First Aid

Learning Objectives:
After the lecture the members of the group will be
able to:
Discuss some medical and non-medical conditions
that needs first aid
Define first aid, different first aid procedures and
explains its importance to the nursing profession
Demonstrate good skills of a first aider
Discuss the importance of first aid and basic life
support
Properly perform first aid procedures such as
cardiopulmonary resuscitation and artificial
respiration for infant, child and adult and the like

Different First Aid Procedures

Trauma Management and Casualty Handling

Basic Extrication
Wound Management
Animal Bites, Snake Bites, Insect Bites, etc.
Basic Life Support/ Cardiopulmonary
Resuscitation
Rescue Breathing
Foreign Body Airway Obstruction
Management

Basic Life Support (BLS)

Is the foundation for saving lives following cardiac
arrest.
Fundamental aspects of which are:
Immediate recognition of sudden cardiac arrest and
activation of emergency response system
Early cardiopulmonary resuscitation
Rapid defibrillation

Initial recognition and response to heart attack and

stroke are also considered to be part of BLS

Sudden Cardiac Arrest (SCA)

Despite important advances in prevention, SCA

continues to be a leading cause of death in
many parts of the world.
A single approach to resuscitation is not
practical, but a core set of actions provides a
universal strategy for achieving successful
resuscitation.

Key Principles in Resuscitation: Strengthening the

links in the Chain of Survival

These set of actions are terms the Links in the

Chain of Survival

The links includes (RACDAP):

Immediate RECOGNITION of cardiac arrest
and ACTIVATION of the emergency response
system
Early CPR with an emphasis on chest
compression
Rapid DEFIBRILLATION
Effective ADVANCED LIFE SUPPORT
Integrated POST-CARDIAC ARREST CARE

When links are implemented:

Survival rates can approach 50% following

witnessed out-of-hospital ventricular fibrillation
(VF)

For laypersons, recognition of cardiac arrest

is not always straightforward
Any confusion on the part of the rescuer can
result in a delay or failure to activate the
emergency response system or to start CPR.
Precious time is lost if bystanders are too
confused to act.
Therefore, CPR guidelines focus on
recognition of cardiac arrest with
appropriate set of rescuer actions

We will only discuss the first 3 links:

Activating the Emergency Response

System
Emergency medical
dispatch is an integral
component of the EMS.
Bystanders should
immediately call their local
emergency to initiate a
response anytime they find
an unresponsive victim.

Cardiopulmonary
Resuscitation (CPR)
Is a series of life-saving actions that improve
the chance of survival following cardiac arrest.
Although CPR may vary, depending on the
rescuer, the victim, and the available resources,
the fundamental challenge remains:
How to achieve early recognition of arrest
and prompt action by the rescuer.

Defibrillation
An AED is a device which
correctly assesses heart
rhythm, enabling a rescuer
who is not trained in heart
rhythm interpretation to
accurately provide a
potentially lifesaving shock to
a victim of SCA.
Rapid defibrillation is a
powerful predictor of
successful resuscitation
following VF SCA.

When will you do

CPR?

AS SOON AS POSSIBLE!
Brain cells begin to die after
4-6 minutes without oxygen.

Who may learn about CPR?

CPR is an easy and life saving procedure and
can be learned by anyone.
One does not need to be a doctor to learn how
to do CPR.

THE TECHNIQUE AND STEPS IN

CPR

IF YOU WITNESS A
CARDIAC ARREST

How to Perform Adult CPR

1
2
3

CHECK AREA
SAFETY.

Survey the scene.

See if the scene is safe to do CPR.
Get an idea of what happened.

CHECK UNRESPONSIVENESS.

CALL FOR HELP:

Ambulance,
Emergency Services,
Doctor

Tap or gently shake the victim

Rescuer shouts Are you OK?
Quick check for normal breathing
If the victim is unconscious,
rescuer calls for help.
Rescuer ACTIVATES the
EMERGENCY MEDICAL
SERVICES.
Get AED/Defibrillator!

NON-RESPONSIVE,
NO NORMAL BREATHING

Get a Defibrillator!
AED!

PULSE CHECK

Palpate for Carotid Pulse within 10

seconds

(at the same time CHECK FOR

BREATHING)

For trained healthcare providers

only

If with definite
pulse but no
breathing

Do Mouth to Mouth
Breathing

Give one breath every 5-6 secs

(about 12
breaths/min)
Recheck pulse every 2 minutes

MOUTH TO MOUTH BREATHING

and PULSE CHECK

Deemphasized in the new guidelines

For trained healthcare providers only
As short and quick as possible
Pulse check not more than 10 seconds
If unsure, proceed directly to CHEST
COMPRESSIONS!

After determining unconsciousness,

CAB
C. COMPRESSION Do chest
compressions first
A. AIRWAY Does the victim have an
open airway (air passage
that allows the victim to
breathe)?
B. BREATHING Is the victim breathing?

C
OMPRESSION
(to assist CIRCULATION)
After determining unconsciousness
and calling for help,

proceed immediately to do

CHEST
COMPRESSIONS!

Chest Compressions

Kneel facing
victims chest
Place the heel of
your hand on the
center of the victim's
chest. Put your other
hand on top of the
first with your
fingers interlaced.

Hand Location

Chest Compressions

Place the
heel of one
hand on the
sternum in
the center of
the chest
between the
nipples and
then place
the heel of
the second
hand on top
of the first so
that the
hands are
overlapped
and parallel.

Position shoulders
over hands w ith
elbow s locked and
arms straight

Compress dow n and

release pressure
smoothly, keeping
hand contact w ith
chest at all times

Give Chest Compressions at 100 per minute

Compress breastbone at least 2 inches deep
Compress at a rate of 100 per minute or more
Compress 30 times initially
Allow the chest to return to its normal position

Give 30 Compressions
Compress breastbone at least 2
inches
(30 compressions should take
15-18 sec)
Count aloud 1, 2, 3, 4,
5,6,7,8,9,10,11,12,13,14,15,16,17,1
8,19,20,21,22,23,24,25,26,27,28,29,
and ONE!
Minimize interruptions
Allow recoil after each compression

A - AIRWAY

Open the Airway:

Use the head tilt/chin
lift method

Place one hand on

the victims
forehead
Place fingers of
other hand under
the bony part of
lower jaw near
chin
Tilt head and lift
jaw--avoid closing
victims mouth

Head Tilt Chin Lift Maneuver

This maneuver prevents airway obstruction by the epiglottis.

B - BREATHINGGive 2 one-second
breaths

Maintain airway
Pinch nose shut
Open your mouth
wide, take a normal
breath, and make a
tight seal around
outside of victims
mouth
Give 2 full breaths
(1 sec/ breath)
Observe chest rise &
fall; listen & feel for
escaping air

Repeat cycles of 30 compressions

& 2 breaths

PULSE CHECK

RECHECK PULSE EVERY 2 MINUTES

(equivalent to 5 cycles CPR)
Very brief pulse check should take less
than 10 seconds (at the same time check
for normal breathing)
In case there is any doubt about the
presence or absence of pulse,
CONTINUE CHEST COMPRESSIONS
For trained healthcare providers only

CONTINUE CPR
UNTIL

HELP ARRIVES.
(Emergency Services, Ambulance, Doctor,
AED)

PERSON IS REVIVED.

If the victim is
breathing

THE RECOVERY POSITION

Maintain open airway & position the victim

The unresponsive victim with spontaneous

respirations should be placed in the recovery
position if no cervical trauma is suspected.
Placement in this position consists of rolling the
victim onto his or her side to help protect the
airway.

How to Do CPR on a Child

1. Stay Safe
Always make sure that the area is safe
for you and the victim.
Children may be infected with
contagious diseases. If you are
concerned about possible
exposure to contagious disease,
practice universal precautions and
wear personal protective
equipment, if available.

How to Do CPR on a Child

2. Try to Wake the Child
Gently tap or shake the child's
shoulders and call out his or her
name in a loud voice. Don't hurt
the child, but be aggressive -you're trying to wake her up.
If the child does not wake up, have
someone call 117 immediately. If
no one else is available to call 117
and the child is not breathing,
continue to step 3 and do CPR for
about 2 minutes before calling
117.

How to Do CPR on a Child

3. Begin chest compressions
If the child is not breathing, put one hand on the
breastbone directly between the child's nipples.
Push straight down about 2 inches or about a
third of the thickness of the child's chest -- and then
let the chest all the way back up. Do that 30 times,
about twice per second.
If you've been trained in CPR and you remember how to
give rescue breaths, go to step 4. If not, just keep
doing chest compressions and go to step 5.

How to Do CPR on a Child

* If you've been trained in CPR and you remember

how to give rescue breaths, go to step 4. If not, just
keep doing chest compressions and go to step 5.

How to Do CPR on a Child

4. Give the child two breaths
After pushing on the chest 30 times, cover the child's
mouth with your mouth and pinch his nose closed
with your fingers. Gently blow until you see his
chest rise. Let the air escape the chest will go
back down -- and give one more breath.
If no air goes in when you try to blow, adjust the child's
head and try again. If that doesn't work, then skip it
and go back to chest compressions (step 3), you can
try rescue breaths again after 30 more
compressions.

How to Do CPR on a Child

5. Keep doing CPR and call 117 after 2 minutes
If you are by yourself, keep doing CPR for 2 minutes
(about 5 groups of compressions) before calling 117.
If someone else is there or comes along as you are
doing CPR, have that person call 117. Even if the
child wakes up, you need to call 117 any time you
had to do CPR.
Once 117 has been called or you have someone else
calling, keep doing CPR. Don't stop until help
arrives or the child wakes up.

How to Do CPR on an Infant

Use these steps to provide CPR to infants

approximately less than 1 year of age

How to Do CPR on an Infant

1. Stay Safe
Children may be infected with
contagious diseases. If you
are concerned about
possible exposure to
contagious disease,
practice universal
precautions and wear
personal protective
equipment, if available.

How to Do CPR on an Infant

2. Try to wake the infant
Really little babies respond well having the soles of
their feet rubbed or tapped. For infants more than
2 months old, tap their shoulder or chest. In either
case, call out his name in a loud voice. Don't hurt
the baby but be aggressive; you're trying to wake
him or her up.
If the infant does not wake up, have someone call 117
immediately. If no one else is available to call 117
and the baby is not breathing, continue to step 3
and do CPR for about 2 minutes before calling 117.

How to Do CPR on an Infant

3. Begin chest compressions
If the baby is not breathing, put two
fingers on the breastbone directly
between the baby's nipples. Push
straight down about an inch and a
half or about a third of the
thickness of the baby's chest and
then let the chest all the way back
up. Do that 30 times, about twice
per second.

How to Do CPR on an Infant

* If you've been trained in CPR and you remember

how to give rescue breaths, go to step 4. If not, just
keep doing chest compressions and go to step 5.

How to Do CPR on an Infant

4. Give the baby two breaths

After pushing on the chest 30 times, cover the baby's
entire mouth and nose with your mouth and
gently blow until you see his or her chest rise. Let
the air escape the chest will go back down and
give one more breath.

How to Do CPR on an Infant

If no air goes in when you try to blow, adjust the baby's

head and try again. If that doesn't work, then skip it
and go back to chest compressions (step 3), you can
try rescue breaths again after 30 more
compressions.

How to Do CPR on an Infant

5. Keep doing CPR and call 117 after 2 minutes
If you are by yourself, keep doing CPR for 2 minutes
(about 5 groups of compressions) before calling 117.
If someone else is there or comes along as you are
doing CPR, have that person call 117. Even if the
baby wakes up, you need to call 117 any time you
had to do CPR.
Once 117 has been called or you have someone else
calling, keep doing CPR. Don't stop until help
arrives or the baby wakes up.

Foreign Body Airway

Obstruction

Principles of when to act on a Mild Airway

Obstruction:
As long as good air exchange continues,
encourage the patient to continue spontaneous
coughing and breathing efforts.
Do not interfere with the patients own attempts
to expel the foreign body, but stay with the
patient and monitor his or her condition.
If this persists, then activate the emergency
response system.

Signs of Severe Airway Obstruction:

Poor or no air exchange
Weak, ineffective cough or no cough
High pitched noise while inhaling or no noise at
all
Increased respiratory difficulty
Possible cyanosis (turning blue)
Unable to speak
Clutching the neck with the thumb and fingers
(universal choking sign)

Universal Choking Sign

Rescuer actions:
Ask the patient if he or she is choking. If the
patient nods yes and cannot talk, severe airway
obstruction is present and you must activate
the emergency response system!

Heimlich Maneuver
1.
2.
3.
4.
5.
6.

Stand or kneel behind the patient and wrap your

arms around the patients waist.
Make a fist with one hand.
Place the thumb side of your fist against the
patients abdomen, in the midline, slightly above
the navel and well below the breastbone.
Grasp your fist with your other hand and press
your fist into the patients abdomen with a quick
upward thrust.
Repeat the upward thrusts until 1) the object is
expelled or 2) the patient becomes unresponsive.
Give each thrust with a little different movement
to expel the object.

Heimlich Maneuver

Heimlich Maneuver
7. If the patient becomes unresponsive, lay the
patient on a firm surface and begin the steps of
CPR for an adult or child.
8. The only extra step is to look for a foreign object
when opening the airway and remove it if
found. DO NOT DO BLIND FINGER
SWEEPS ON ANYONE OF ANY AGE.
9. For infants when responsive, provide 5 back
slaps and then 5 chest compressions using the 2
finger method. When unresponsive, treat like
infant CPR with 1 extra step. Look for a foreign
object in the mouth when opening the airway
and giving breaths.

Heimlich Maneuver

Special Notes:
If a patient is pregnant or
too large to wrap your
arms around the stomach,
one would apply chest
compressions to relieve
the obstruction. This can
be done behind the
patient or have the patient
stand against the wall or
lie down and perform
chest compressions as if
doing CPR.

END OF MY DISCUSSION
Thank you for listening again!

- MEFLORES