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First Aid Training
2
Course Basis
āš« In construction industries not a day goes by without
some type of injury occurring
āš« The direct cost and indirect cost of injuries is getting
higher
āš« Peoples basics instinct is to help injured people, but
using improper help procedures may lead to a more
disastrous situation rather than saving lives
āš« Prompt, properly administered first aid care can
mean the difference between life and death, rapid
versus prolonged recovery, temporary versus
permanent disability.
3
āš« Prolonged life
āš« Alleviate suffering
āš« First aiders responsibilities ends
when the services of Medical
professional begins
āš« First aiders are not intended to
compete with Medical professionals
Objectives of the First Aid
4
First Aid - Basic
We all take certain measures to prevent accidents
but despite our best efforts emergencies arise. You
or people nearby trip and fall... unintentionally come
in contact with exposed wiring... step on a rusty nail...
or literarily bite off more than you can chew... And
when an accident happens, time is not on your side.
Besides a well-stocked and functional First Aid Kit,
preparation and skills are the most important tools
you can have at your disposal.
5
First Aid Kit
āš« Sterile adhesive
bandages in assorted
sizes
āš« Sterile gauze pads in
assorted sizes
āš« Hypoallergenic adhesive
tape
āš« Scissors
āš« Tweezers
āš« Needle
āš« Ace bandage
āš« Moistened towelettes
āš« Antiseptic
āš« Splints in assorted sizes
āš« Petroleum jelly
āš« Assorted sizes of safety pins
āš« Anti-bacterial soap
āš« Antibiotic ointment
āš« Latex gloves and face mask
āš« Sunscreen
āš« Aspirin and/or ibuprofen
āš« Ice Pack
āš« Thermometer
āš« Tongue blades
6
Cuts and Scrapes
Open Wound apply 5 Cā€™s
āš« Clean the wound
āš« Control Bleeding
āž¢ By applying pressure
āž¢ Elevating the wounded part at
least above the heart
āž¢ Put pressure on Limbs
pressure points
āš« Cover the wounds with
sterilize or clean cloths
āš« Care for shock
āš« Call Physician
7
Cuts and Scrapes
Clean the wound with mild anti-
bacterial soap and water. You
can use sterilized tweezers to
remove any debris that remains
embedded in the wound after
rinsing. This will reduce the risk
of an infection and possible
complications. If the debris is
abundant or can't be removed
for some other reason, a trip to
the emergency room will be
necessary.
8
Cuts and Scrapes
āš« Control the bleeding.
Water may induce
bleeding by thinning the
blood. If while rinsing the
wound you notice
increased blood flow, use
gauze or a clean cloth to
apply gentle, continuous
pressure until the blood
clots.
āš« Elevate the wounded part
of the body if possible
above the heart level
9
Cuts and Scrapes
Although hydrogen peroxide is
commonly used as a disinfectant
for minor cuts and scrapes, it is
actually not very effective and
may even delay the healing
process by irritating a person's
living cells. You can use
hydrogen peroxide but apply it
around the open wound, not
directly to it. An antibiotic
ointment such as Neosporin is a
better alternative - it will keep the
wound from getting infected and
speed up the healing process.
10
Cuts and Scrapes
Cover the wound with a
bandage or sterile gauze to
keep dirt and bacteria out.
Change the dressing
frequently and rinse the
wound as often as necessary
to keep it free of dirt.
11
Cuts and Scrapes
āš« Care for shock. Some victim may
lead to shock due to blood loss.
Gently lay him down with his
head slightly lower than his chest
and his feet elevated.
āš« Call the Physician. If the wound is
very deep or the bleeding is
profuse, it may require stitches in
order to heal properly.
12
Puncture Wounds
āš« Unlike a cut, a puncture wound does not
typically result in profuse or excessive bleeding
and although painful, may look harmless as the
skin around the wound simply closes. But
puncture wounds carry a risk of infection and if
left unattended can result in serious
complications.
āš« Injuries sustained by stepping on a nail that
punctures through a shoe are especially prone
to infection. If the injury is caused by stepping
on a nail or a shard of glass that's been
exposed to the elements, it is a good idea to
consult a physician who may recommend a
tetanus shot or booster.
13
Puncture Wounds
āš« A bite from a household pet or another person that
results in a puncture wound should be considered and
treated as serious injury. If the bleeding is heavy or the
item that caused the wound appears unsanitary,
thoroughly clean the injured area with mild anti-bacterial
soap and water and seek professional medical assistance
as soon as possible.
āš« If the injury is minor, clean it with soap and water and
apply an antibiotic ointment such as Neosporin to prevent
infection. Dress the wound with sterile bandage and
replace the dressing frequently. It is prudent to keep a
close eye on the wound for several days to prevent an
onset of an infection from any debris that may've lodged
itself deep in the wound. If you notice persistent redness
or puffiness or if the wound starts to ooze pus, have the
victim consult a doctor right away.
14
Shock
Shock is a life-threatening condition that occurs
when the body is not getting enough blood flow. This
can damage multiple organs. Shock requires
IMMEDIATE medical treatment and can get worse
very rapidly.
āš« Major classes of shock include:
āž¢ Cardiogenic shock (associated with heart problems)
āž¢ Hypovolemic shock (caused by inadequate blood
volume / Blood loss /Severe bleeding)
āž¢ Anaphylactic shock (caused by allergic reaction)
āž¢ Septic shock (associated with infections)
āž¢ Neurogenic shock (caused by damage to the
nervous system)
15
Shock
āš« Shock can be caused by any condition that reduces
blood flow, including:
āš« Heart problems (such as heart attack or heart failure)
āš« Low blood volume (as with heavy bleeding or
dehydration)
āš« Changes in blood vessels (as with infection or
severe allergic reactions)
āš« Shock is often associated with heavy external or
internal bleeding from a serious injury. Spinal injuries
can also cause shock
16
Shock
A person in shock has extremely low blood pressure.
Depending on the specific cause and type of shock,
symptoms will include one or more of the following:
āš« Anxiety or agitation
āš« Confusion
āš« Pale, cool, clammy skin
āš« Low or no urine output
āš« Bluish lips and fingernails
āš« Dizziness, light-headedness, or faintness
āš« Profuse sweating, moist skin
āš« Rapid but weak pulse
āš« Shallow breathing
āš« Chest pain
āš« Unconsciousness
17
Shock
First Aid for Shock
āš« Call 911 for immediate medical help.
āš« Check the person's airway, breathing, and
circulation. If necessary, begin rescue breathing
and CPR.
āš« Even if the person is able to breathe on his or
her own, continue to check rate of breathing at
least every 5 minutes until help arrives.
āš« If the person is conscious and DOES NOT have
an injury to the head, leg, neck, or spine, place
the person in the shock position. Lay the person
on the back and elevate the legs about 12
inches. DO NOT elevate the head. If raising the
legs will cause pain or potential harm, leave the
person lying flat.
āš« Give appropriate first aid for any wounds,
injuries, or illnesses.
āš« Keep the person warm and comfortable. Loosen
tight clothing.
18
Adjust the top leg so that
both the hip and knee are
bent at right angles. Gently
tilt the head back to keep
the airway open. Keep the
person warm until medical
help is obtained.
Shock
RECOVERY POSITION
To put the victim in
the recovery position
grab the victim's leg
and shoulder and roll
him towards you
Continue to roll the
victim until he is on
his side.
19
Shock
DO NOT
āš« DO NOT give the person anything by mouth, including
anything to eat or drink.
āš« DO NOT move the person with a known or suspected spinal
injury.
āš« DO NOT wait for milder shock symptoms to worsen before
calling for emergency medical help.
IF THE PERSON VOMITS OR DROOLS
āš« Turn the head to one side so he or she will not choke. Do
this as long as there is NO suspicion of spinal injury.
āš« If a spinal injury is suspected, "log roll" him instead. Keep the
person's head, neck and back in line and roll him or her as a
unit.
20
Burns
āš« A burn victim will require different
type of care depending on the
type and extent of his injury.
Burns vary greatly from a
common, fairly harmless sunburn
to a potentially life-threatening
3rd degree burn caused by open
flames or electrocution. Here's
how to distinguish the three
different types of burn injuries
and how to care for each:
21
Burns
āš« 1st degree burns are usually
accompanied by redness and some
swelling of the skin.
Treat a minor burn by first cooling the
affected area. If possible, keep the injury
under cool running water for at least 10
minutes. If running water is not available
place the burn in a container of cold water
such as a bucket, tub or even a deep dish.
Using a cool, wet compress made of clean
cloth will also work if nothing else is available.
Keeping the burn cool will reduce pain and
minimize the swelling. If the injury is on the
part of a body where jewelry or snug clothing
is present, carefully remove them before it
begins to swell. Apply a moisturizing lotion or
Aloe Vera extract and dress the burnt area
with loosely wrapped sterile gauze.
22
Burns
āš« 2nd degree burns will result in
deeper, more intense redness of
the skin as well as swelling and
blistering.
This type of burn should be treated
just as a 1st degree burn but
because the damage to the skin is
more extensive, extra care should be
taken to avoid infection and
excessive scarring. Replace the
dressing daily and keep the wound
clean. If a blister breaks use mild
soap and warm water to rinse the
area. Apply antibiotic cream such as
Neosporin to prevent infection before
redressing in sterile gauze.
23
Burns
āš« 3rd degree burns mayappear and
feel deceptively harmless as the
victim maynot feel much pain due to
complete destruction of all layers of
skin and tissue as well as nerve
endings. Thedamaged area may
appear charred or ash-color and will
instantlystart to blister or "peel".
If the victim's clothing is on fire, douse
him with non-flammable liquid.
āš« Dial 9-1-1. Do not remove burnt clothing
from the victim as this will expose open
wounds to the elements and potential
infection. If possible, cover the victim's
injuries with wet sterile cloth to reduce
the pain and swelling. If you notice that
the victim is going into shock and loses
consciousness, you will need to perform
CPR.
24
Electrocution
āš« Electricity travels through conductors -
any material which allows electrical
flow - as it tries to reach the ground.
Because people make excellent
conductors, minor electrocution is a
common household hazard.
Fortunately it is usually more
surprising than dangerous and does
not require medical attention. However,
some basic precautions should be
taken to insure that the shock does
not interfere with the body's normal
electrical impulses including the
functions of the brain and the heart.
Prolonged exposure to a direct source
of electricity can also cause severe
burns to the skin and the tissue.
25
Electrocution
āš« In the event of electrocution do NOT
rush to assist the victim until you are
certain that he is no longer in contact
with electricity. Otherwise the current
will pass through the victim directly to
you.
āš« If at all possible, turn off the source of
electricity (i.e. light switch, circuit
breaker, etc.) If this is not an option,
use non-conductive material such as
plastic or dry wood to separate the
source of electricity from the victim.
āš« If the injuries appear serious or
extensive, dial 9-1-1.
26
Electrocution
āš« Check the victim's vitals signs such
as the depth of his breathing and
regularity of his heart beat. If either
one is effected by exposure to
electricity or if the victim is
unconscious, begin to perform CPR.
āš« Treat any areas of the victim's body
that may have sustained burns.
āš« If the victim is responsive and does
not appear seriously injured but looks
pale or faint, he may be at risk of
going into shock. Gently lay him
down with his head slightly lower
than his chest and his feet elevated.
27
Fractures
āš« A fracture (broken bone) may not always be obvious
as most breaks do not result in compound fractures
(bone protruding through the skin). It is important
not to misdiagnose a break and mistake it for a
bruise or sprain. Typical symptoms of a fracture are:
āš« Immediate and excessive swelling
āš« Injured area appears deformed
āš« The farthest point of the injured limb turns blue or is
numb to the touch
āš« Even slight movement or contact to the injured area
causes excessive pain
28
Fractures
There are several types of
bone fracture, including:
āš« Oblique - a fracture which
goes at an angle to the axis
āš« Comminuted - a fracture of
many relatively small
fragments
āš« Spiral - a fracture which
runs around the axis of the
bone
āš« Compound - a fracture
(also called open) which
breaks the skin
29
Fractures
āš« Dial 9-1-1 immediately and immobilize the broken bone
with a splint. A functional splint can be made of almost
any material (wood, plastic, etc.) as long as it is rigid and
is longer than the broken bone. To apply the splint simply
lay it along the broken bone and wrap it against the limb
with gauze or a length of cloth, starting at a point farthest
from the body. Do not wrap it too tight as this may cut off
blood flow.
āš« If the break is in the forearm, loosely wrap a magazine or
a thick newspaper around the break and use a sling
fashioned from gauze or a strip of cloth to keep the elbow
immobilized.
āš« A break in the lower part of the leg requires two splints,
one on each side of the leg (or at least the shin). If
suitable material is not available, you can use the victim's
healthy leg as a makeshift splint.
30
Fractures
As much as possible, keep the victim from moving
and until an ambulance arrives, remember ICE:
āš« "I" is for ice - if possible apply an ice pack or ice
cubes to the injured area. This will keep down the
swelling and reduce pain.
āš« "C" is for compression - if the wound is bleeding,
apply direct pressure with a clean cloth to reduce
blood flow.
āš« "E" is for elevation - try to keep the injured area as
high above heart level as possible. This will reduce
blood flow to the injury and minimize swelling.
31
Fractures
Splint is a medical device for
the immobilization of limbs or
of the spine. It can be used:
āš« By the Emergency Medical
Services or by volunteer first
responders, to immobilize a
fractured limb before the
transportation; it is then a
temporary immobilization;
32
Fractures
In case of a medical emergency, one should make a splint:
āš« Treat the area of all wounds before creating the splint.
āš« The injured limb should be left in the position that it was
found in.
āš« Something rigid will be best for support such as sticks,
boards, or rolled up newspaper. If these are not available, try
rolled up clothing. The limb can also be taped to an
uninjured body part to prevent it from moving.
āš« Extend the splint above and below the injured area to
prevent it from moving. Splinting beyond the closest two
joints is ideal.
āš« Secure the splint with ties and be sure not to knot the injured
area. Avoid tying too tight as it may cut off circulation.
āš« Check the area often for swelling or paleness
āš« Seek medical attention quickly
33
Head Injury
Although most minor head injuries caused by a fall or a
strike to the head may result in a bruise or a bump and
are not dangerous, it is extremely important to pay close
attention to the following symptoms:
āš« Excessive bleeding from an open wound
āš« Loss of consciousness
āš« Interruption of breathing
āš« Prolonged disorientation or apparent memory loss
If you detect any of the above, the victim may have
sustained serious head trauma and will require
professional medical attention. If that's the case, dial 9-1-
1 immediately. Until the ambulance arrives:
34
Head Injury
āš« If possible, place the victim in a dim,
quiet area.
āš« Lay the victim down with his head
and shoulders slightly elevated.
āš« If the wound is bleeding, dress it
with gauze or clean cloth.
āš« Do not leave the victim unattended.
āš« If the victim loses consciousness,
you may need to perform CPR.
If the injury does not appear
serious or extend beyond minor
bruising, it should be treated
accordingly.
35
Nose Bleed
āš« A human nose is rich with small
fragile blood vessels which are
susceptible to damage. A
nosebleed may be caused by a
fall, a strike to the nose, or
even from breathing
excessively dry air.
āš« If the nosebleed is not a
symptom of a more serious
injury, it is rarely dangerous
and can usually be stopped by
applying continuous pressure
36
Nose Bleed
āš« Do NOT tilt the victim's head backward.
āš« Have the victim sit or stand upright to slow down the
flow of blood.
āš« Loosen any tight clothing around the victim's neck.
āš« If possible, have the victim spit out excess saliva -
swallowing may disturb the clot and cause nausea.
āš« Pinch the nostrils shut and press the tip of the nose
against the bones of the face.
āš« Maintain pressure for 5 to 10 minutes.
āš« Once the bleeding has stopped, the victim should avoid
blowing his nose or otherwise straining himself for at
least an hour.
If the victim's nose continues to bleed or if the blood
flow appears to be excessive, or if the victim feels weak
or faint, the damage may be more serious than it
appears. You should call 9-1-1 or take him to the
nearest emergency room as soon as possible.
37
Bite Wound
āš« If the victim was bitten by an
animal or insects such as dog,
cat, snake, scorpion, poisonous
spider or a rat, an immediate shot
may be necessary to prevent the
possibility of a rabies infection or
venom.
āš« Contrary to common belief, a
human bite can sometimes be
more dangerous than that of an
animal because human saliva
contains many more types of
bacteria which may cause
infection.
38
Bite Wound
First Aid treatment should be;
āš« Use anti-bacterial soap and water to
thoroughly clean the bite wound.
āš« Apply antibiotic ointment such as
Neosporin to prevent infection.
āš« If the injury resulted in broken skin,
dress it with a sterile bandage and
replace the dressing frequently.
āš« If the bite is deep, the victim may need
to be treated for a puncture wound.
āš« Bring to Physician
39
Basic Life Support (BLS)
Basic Life Support (BLS) is a specific level of pre-hospital
medical care provided by trained responders, including
emergency medical technicians, in the absence of advanced
medical care.
āš« Basic Life Support consists of a number of life-saving techniques
focused on the "ABC"s of pre-hospital emergency care:
āš« Airway: the protection and maintenance of patient airway
including the use of airway adjuncts such as an oral or nasal
airway
āš« Breathing: the actual flow of air through respiration, natural or
artificial respiration, often assisted by emergency oxygen
āš« Circulation: the movement of blood through the beating of the
heart or the emergency measure of CPR
BLS may also include considerations of patient transport such as
the protection of the cervical spine and avoiding additional
injuries through splinting and immobilization.
40
Basic Life Support (BLS)
āš« BLS generally does not include the use of drugs or
invasive skills, and can be contrasted with the provision of
Advanced cardiac life support (ACLS). Most laypersons
can master BLS skill after attending a short course.
Firefighters and Safety Officers are often required to be
BLS certified. BLS is also immensely useful for almost
everybody who is in the right age and can do it properly.
āš« CPR provided in the field buys time for higher medical
responders to arrive and provide ACLS. For this reason it
is essential that any person starting CPR also obtains
ACLS support by calling for help via radio using agency
policies and procedures and/or using an appropriate
emergency telephone number.
41
What Not to Do?
Before we learn what to do in an emergency, we
must first emphasize what not to do:
āš« DO NOT leave the victim alone.
āš« DO NOT try make the victim drink water.
āš« DO NOT throw water on the victim's face.
āš« DO NOT prompt the victim into a sitting position.
āš« DO NOT try to revive the victim by slapping his face.
Always remember to exercise solid common
sense!
When faced with an emergency situation we may act
impulsively and place ourselves in harm's way.
Although time should not be wasted, only approach
the victim after determining that the scene is safe:
always check for any potential hazards before
attempting to perform CPR.
42
Artificial Respiration (AR)
āš« Artificial respiration is the act of simulating respiration,
which provides for the overall exchange of gases in the
body by pulmonary ventilation, external respiration and
internal respiration
āš« This means providing air for a person who is not
breathing or is not making sufficient respiratory effort on
their own (although it must be used on a patient with a
beating heart or as part of cardiopulmonary resuscitation
in order to achieve the internal respiration).
āš« Pulmonary ventilation (and hence external respiration) is
achieved through manual insufflations of the lungs either
by the rescuer blowing in to the patient's lungs
āš« It is also commonly called as rescue breathing or
ventilation
43
Artificial Respiration (AR)
āš« Artificial respiration is a part of most protocols for
performing cardiopulmonary resuscitation (CPR) making
it an essential skill for first aid. In some situations, artificial
respiration is also performed separately, for instance in
near-drowning and opiate overdoses. The performance of
artificial respiration in its own is now limited in most
protocols to health professionals, whereas lay first aiders
are advised to undertake full CPR in any case where the
patient is not breathing sufficiently
āš« Insufflation, also known as 'rescue breaths' or
'ventilations', is the act of mechanically forcing air into a
patient's respiratory system. This can be achieved via a
number of methods, which will depend on the situation
and equipment available. All methods require good
airway management to perform, which ensures that the
method is effective.
44
Artificial Respiration (AR)
These methods include:
āš« Mouth to mouth - This involves
the rescuer making a seal
between their mouth and the
patient's mouth and 'blowing', in
order to pass air in to the
patient's body
āš« Mouth to nose - In some
instances, the rescuer may need
or wish to form a seal with the
patient's nose. Typical reasons
for this include maxillofacial
injuries, performing the procedure
in water or the remains of vomit
in the mouth
45
Artificial Respiration (AR)
āš« Mouth to mask ā€“ Most
organizations recommend the use
of some sort of barrier between
rescuer and patient to reduce cross
infection risk. One popular type is
the 'pocket mask'.
āš« If you feel a pulse (i.e. the victim's
heart is beating) but the victim is still
not breathing, rescue breaths should
be administered, one rescue breath
every five seconds (remember to pinch
the nose to prevent air from escaping).
After the first rescue breath, count five
seconds and if the victim does not take
a breath on his own, give another
rescue breath.
46
Artificial Respiration (AR)
Efficiency of mouth to patient insufflation
āš« Normal atmospheric air contains approximately 21%
oxygen when created in. After gaseous exchange has
taken place in the lungs, with waste products (notably
carbon dioxide) moved from the bloodstream to the lungs,
the air being exhaled by humans normally contains
around 17% oxygen.
āš« This means that the human body utilizes only around
19% of the oxygen inhaled, leaving over 80% of the
oxygen available in the exhalatory breath.
āš« This means that there is more than enough residual
oxygen to be used in the lungs of the patient, which then
crosses the cell membrane to form oxyhemoglobin.
47
Cardio Pulmonary Resuscitation (CPR)
Can you save a life? In an
emergency, when every second
is critical, do you know what to
do?
āš« According to recent statistics
sudden cardiac arrest is rapidly
becoming the leading cause of
death in world. Once the heart
ceases to function, a healthy human
brain may survive without oxygen
for up to 4 minutes without suffering
any permanent damage.
Unfortunately, a typical ERT
response may take 6, 8 or even 10
minutes.
48
Cardio Pulmonary Resuscitation (CPR)
CPR is a lifesaving procedure that is performed when
someone's breathing or heartbeat has stopped, as in cases
of electric shock, drowning, or heart attack. CPR is a
combination of:
āš« Rescue breathing, which provides oxygen to a person's
lungs
āš« Chest compressions, which keep the person's blood
circulating.
CPR = ECC + AR
ECC ā€“ External Chest Compression
AR ā€“ Artificial Respiration / rescue breathing / ventilation
Permanent brain damage or death can occur within minutes
if a person's blood flow stops. Therefore, you must continue
these procedures until the person's heartbeat and breathing
return, or trained medical help arrives.
49
Cardio Pulmonary Resuscitation (CPR)
It is during those critical minutes
that CPR can provide oxygenated
blood to the victim's brain and the
heart, dramatically increasing his
chance of survival. And if properly
instructed, almost anyone can
learn and perform CPR.
CPR TIME LINE
0-4 minutes - brain damage unlikely
4-6 minutes - brain damage possible
6-10 minutes - brain damage probable
over 10 minutes - probable brain death
50
How CPR Works
āš« The air we breathe in travels to our lungs
where oxygen is picked up by our blood
and then pumped by the heart to our
tissue and organs. When a person
experiences cardiac arrest - whether due
to heart failure in adults and the elderly
or an injury such as near drowning,
electrocution or severe trauma in a child -
the heart goes from a normal beat to an
arrhythmic pattern called ventricular
fibrillation, and eventually ceases to beat
altogether.
āš« This prevents oxygen from circulating
throughout the body, rapidly killing cells
and tissue. In essence, Cardio (heart)
Pulmonary (lung) Resuscitation (revive,
revitalize) serves as an artificial
heartbeat and an artificial respirator.
51
How CPR Works
āš« CPR may not save the victim even when performed
properly, but if started within 4 minutes of cardiac arrest
and defibrillation is provided within 10 minutes, a person
has a 40% chance of survival.
āš«
CPR is a simple but effective procedure that allows
almost anyone to sustain life in the first critical minutes of
cardiac arrest. CPR provides oxygenated blood to the
brain and the heart long enough to keep vital organs alive
until emergency equipment arrives.
To make learning CPR easier, a system was devised that makes
remembering it as simple as A-B-C:
Airway
Breathing
Circulation
52
Calling for Help (Dial 9-1-1)
āš« It is critical to remember that
dialing 911 may be the most
important step you can take to
save a life.
If someone besides you is
present, they should dial 911
immediately. If youā€™re alone with
the victim, try to call for help
prior to starting CPR on an
adult and after a minute on a
child.
Provide operator
with:
1. Your location
2. Your phone
number
3. Type of
emergency
4. Victim's
condition
53
Adult CPR
āš« American Heart Association's
guidelines dictate that Adult CPR is
performed on any person over the
age of 8. The procedure outlined in
the following lessons is similar to
Children CPR and Infant CPR,
although some critical differences
apply.
āš« Before you start any rescue efforts,
you must remember to check the
victim for responsiveness.
āš« If you suspect that the victim has sustained spinal or neck injury,
do not move or shake him. Otherwise, shake the victim gently and
shout "Are you okay?" to see if there is any response. If the victim
is someone you know, call out his name as you shake him.
āš« If there is no response, immediately dial 9-1-1 and check the
airway
54
Adult CPR
AIRWAY
āš« "A" is for AIRWAY. If the victim
is unconscious and is
unresponsive, you need to
make sure that his airway is
clear of any obstructions.
āš« The breaths may be faint and
shallow - look, listen and feel
for any signs of breathing.
āš« If you determine that the victim
is not breathing, then something
may be blocking his air passage.
The tongue is the most
common airway obstruction in
an unconscious person.
55
Adult CPR
āš« With the victim lying flat on his
back, place your hand on his
forehead and your other hand
under the tip of the chin
āš« Gently tilt the victim's head
backward. In this position the
weight of the tongue will force it
to shift away from the back of
the throat, opening the airway
āš« If the person is still not
breathing on his own after the
airway has been cleared, you
will have to assist him
breathing
56
Adult CPR
BREATHING
āš« "B" is for BREATHING. With the
victim's airway clear of any
obstructions, gently support his chin
so as to keep it lifted up and the head
tilted back. Pinch his nose with your
fingertips to prevent air from escaping
once you begin to ventilate and place
your mouth over the victim's, creating
a tight seal.
āš« As you assist the person in breathing,
keep an eye on his chest. Try not to
over-inflate the victim's lungs as this
may force air into the stomach,
causing him to vomit. If this happens,
turn the person's head to the side and
sweep any obstructions out of the
mouth before proceeding.
57
Adult CPR
Give two full breaths.
āš« Between each breath allow
the victim's lungs to relax -
place your ear near his
mouth and listen for air to
escape and watch the
chest fall as the victim
exhales
āš« If the victim remains
unresponsive (no breathing,
coughing or moving), check
his circulation
58
Adult CPR
CIRCULATION
āš« "C" is for CIRCULATION. In
order to determine if the
victim's heart is beating, place
two fingertips on his carotid
artery, located in the
depression between the
windpipe and the neck muscles,
and apply slight pressure for
several seconds.
āš« If there is no pulse then the
victim's heart is not beating,
and you will have to perform
chest compressions
59
Adult CPR
COMPRESSIONS
āš« When performing chest
compressions, proper hand
placement is very important. To
locate the correct hand position
place two fingers at the sternum
(the spot where the lower ribs
meet) then put the heel of your
other hand next to your fingers
āš« Place one hand on top of the other
and interlace the fingers . Lock
your elbows and using your body's
weight, compress the victimā€™s
chest. The depth of compressions
should be approximately 1Ā½ to 2
inches - remember: 2 hands, 2
inches
60
Adult CPR
āš« If you feel or hear slight cracking
sound, you may be pressing too hard.
Do not become alarmed and do not
stop your rescue efforts! Damaged
cartilage or cracked ribs are far less
serious than a lost life. Simply apply
less pressure as you continue
compressions.
āš« Count aloud as you compress 15
times and giving the victim 2 breaths.
This process should be performed
four times in the span of 1 minute- 15
compressions and 2 breaths - after
which remember to check the victim's
carotid artery for pulse and any signs
of consciousness.
61
Adult CPR
āš« If there is no pulse, continue performing 15
compressions/2 breaths, checking for pulse after
every 4 cycles in the span of 1 minute until help
arrives.
āš« If you feel a pulse (i.e. the victim's heart is beating)
but the victim is still not breathing, rescue breaths
should be administered, one rescue breath every
five seconds (remember to pinch the nose to prevent
air from escaping). After the first rescue breath,
count five seconds and if the victim does not take a
breath on his own, give another rescue breath.
62
Adult CPR
Two Man Rescue
āš« Just like the procedure in one
man rescue, ABC shall be apply
before proceeding to CPR
āš« The only difference is the
manner of ratio of ECC and AR
to be given
āš« For One man rescue 15:2 , 4
cycles in 1 minute
āš« For Two man rescue 5:1 , 12
cycles in 1 minute
63
Adult CPR
When to stop CPR /AR?
āš« When the victim is already
conscious / breathing / with pulse
āš« When the rescuer is totally
exhausted to perform a rescue
āš« When another rescuer takes his
place after completing 4 cycles
āš« When the services of the Medical
professional takes over
āš« When the Medical professionals
pronounced that the victim is dead.
64
Adult CPR Review
In case of an emergency you may be the victim's only chance
of survival. Until an ambulance arrives and professional
assistance is available, you can increase that chance by 40%
simply by remembering and effectively administering Cardio
Pulmonary Resuscitation.
1. Check for responsiveness by shouting and shaking the
victim. Do not shake or move the victim if you suspect he may
have sustained spinal injury.
2. Call for HELP!!!!! (9-1-1).
3. Remember your A-B-C:
Airway: tilt the head back and lift the neck to clear the airway.
Breathing: pinch the victim's nose and give 2 breaths, watching
for the chest to rise with each breath.
Circulation: if there is no pulse, perform 15 chest compressions
2 Breaths 4 cycles in 1 minute - 2 hands, 2 inches.
āš« 4. Check for pulse and if necessary perform the cycle again.
65
Choking
Choking is usually caused by a
piece of foreign matter such as
food becoming lodged in a
person's windpipe. Because a
choking victim is fully aware that
he cannot breathe normally, a
sense of panic may overcome
them, making assessing the
situation and rescue efforts difficult.
It is important to try and keep the
victim calm in order to determine
whether your assistance is truly
necessary or if the victim's own
coughing reflex is sufficient.
66
Choking
Start by asking the person if he is
choking. This simple step can be
deceptively effective - the victim may
be coughing violently or even gasping
for air, but if he is able to answer then
he is probably not choking. A choking
victim will not be able to speak since
oxygen cannot reach his lungs. But if
after asking the person if he's choking
all he can do is gesture or point to his
throat and you notice his face starting
to turn blue, then he is most likely
choking and you will need to perform
the Heimlich Maneuver immediately.
67
Choking
āš« Start by finding the proper stance -
behind the victim with one of your
feet planted firmly between the
victim's feet.
āš« Place one fist just above the
personā€™s navel with your thumb
against the abdomen.
āš« Place your other hand directly on
top of the first.
āš« Squeeze the victim's abdomen in
quick upward thrusts as many times
as it is necessary to dislodge the
object in his windpipe.
68
Choking
āš« If he was choked very badly the chance that he will collapse is
eminent since he is running out of air, you must properly positioned
your self and hold him to prevent him directly from falling
āš« Lie him down properly. Check for foreign object in his mouth by
sweeping using one finger.
āš« Give full breath to check if his airway is still blocked. If air fast
through his airway is clear then check for ABC
āš« If still block, Kneel beside the victim and apply pressure on the
abdomen put your 2 palms just above his navel and make a quick
upward thrusts ; this will pushed out the air inside his stomach to
expelled the foreign object in his mouth
āš« You need at least 8-10 stroke and then Check for foreign object in
his mouth by sweeping using one finger
āš« Repeat the above procedures until object is expelled and air fast
through.
69
Choking
70
Choking
Obstructedairway
Air fast through
Check ABC
71
Summary
First aid includes any one-time treatment and follow-
up for observation of minor injuries, including cuts,
abrasions, bruises, first-degree burns, sprains, and
splinters. Injuries or illnesses requiring only first aid
are commonplace. One or more workers should be
properly trained to administer basic first aid,
including CPR. Workplaces should have a well-
stocked first-aid kit and at least one or more
employee assigned the responsibility for
administering or coordinating first-aid treatments.
72
Summary
āš« When an injury does take place, whether it is to
ourselves or a fellow employee, knowing what
to do and being able to react quickly can limit
the severity of the injury... or even prevent a
death.
āš« First Aid is a best tool to help your co-workers,
your family or maybe your own

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First Aid Training

  • 2. 2 Course Basis āš« In construction industries not a day goes by without some type of injury occurring āš« The direct cost and indirect cost of injuries is getting higher āš« Peoples basics instinct is to help injured people, but using improper help procedures may lead to a more disastrous situation rather than saving lives āš« Prompt, properly administered first aid care can mean the difference between life and death, rapid versus prolonged recovery, temporary versus permanent disability.
  • 3. 3 āš« Prolonged life āš« Alleviate suffering āš« First aiders responsibilities ends when the services of Medical professional begins āš« First aiders are not intended to compete with Medical professionals Objectives of the First Aid
  • 4. 4 First Aid - Basic We all take certain measures to prevent accidents but despite our best efforts emergencies arise. You or people nearby trip and fall... unintentionally come in contact with exposed wiring... step on a rusty nail... or literarily bite off more than you can chew... And when an accident happens, time is not on your side. Besides a well-stocked and functional First Aid Kit, preparation and skills are the most important tools you can have at your disposal.
  • 5. 5 First Aid Kit āš« Sterile adhesive bandages in assorted sizes āš« Sterile gauze pads in assorted sizes āš« Hypoallergenic adhesive tape āš« Scissors āš« Tweezers āš« Needle āš« Ace bandage āš« Moistened towelettes āš« Antiseptic āš« Splints in assorted sizes āš« Petroleum jelly āš« Assorted sizes of safety pins āš« Anti-bacterial soap āš« Antibiotic ointment āš« Latex gloves and face mask āš« Sunscreen āš« Aspirin and/or ibuprofen āš« Ice Pack āš« Thermometer āš« Tongue blades
  • 6. 6 Cuts and Scrapes Open Wound apply 5 Cā€™s āš« Clean the wound āš« Control Bleeding āž¢ By applying pressure āž¢ Elevating the wounded part at least above the heart āž¢ Put pressure on Limbs pressure points āš« Cover the wounds with sterilize or clean cloths āš« Care for shock āš« Call Physician
  • 7. 7 Cuts and Scrapes Clean the wound with mild anti- bacterial soap and water. You can use sterilized tweezers to remove any debris that remains embedded in the wound after rinsing. This will reduce the risk of an infection and possible complications. If the debris is abundant or can't be removed for some other reason, a trip to the emergency room will be necessary.
  • 8. 8 Cuts and Scrapes āš« Control the bleeding. Water may induce bleeding by thinning the blood. If while rinsing the wound you notice increased blood flow, use gauze or a clean cloth to apply gentle, continuous pressure until the blood clots. āš« Elevate the wounded part of the body if possible above the heart level
  • 9. 9 Cuts and Scrapes Although hydrogen peroxide is commonly used as a disinfectant for minor cuts and scrapes, it is actually not very effective and may even delay the healing process by irritating a person's living cells. You can use hydrogen peroxide but apply it around the open wound, not directly to it. An antibiotic ointment such as Neosporin is a better alternative - it will keep the wound from getting infected and speed up the healing process.
  • 10. 10 Cuts and Scrapes Cover the wound with a bandage or sterile gauze to keep dirt and bacteria out. Change the dressing frequently and rinse the wound as often as necessary to keep it free of dirt.
  • 11. 11 Cuts and Scrapes āš« Care for shock. Some victim may lead to shock due to blood loss. Gently lay him down with his head slightly lower than his chest and his feet elevated. āš« Call the Physician. If the wound is very deep or the bleeding is profuse, it may require stitches in order to heal properly.
  • 12. 12 Puncture Wounds āš« Unlike a cut, a puncture wound does not typically result in profuse or excessive bleeding and although painful, may look harmless as the skin around the wound simply closes. But puncture wounds carry a risk of infection and if left unattended can result in serious complications. āš« Injuries sustained by stepping on a nail that punctures through a shoe are especially prone to infection. If the injury is caused by stepping on a nail or a shard of glass that's been exposed to the elements, it is a good idea to consult a physician who may recommend a tetanus shot or booster.
  • 13. 13 Puncture Wounds āš« A bite from a household pet or another person that results in a puncture wound should be considered and treated as serious injury. If the bleeding is heavy or the item that caused the wound appears unsanitary, thoroughly clean the injured area with mild anti-bacterial soap and water and seek professional medical assistance as soon as possible. āš« If the injury is minor, clean it with soap and water and apply an antibiotic ointment such as Neosporin to prevent infection. Dress the wound with sterile bandage and replace the dressing frequently. It is prudent to keep a close eye on the wound for several days to prevent an onset of an infection from any debris that may've lodged itself deep in the wound. If you notice persistent redness or puffiness or if the wound starts to ooze pus, have the victim consult a doctor right away.
  • 14. 14 Shock Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. This can damage multiple organs. Shock requires IMMEDIATE medical treatment and can get worse very rapidly. āš« Major classes of shock include: āž¢ Cardiogenic shock (associated with heart problems) āž¢ Hypovolemic shock (caused by inadequate blood volume / Blood loss /Severe bleeding) āž¢ Anaphylactic shock (caused by allergic reaction) āž¢ Septic shock (associated with infections) āž¢ Neurogenic shock (caused by damage to the nervous system)
  • 15. 15 Shock āš« Shock can be caused by any condition that reduces blood flow, including: āš« Heart problems (such as heart attack or heart failure) āš« Low blood volume (as with heavy bleeding or dehydration) āš« Changes in blood vessels (as with infection or severe allergic reactions) āš« Shock is often associated with heavy external or internal bleeding from a serious injury. Spinal injuries can also cause shock
  • 16. 16 Shock A person in shock has extremely low blood pressure. Depending on the specific cause and type of shock, symptoms will include one or more of the following: āš« Anxiety or agitation āš« Confusion āš« Pale, cool, clammy skin āš« Low or no urine output āš« Bluish lips and fingernails āš« Dizziness, light-headedness, or faintness āš« Profuse sweating, moist skin āš« Rapid but weak pulse āš« Shallow breathing āš« Chest pain āš« Unconsciousness
  • 17. 17 Shock First Aid for Shock āš« Call 911 for immediate medical help. āš« Check the person's airway, breathing, and circulation. If necessary, begin rescue breathing and CPR. āš« Even if the person is able to breathe on his or her own, continue to check rate of breathing at least every 5 minutes until help arrives. āš« If the person is conscious and DOES NOT have an injury to the head, leg, neck, or spine, place the person in the shock position. Lay the person on the back and elevate the legs about 12 inches. DO NOT elevate the head. If raising the legs will cause pain or potential harm, leave the person lying flat. āš« Give appropriate first aid for any wounds, injuries, or illnesses. āš« Keep the person warm and comfortable. Loosen tight clothing.
  • 18. 18 Adjust the top leg so that both the hip and knee are bent at right angles. Gently tilt the head back to keep the airway open. Keep the person warm until medical help is obtained. Shock RECOVERY POSITION To put the victim in the recovery position grab the victim's leg and shoulder and roll him towards you Continue to roll the victim until he is on his side.
  • 19. 19 Shock DO NOT āš« DO NOT give the person anything by mouth, including anything to eat or drink. āš« DO NOT move the person with a known or suspected spinal injury. āš« DO NOT wait for milder shock symptoms to worsen before calling for emergency medical help. IF THE PERSON VOMITS OR DROOLS āš« Turn the head to one side so he or she will not choke. Do this as long as there is NO suspicion of spinal injury. āš« If a spinal injury is suspected, "log roll" him instead. Keep the person's head, neck and back in line and roll him or her as a unit.
  • 20. 20 Burns āš« A burn victim will require different type of care depending on the type and extent of his injury. Burns vary greatly from a common, fairly harmless sunburn to a potentially life-threatening 3rd degree burn caused by open flames or electrocution. Here's how to distinguish the three different types of burn injuries and how to care for each:
  • 21. 21 Burns āš« 1st degree burns are usually accompanied by redness and some swelling of the skin. Treat a minor burn by first cooling the affected area. If possible, keep the injury under cool running water for at least 10 minutes. If running water is not available place the burn in a container of cold water such as a bucket, tub or even a deep dish. Using a cool, wet compress made of clean cloth will also work if nothing else is available. Keeping the burn cool will reduce pain and minimize the swelling. If the injury is on the part of a body where jewelry or snug clothing is present, carefully remove them before it begins to swell. Apply a moisturizing lotion or Aloe Vera extract and dress the burnt area with loosely wrapped sterile gauze.
  • 22. 22 Burns āš« 2nd degree burns will result in deeper, more intense redness of the skin as well as swelling and blistering. This type of burn should be treated just as a 1st degree burn but because the damage to the skin is more extensive, extra care should be taken to avoid infection and excessive scarring. Replace the dressing daily and keep the wound clean. If a blister breaks use mild soap and warm water to rinse the area. Apply antibiotic cream such as Neosporin to prevent infection before redressing in sterile gauze.
  • 23. 23 Burns āš« 3rd degree burns mayappear and feel deceptively harmless as the victim maynot feel much pain due to complete destruction of all layers of skin and tissue as well as nerve endings. Thedamaged area may appear charred or ash-color and will instantlystart to blister or "peel". If the victim's clothing is on fire, douse him with non-flammable liquid. āš« Dial 9-1-1. Do not remove burnt clothing from the victim as this will expose open wounds to the elements and potential infection. If possible, cover the victim's injuries with wet sterile cloth to reduce the pain and swelling. If you notice that the victim is going into shock and loses consciousness, you will need to perform CPR.
  • 24. 24 Electrocution āš« Electricity travels through conductors - any material which allows electrical flow - as it tries to reach the ground. Because people make excellent conductors, minor electrocution is a common household hazard. Fortunately it is usually more surprising than dangerous and does not require medical attention. However, some basic precautions should be taken to insure that the shock does not interfere with the body's normal electrical impulses including the functions of the brain and the heart. Prolonged exposure to a direct source of electricity can also cause severe burns to the skin and the tissue.
  • 25. 25 Electrocution āš« In the event of electrocution do NOT rush to assist the victim until you are certain that he is no longer in contact with electricity. Otherwise the current will pass through the victim directly to you. āš« If at all possible, turn off the source of electricity (i.e. light switch, circuit breaker, etc.) If this is not an option, use non-conductive material such as plastic or dry wood to separate the source of electricity from the victim. āš« If the injuries appear serious or extensive, dial 9-1-1.
  • 26. 26 Electrocution āš« Check the victim's vitals signs such as the depth of his breathing and regularity of his heart beat. If either one is effected by exposure to electricity or if the victim is unconscious, begin to perform CPR. āš« Treat any areas of the victim's body that may have sustained burns. āš« If the victim is responsive and does not appear seriously injured but looks pale or faint, he may be at risk of going into shock. Gently lay him down with his head slightly lower than his chest and his feet elevated.
  • 27. 27 Fractures āš« A fracture (broken bone) may not always be obvious as most breaks do not result in compound fractures (bone protruding through the skin). It is important not to misdiagnose a break and mistake it for a bruise or sprain. Typical symptoms of a fracture are: āš« Immediate and excessive swelling āš« Injured area appears deformed āš« The farthest point of the injured limb turns blue or is numb to the touch āš« Even slight movement or contact to the injured area causes excessive pain
  • 28. 28 Fractures There are several types of bone fracture, including: āš« Oblique - a fracture which goes at an angle to the axis āš« Comminuted - a fracture of many relatively small fragments āš« Spiral - a fracture which runs around the axis of the bone āš« Compound - a fracture (also called open) which breaks the skin
  • 29. 29 Fractures āš« Dial 9-1-1 immediately and immobilize the broken bone with a splint. A functional splint can be made of almost any material (wood, plastic, etc.) as long as it is rigid and is longer than the broken bone. To apply the splint simply lay it along the broken bone and wrap it against the limb with gauze or a length of cloth, starting at a point farthest from the body. Do not wrap it too tight as this may cut off blood flow. āš« If the break is in the forearm, loosely wrap a magazine or a thick newspaper around the break and use a sling fashioned from gauze or a strip of cloth to keep the elbow immobilized. āš« A break in the lower part of the leg requires two splints, one on each side of the leg (or at least the shin). If suitable material is not available, you can use the victim's healthy leg as a makeshift splint.
  • 30. 30 Fractures As much as possible, keep the victim from moving and until an ambulance arrives, remember ICE: āš« "I" is for ice - if possible apply an ice pack or ice cubes to the injured area. This will keep down the swelling and reduce pain. āš« "C" is for compression - if the wound is bleeding, apply direct pressure with a clean cloth to reduce blood flow. āš« "E" is for elevation - try to keep the injured area as high above heart level as possible. This will reduce blood flow to the injury and minimize swelling.
  • 31. 31 Fractures Splint is a medical device for the immobilization of limbs or of the spine. It can be used: āš« By the Emergency Medical Services or by volunteer first responders, to immobilize a fractured limb before the transportation; it is then a temporary immobilization;
  • 32. 32 Fractures In case of a medical emergency, one should make a splint: āš« Treat the area of all wounds before creating the splint. āš« The injured limb should be left in the position that it was found in. āš« Something rigid will be best for support such as sticks, boards, or rolled up newspaper. If these are not available, try rolled up clothing. The limb can also be taped to an uninjured body part to prevent it from moving. āš« Extend the splint above and below the injured area to prevent it from moving. Splinting beyond the closest two joints is ideal. āš« Secure the splint with ties and be sure not to knot the injured area. Avoid tying too tight as it may cut off circulation. āš« Check the area often for swelling or paleness āš« Seek medical attention quickly
  • 33. 33 Head Injury Although most minor head injuries caused by a fall or a strike to the head may result in a bruise or a bump and are not dangerous, it is extremely important to pay close attention to the following symptoms: āš« Excessive bleeding from an open wound āš« Loss of consciousness āš« Interruption of breathing āš« Prolonged disorientation or apparent memory loss If you detect any of the above, the victim may have sustained serious head trauma and will require professional medical attention. If that's the case, dial 9-1- 1 immediately. Until the ambulance arrives:
  • 34. 34 Head Injury āš« If possible, place the victim in a dim, quiet area. āš« Lay the victim down with his head and shoulders slightly elevated. āš« If the wound is bleeding, dress it with gauze or clean cloth. āš« Do not leave the victim unattended. āš« If the victim loses consciousness, you may need to perform CPR. If the injury does not appear serious or extend beyond minor bruising, it should be treated accordingly.
  • 35. 35 Nose Bleed āš« A human nose is rich with small fragile blood vessels which are susceptible to damage. A nosebleed may be caused by a fall, a strike to the nose, or even from breathing excessively dry air. āš« If the nosebleed is not a symptom of a more serious injury, it is rarely dangerous and can usually be stopped by applying continuous pressure
  • 36. 36 Nose Bleed āš« Do NOT tilt the victim's head backward. āš« Have the victim sit or stand upright to slow down the flow of blood. āš« Loosen any tight clothing around the victim's neck. āš« If possible, have the victim spit out excess saliva - swallowing may disturb the clot and cause nausea. āš« Pinch the nostrils shut and press the tip of the nose against the bones of the face. āš« Maintain pressure for 5 to 10 minutes. āš« Once the bleeding has stopped, the victim should avoid blowing his nose or otherwise straining himself for at least an hour. If the victim's nose continues to bleed or if the blood flow appears to be excessive, or if the victim feels weak or faint, the damage may be more serious than it appears. You should call 9-1-1 or take him to the nearest emergency room as soon as possible.
  • 37. 37 Bite Wound āš« If the victim was bitten by an animal or insects such as dog, cat, snake, scorpion, poisonous spider or a rat, an immediate shot may be necessary to prevent the possibility of a rabies infection or venom. āš« Contrary to common belief, a human bite can sometimes be more dangerous than that of an animal because human saliva contains many more types of bacteria which may cause infection.
  • 38. 38 Bite Wound First Aid treatment should be; āš« Use anti-bacterial soap and water to thoroughly clean the bite wound. āš« Apply antibiotic ointment such as Neosporin to prevent infection. āš« If the injury resulted in broken skin, dress it with a sterile bandage and replace the dressing frequently. āš« If the bite is deep, the victim may need to be treated for a puncture wound. āš« Bring to Physician
  • 39. 39 Basic Life Support (BLS) Basic Life Support (BLS) is a specific level of pre-hospital medical care provided by trained responders, including emergency medical technicians, in the absence of advanced medical care. āš« Basic Life Support consists of a number of life-saving techniques focused on the "ABC"s of pre-hospital emergency care: āš« Airway: the protection and maintenance of patient airway including the use of airway adjuncts such as an oral or nasal airway āš« Breathing: the actual flow of air through respiration, natural or artificial respiration, often assisted by emergency oxygen āš« Circulation: the movement of blood through the beating of the heart or the emergency measure of CPR BLS may also include considerations of patient transport such as the protection of the cervical spine and avoiding additional injuries through splinting and immobilization.
  • 40. 40 Basic Life Support (BLS) āš« BLS generally does not include the use of drugs or invasive skills, and can be contrasted with the provision of Advanced cardiac life support (ACLS). Most laypersons can master BLS skill after attending a short course. Firefighters and Safety Officers are often required to be BLS certified. BLS is also immensely useful for almost everybody who is in the right age and can do it properly. āš« CPR provided in the field buys time for higher medical responders to arrive and provide ACLS. For this reason it is essential that any person starting CPR also obtains ACLS support by calling for help via radio using agency policies and procedures and/or using an appropriate emergency telephone number.
  • 41. 41 What Not to Do? Before we learn what to do in an emergency, we must first emphasize what not to do: āš« DO NOT leave the victim alone. āš« DO NOT try make the victim drink water. āš« DO NOT throw water on the victim's face. āš« DO NOT prompt the victim into a sitting position. āš« DO NOT try to revive the victim by slapping his face. Always remember to exercise solid common sense! When faced with an emergency situation we may act impulsively and place ourselves in harm's way. Although time should not be wasted, only approach the victim after determining that the scene is safe: always check for any potential hazards before attempting to perform CPR.
  • 42. 42 Artificial Respiration (AR) āš« Artificial respiration is the act of simulating respiration, which provides for the overall exchange of gases in the body by pulmonary ventilation, external respiration and internal respiration āš« This means providing air for a person who is not breathing or is not making sufficient respiratory effort on their own (although it must be used on a patient with a beating heart or as part of cardiopulmonary resuscitation in order to achieve the internal respiration). āš« Pulmonary ventilation (and hence external respiration) is achieved through manual insufflations of the lungs either by the rescuer blowing in to the patient's lungs āš« It is also commonly called as rescue breathing or ventilation
  • 43. 43 Artificial Respiration (AR) āš« Artificial respiration is a part of most protocols for performing cardiopulmonary resuscitation (CPR) making it an essential skill for first aid. In some situations, artificial respiration is also performed separately, for instance in near-drowning and opiate overdoses. The performance of artificial respiration in its own is now limited in most protocols to health professionals, whereas lay first aiders are advised to undertake full CPR in any case where the patient is not breathing sufficiently āš« Insufflation, also known as 'rescue breaths' or 'ventilations', is the act of mechanically forcing air into a patient's respiratory system. This can be achieved via a number of methods, which will depend on the situation and equipment available. All methods require good airway management to perform, which ensures that the method is effective.
  • 44. 44 Artificial Respiration (AR) These methods include: āš« Mouth to mouth - This involves the rescuer making a seal between their mouth and the patient's mouth and 'blowing', in order to pass air in to the patient's body āš« Mouth to nose - In some instances, the rescuer may need or wish to form a seal with the patient's nose. Typical reasons for this include maxillofacial injuries, performing the procedure in water or the remains of vomit in the mouth
  • 45. 45 Artificial Respiration (AR) āš« Mouth to mask ā€“ Most organizations recommend the use of some sort of barrier between rescuer and patient to reduce cross infection risk. One popular type is the 'pocket mask'. āš« If you feel a pulse (i.e. the victim's heart is beating) but the victim is still not breathing, rescue breaths should be administered, one rescue breath every five seconds (remember to pinch the nose to prevent air from escaping). After the first rescue breath, count five seconds and if the victim does not take a breath on his own, give another rescue breath.
  • 46. 46 Artificial Respiration (AR) Efficiency of mouth to patient insufflation āš« Normal atmospheric air contains approximately 21% oxygen when created in. After gaseous exchange has taken place in the lungs, with waste products (notably carbon dioxide) moved from the bloodstream to the lungs, the air being exhaled by humans normally contains around 17% oxygen. āš« This means that the human body utilizes only around 19% of the oxygen inhaled, leaving over 80% of the oxygen available in the exhalatory breath. āš« This means that there is more than enough residual oxygen to be used in the lungs of the patient, which then crosses the cell membrane to form oxyhemoglobin.
  • 47. 47 Cardio Pulmonary Resuscitation (CPR) Can you save a life? In an emergency, when every second is critical, do you know what to do? āš« According to recent statistics sudden cardiac arrest is rapidly becoming the leading cause of death in world. Once the heart ceases to function, a healthy human brain may survive without oxygen for up to 4 minutes without suffering any permanent damage. Unfortunately, a typical ERT response may take 6, 8 or even 10 minutes.
  • 48. 48 Cardio Pulmonary Resuscitation (CPR) CPR is a lifesaving procedure that is performed when someone's breathing or heartbeat has stopped, as in cases of electric shock, drowning, or heart attack. CPR is a combination of: āš« Rescue breathing, which provides oxygen to a person's lungs āš« Chest compressions, which keep the person's blood circulating. CPR = ECC + AR ECC ā€“ External Chest Compression AR ā€“ Artificial Respiration / rescue breathing / ventilation Permanent brain damage or death can occur within minutes if a person's blood flow stops. Therefore, you must continue these procedures until the person's heartbeat and breathing return, or trained medical help arrives.
  • 49. 49 Cardio Pulmonary Resuscitation (CPR) It is during those critical minutes that CPR can provide oxygenated blood to the victim's brain and the heart, dramatically increasing his chance of survival. And if properly instructed, almost anyone can learn and perform CPR. CPR TIME LINE 0-4 minutes - brain damage unlikely 4-6 minutes - brain damage possible 6-10 minutes - brain damage probable over 10 minutes - probable brain death
  • 50. 50 How CPR Works āš« The air we breathe in travels to our lungs where oxygen is picked up by our blood and then pumped by the heart to our tissue and organs. When a person experiences cardiac arrest - whether due to heart failure in adults and the elderly or an injury such as near drowning, electrocution or severe trauma in a child - the heart goes from a normal beat to an arrhythmic pattern called ventricular fibrillation, and eventually ceases to beat altogether. āš« This prevents oxygen from circulating throughout the body, rapidly killing cells and tissue. In essence, Cardio (heart) Pulmonary (lung) Resuscitation (revive, revitalize) serves as an artificial heartbeat and an artificial respirator.
  • 51. 51 How CPR Works āš« CPR may not save the victim even when performed properly, but if started within 4 minutes of cardiac arrest and defibrillation is provided within 10 minutes, a person has a 40% chance of survival. āš« CPR is a simple but effective procedure that allows almost anyone to sustain life in the first critical minutes of cardiac arrest. CPR provides oxygenated blood to the brain and the heart long enough to keep vital organs alive until emergency equipment arrives. To make learning CPR easier, a system was devised that makes remembering it as simple as A-B-C: Airway Breathing Circulation
  • 52. 52 Calling for Help (Dial 9-1-1) āš« It is critical to remember that dialing 911 may be the most important step you can take to save a life. If someone besides you is present, they should dial 911 immediately. If youā€™re alone with the victim, try to call for help prior to starting CPR on an adult and after a minute on a child. Provide operator with: 1. Your location 2. Your phone number 3. Type of emergency 4. Victim's condition
  • 53. 53 Adult CPR āš« American Heart Association's guidelines dictate that Adult CPR is performed on any person over the age of 8. The procedure outlined in the following lessons is similar to Children CPR and Infant CPR, although some critical differences apply. āš« Before you start any rescue efforts, you must remember to check the victim for responsiveness. āš« If you suspect that the victim has sustained spinal or neck injury, do not move or shake him. Otherwise, shake the victim gently and shout "Are you okay?" to see if there is any response. If the victim is someone you know, call out his name as you shake him. āš« If there is no response, immediately dial 9-1-1 and check the airway
  • 54. 54 Adult CPR AIRWAY āš« "A" is for AIRWAY. If the victim is unconscious and is unresponsive, you need to make sure that his airway is clear of any obstructions. āš« The breaths may be faint and shallow - look, listen and feel for any signs of breathing. āš« If you determine that the victim is not breathing, then something may be blocking his air passage. The tongue is the most common airway obstruction in an unconscious person.
  • 55. 55 Adult CPR āš« With the victim lying flat on his back, place your hand on his forehead and your other hand under the tip of the chin āš« Gently tilt the victim's head backward. In this position the weight of the tongue will force it to shift away from the back of the throat, opening the airway āš« If the person is still not breathing on his own after the airway has been cleared, you will have to assist him breathing
  • 56. 56 Adult CPR BREATHING āš« "B" is for BREATHING. With the victim's airway clear of any obstructions, gently support his chin so as to keep it lifted up and the head tilted back. Pinch his nose with your fingertips to prevent air from escaping once you begin to ventilate and place your mouth over the victim's, creating a tight seal. āš« As you assist the person in breathing, keep an eye on his chest. Try not to over-inflate the victim's lungs as this may force air into the stomach, causing him to vomit. If this happens, turn the person's head to the side and sweep any obstructions out of the mouth before proceeding.
  • 57. 57 Adult CPR Give two full breaths. āš« Between each breath allow the victim's lungs to relax - place your ear near his mouth and listen for air to escape and watch the chest fall as the victim exhales āš« If the victim remains unresponsive (no breathing, coughing or moving), check his circulation
  • 58. 58 Adult CPR CIRCULATION āš« "C" is for CIRCULATION. In order to determine if the victim's heart is beating, place two fingertips on his carotid artery, located in the depression between the windpipe and the neck muscles, and apply slight pressure for several seconds. āš« If there is no pulse then the victim's heart is not beating, and you will have to perform chest compressions
  • 59. 59 Adult CPR COMPRESSIONS āš« When performing chest compressions, proper hand placement is very important. To locate the correct hand position place two fingers at the sternum (the spot where the lower ribs meet) then put the heel of your other hand next to your fingers āš« Place one hand on top of the other and interlace the fingers . Lock your elbows and using your body's weight, compress the victimā€™s chest. The depth of compressions should be approximately 1Ā½ to 2 inches - remember: 2 hands, 2 inches
  • 60. 60 Adult CPR āš« If you feel or hear slight cracking sound, you may be pressing too hard. Do not become alarmed and do not stop your rescue efforts! Damaged cartilage or cracked ribs are far less serious than a lost life. Simply apply less pressure as you continue compressions. āš« Count aloud as you compress 15 times and giving the victim 2 breaths. This process should be performed four times in the span of 1 minute- 15 compressions and 2 breaths - after which remember to check the victim's carotid artery for pulse and any signs of consciousness.
  • 61. 61 Adult CPR āš« If there is no pulse, continue performing 15 compressions/2 breaths, checking for pulse after every 4 cycles in the span of 1 minute until help arrives. āš« If you feel a pulse (i.e. the victim's heart is beating) but the victim is still not breathing, rescue breaths should be administered, one rescue breath every five seconds (remember to pinch the nose to prevent air from escaping). After the first rescue breath, count five seconds and if the victim does not take a breath on his own, give another rescue breath.
  • 62. 62 Adult CPR Two Man Rescue āš« Just like the procedure in one man rescue, ABC shall be apply before proceeding to CPR āš« The only difference is the manner of ratio of ECC and AR to be given āš« For One man rescue 15:2 , 4 cycles in 1 minute āš« For Two man rescue 5:1 , 12 cycles in 1 minute
  • 63. 63 Adult CPR When to stop CPR /AR? āš« When the victim is already conscious / breathing / with pulse āš« When the rescuer is totally exhausted to perform a rescue āš« When another rescuer takes his place after completing 4 cycles āš« When the services of the Medical professional takes over āš« When the Medical professionals pronounced that the victim is dead.
  • 64. 64 Adult CPR Review In case of an emergency you may be the victim's only chance of survival. Until an ambulance arrives and professional assistance is available, you can increase that chance by 40% simply by remembering and effectively administering Cardio Pulmonary Resuscitation. 1. Check for responsiveness by shouting and shaking the victim. Do not shake or move the victim if you suspect he may have sustained spinal injury. 2. Call for HELP!!!!! (9-1-1). 3. Remember your A-B-C: Airway: tilt the head back and lift the neck to clear the airway. Breathing: pinch the victim's nose and give 2 breaths, watching for the chest to rise with each breath. Circulation: if there is no pulse, perform 15 chest compressions 2 Breaths 4 cycles in 1 minute - 2 hands, 2 inches. āš« 4. Check for pulse and if necessary perform the cycle again.
  • 65. 65 Choking Choking is usually caused by a piece of foreign matter such as food becoming lodged in a person's windpipe. Because a choking victim is fully aware that he cannot breathe normally, a sense of panic may overcome them, making assessing the situation and rescue efforts difficult. It is important to try and keep the victim calm in order to determine whether your assistance is truly necessary or if the victim's own coughing reflex is sufficient.
  • 66. 66 Choking Start by asking the person if he is choking. This simple step can be deceptively effective - the victim may be coughing violently or even gasping for air, but if he is able to answer then he is probably not choking. A choking victim will not be able to speak since oxygen cannot reach his lungs. But if after asking the person if he's choking all he can do is gesture or point to his throat and you notice his face starting to turn blue, then he is most likely choking and you will need to perform the Heimlich Maneuver immediately.
  • 67. 67 Choking āš« Start by finding the proper stance - behind the victim with one of your feet planted firmly between the victim's feet. āš« Place one fist just above the personā€™s navel with your thumb against the abdomen. āš« Place your other hand directly on top of the first. āš« Squeeze the victim's abdomen in quick upward thrusts as many times as it is necessary to dislodge the object in his windpipe.
  • 68. 68 Choking āš« If he was choked very badly the chance that he will collapse is eminent since he is running out of air, you must properly positioned your self and hold him to prevent him directly from falling āš« Lie him down properly. Check for foreign object in his mouth by sweeping using one finger. āš« Give full breath to check if his airway is still blocked. If air fast through his airway is clear then check for ABC āš« If still block, Kneel beside the victim and apply pressure on the abdomen put your 2 palms just above his navel and make a quick upward thrusts ; this will pushed out the air inside his stomach to expelled the foreign object in his mouth āš« You need at least 8-10 stroke and then Check for foreign object in his mouth by sweeping using one finger āš« Repeat the above procedures until object is expelled and air fast through.
  • 71. 71 Summary First aid includes any one-time treatment and follow- up for observation of minor injuries, including cuts, abrasions, bruises, first-degree burns, sprains, and splinters. Injuries or illnesses requiring only first aid are commonplace. One or more workers should be properly trained to administer basic first aid, including CPR. Workplaces should have a well- stocked first-aid kit and at least one or more employee assigned the responsibility for administering or coordinating first-aid treatments.
  • 72. 72 Summary āš« When an injury does take place, whether it is to ourselves or a fellow employee, knowing what to do and being able to react quickly can limit the severity of the injury... or even prevent a death. āš« First Aid is a best tool to help your co-workers, your family or maybe your own