterile aluminum foil
Cover dressing and transport to hospital
Explain why foil
External male genitalia – avulsion (tearing away) of the skin of the penis particularly in
the uncircumcised can occur in the industrial accident.
Denuded (nabunot) penis should be wrapped in soft sterile dressing moistened.
Salvage the avulsed skin and preserved it.
Explain “How”
AMPUTATION – partial or complete penile shaft demands immediate attention to blood
loss with can be manage by local or direct pressure
Wrapped in sterile dry dressing in plastic bag transport in cooled container but not
directly to ice, transport for medical reconstruction.
Note: Pacify in historical victim
GUNSHOT WOUNDS
SEXUAL ASSULT AND RAPE
Patient or victim should be advised not to urinate wash, for Physician opportunity
examine
Note: Must be aware that patient has the right to refuse assistant and have right not to
be brought to hospital especially matured person.
Diabetes – always in mind that diabetes Pt smell sweaty, fruity breath.
Unconscious during Epileptic attack – management
Out of control individual – will be called in a
