protrainings basic life support manual · welcome to your protrainings basic life support or bls...

WelcometoyourProTrainingsBasicLifeSupportorBLScourse.BasicLifeSupportcoursescanbetakenasaclassroom,blendedor100%onlinecourse.Pleasecheckifyouareabletotakethiscourseas100%onlineifyouworkinthemedicalsectorasapracticalmoduleisoftenrequired.ThismanualgoeswithallofourBasicLifeSupportcoursesandgivessupportinginformationtoyourcourse.Theremaybesubjectscoveredinthismanualthatwerenotonyourcoursebutyoumayfindtheminteresting.Moreinformationandaccesstofreevideosandmaterialsisavailableatwww.probls.co.uk.

TheclassroomcoursemustbeconductedwithaProTrainingsapprovedinstructor.Youcanfindapprovedinstructorsnearyoubysearchingonwww.procourses.co.ukorbycontactingusdirectlyonsupport@protrainings.euor01206805359.

ThismanualisdesignedtobeusedexclusivelybystudentswhohavecompletedaProTrainingsFirstAidCourseoracoursethathasbeencertifiedbyProTrainingsEuropeLtd.YoucanvalidateyourcertificateandreceiveaPDFversiononlinefromthebottomofwww.probls.co.ukoranyofourwebsites.

Oncompletionofaclassroomcourseyouwillreceiveacertificateandwallet-sizedcardfromyourinstructorinthepost.YoucanalsodownloadacertifiedCPDcertificatefromyourfreeProTrainingsloginarea,aswellasotherdownloads,remindersandweeklyrefreshers.Ifyoudonothavealogin,emailsupport@protrainings.eu.

Makesureyouregisteronlineforthelatestupdates,theseareautomaticforonlinestudents.Yourinstructorshouldhaveregisteredyoualreadyandifyouaredoinganonlinecourseyouwillhavealreadyreceivedyourlogindetailsifyouhavethisbook.OnlineyouwillhaveaccesstovideosandresourcesaswellasbeingabletoprintyouCertifiedCPDcertificateandtocreateyourfreetrainingportfoliorecord.

Formoreinformationonfirstaidandmedicalissuesregisterfreeatwww.firstaidshow.comforthelatestnewsanddetailsofhowyoucanviewoniTunes,Reku,YouTubeandmanyotherformats.

Ifyouhaveanyproblemswithloginorcertificates,emailorcallusdirectlyonsupport@protrainings.euor01206805359.

BelowareexamplesoftheProTrainingsclassroomcertificateyouwillreceiveinthepostafteryourcourse.OnlinecoursecertificatesareavailableonlinetoprintalongwithCertifiedCPDStatements.

ProTrainingsBasicLifeSupportManual

BeforewestartBeforewestartitisworthgivingyouthedefinitionsofsomeofthetermsusedinfirstaid.

GoodSamaritanLaw-statesthatapersonactingingoodfaith,renderingreasonablefirstaidwillnotbeheldaccountablefordamagestothepersontheyareassisting,unlessgrosswilfulmisconductisused.Thislawisnotvalidinsomecountries,forexampletheUK,butotherlawsaretheretoprotectthefirstaider.

Consent-apatientallowingyoutogivefirstaid.Thisisgainedbyaskingthepatientifyoucanhelpthem.Youcanalsoaskaparentorfamilymember.

InformedConsent-youinformingthepatientoftheconsequences,followedbythepatientgivingyoupermissiontogivefirstaid.

ImpliedConsent-whenapatientisunconscious,itisgiventhat,ifthepersonwereconscious,theywouldrequestfirstaid.

Abandonment-initiatingcareandthenstoppingwithoutensuringthatthepersonhasthesamelevelorhighercarebeingrendered.

Negligence-whenyouhaveadutytorespondandyoufailtoprovidecareoryougiveinappropriatecare,andyourfailuretoprovidecareorinappropriatecarecausesinjuryorharm.

UniversalPrecautions-usinggloves,masks,gowns,etc.,foreverypatienteverytime,whenthereisapossibilityofcomingintocontactwithanybodilyfluids

ClinicalDeath-themomentbreathingandheartbeatstop.Typicallyapersonhasahighlikelihoodofbeingrevivedwithoutmuchcellulardamagewhenclinicallydeadforapproximately0-6minutes.Within6-10minutesbraincelldamageishighlylikely.

BiologicalDeath-irreversibledamagetobraincellsandtissues.Ifapersonhasbeenclinicallydeadfor10minutesormore,therewillbeirreversiblecelldamage.Resuscitationisunlikelybutnotimpossible.Withfirstaidwealwaysassumethereisachanceofsurvivalandcontinuetogivehelp.

Child–Agedoneyearoldtopuberty.

Infant–FromBirthtooneyearold.

FirstAidintheWorkplaceManycountrieshavespecificrulesandregulationsfortheprovisionoffirstaidintheworkplace.IntheUK,theHealthandSafetyExecutive(HSE)laysdownlawswhereemployershavetoprovideadequatenumbersoffirstaidtrainedstaff,whetherthisisaone-dayEFAWorathree-dayFAWCourse.

TheHSEstronglyrecommendsanannualrefresherforfirstaidtrainedstaffandthiscanbedoneusingouronlinetrainingcourseorashands-ontrainingwithacertifiedinstructor.

OtherrequirementsintheUKworkplaceandothercountriesincludethebusiness’responsibilitytokeeparecordofallaccidentsandillnessesinvolvingtreatmentthatoccurintheworkplace.

UnderUKregulations,thecompletedpagesofthisaccidentbookhavetoberemovedandstoredsafelyinaccordancewiththeDataProtectionAct.

ThereareadditionallawsthatrequiretheemployertoreportaccidentstotheHSEwheretheaccidentresultsinmorethansevendays’absencefromwork,deathorseriousinjury,includingnearmissesandindustrialdiseases.

Companiesmayalsohavetheirownin-housefirstaidrecordsthatafirstaiderintheworkplacemayneedtocomplete.

Otherdutiesofafirstaiderintheworkplacemayincludere-stockingfirstaidkits,ensuringadequateprovisionoffirstaidkitsandensuringthatanycontaminatedmaterialiscleanedupanddisposedofcorrectlyfollowinganaccidentatwork.

FurtherinformationonRulesandRegulationsintheworkplaceintheUKcanbefoundontheHSEWebsitewww.hse.gov.uk/firstaid.

HealthandSafety(FirstAid)Regulations(1981)-themainactthatcoversfirstaidintheworkplace.Thisisworthhaving-youcangetitfromHMSOBooks.

ManagementoftheHealthandSafetyatWorkRegulations1999-thisensurescompaniescarryoutriskassessmentsonallaspectsofworkcarriedoutbytheiremployees.

RIDDOR-ReportingofInjuries,DiseasesandDangerousOccurrencesRegulations.

COSHH-ControlofSubstancesHazardoustoHealth(2002).

SocialSecurityAdministrationAct1992-covershowcompaniesreportinformationonincidents.

HealthandSafetyatWorkAct1974-thisrequiresbusinessestomakeprovisionsavailabletoensurethattheyprotecttheirstaffagainstinjuryanddisease.Itcoverscompanies’useofcontractorsandotherpeopleenteringtheirpremises.

SomeImportantPartsoftheBodyHeartConsistsoffourchambers,aboutthesizeofyourfist,locatedunderthebreastbone.Thefunctionoftheheartistopumpbloodtothebrain,lungsandbody.Yourbodyhasabout5.6litresofblood,whichcirculatesthroughthebodythreetimeseveryminute.

Thecardiovascularsystemcomprisestheheart,arteries,capillariesandveins.

LungsTherearetwolungsandtheirfunctionistotakeinoxygenandreleasecarbondioxide.Roomaircontains21%oxygen.Ourbodiesuseabout4-6%.

Whenwebreatheoutweexhalecarbondioxideandabout16%oxygen.

BrainTellstherestofthebodywhattodoandneedsoxygenonaregularbasis.Braincellswillbegintodiein4-6minuteswithoutoxygen.

Theaveragehumanbrainweighs1.36kilos(threepounds)anduses20%ofthebody'soxygen.

Allcellsofthebodyrequireoxygencontinuouslytocarryoutnormalfunctions.Carbondioxideisproducedasawasteproductandmustbeeliminatedfromthebodythroughthelungs.Redbloodcellstransportoxygentothetissue.

TheFearsofFirstAidWehavefoundthatwhenpeopleattendafirstaidcourse,theyareoftenreluctantparticipantsbecausetheyhavefearsandconcernsaboutadministeringfirstaid.Addressingthesefearsandshowingthattheyareeasilyresolvedmakestherestofthelessonmucheasiertounderstandandenjoy.

Fearofbeingsued-thisisthefirstfearpeoplehaveaboutadministeringfirstaid.Manycountrieshavea"GoodSamaritanAct"orsimilarlawthatprotectsfirstaidersofalllevelsfromunnecessarylawsuits.Thekeypointstorememberaretoactwithinyourtraining,askpermissiontohelp,don'tleavethepatientunlessyouhavetoalerttheEMSandactasanormalprudentpersonwoulddo.

Fearofinfection-frombloodandotherbodyfluids.Peoplearegenerallyreluctantofclosecontactwithbodyfluids,aswellbeingconcernedaboutinfectionssuchasHIVandhepatitis.Thisisaddressedbytheeffectiveuseofbarriers,whichwillbecoveredlateroninthelesson.

Fearofdoingsomethingwrong-orsimplynotknowingwhattodo.Theworstmedicalconditionyouhavetodealwithiswhensomeonehasnoheartbeatandisnotbreathing.Inthissituation,thepersonisdeadandyoumustrememberthatyoucannotmakeapersonanyworseiftheyaredead.Anyhelpyouprovidetothatpersoncanonlyincreasetheirchanceofsurvival.Theworst-casescenarioisthattheywillremaindead.

Fearofhurtingthepatient-CPRisareallybasicskill.Medicalresearchtellsusthatanyformofoxygencirculationisthemostimportantfirststepinprovidinglifesupport.TherealproblemisnotindoingCPRwrong,itisinnotdoingCPRatall.Therearesomeinstanceswhereyoucoulddoharm,butwewillcovertheseasthelessoncontinues.Generallyspeaking,firstaidisaboutcaringforthepersonandgettingtheEmergencyMedicalServices(EMS)thereasquicklyaspossible,andinmanycasesthismaymeanjustsittingwith,andprovidingcomfortto,thepatient.

Fearforyourownsafety-ironically,inrealrescuesthisoftenisnotanissue.Infact,inmanycasespeopleautomaticallyentersceneswithoutadequateconsiderationforthemselves.Wewillbelookingatscenesafetyandhowyoucanusethreesimplestepstoensurethatyoukeepyourselfsafeinalaterlesson.

AskingPermissiontoHelpOnesimplewayofprotectingyourselfagainstthefearofpossiblelegalactionistoobtainthepatient’spermissionbysaying:"Hi,mynameisKeith.Iamafirstaider.MayIhelpyou?"

Aconsciouspatientmayanswerverbally,bynoddingormaybeofferinguphisinjuredlimbtoyou.Allofthesecanbetakenasgainingtheperson'sconsent.

Withanunconsciouscasualty,theycannotgiveyoupermissiontohelp.However,consentcanbeassumedtohavebeengivenasthepatientislikelytohaveaskedforhelpiftheywereconscious.Youshouldstillaskthepersonandintroduceyourself,butwhentheycannotansweryoucanstillhelp.Keeptalkingthewholetimeyouarehelping,asthehearingisthelastthingtogoandthefirsttocomeback.

Ifsomeonerefusesyourhelpandyouarenotabletohelpthem,youcanstillassistbycallingtheEMS,referringtobossesorfamilymembersandtryingtoreassurethem.

Asafirstaiderintheworkplace,youmayhaveadutyofcare.Inthesecasesthecasualtywillusuallyhavetocometoyouforyourhelp.

ChainofSurvivalThechainofsurvivalconceptisdesignedtoshowyouyourroleinanemergencyprocedure.Followingeachlinkinthechaininthecorrectordercangreatlyincreasethepatient'schancesofsurvival.

RememberthelinksinthechainareEarlyActivationoftheEmergencyServices,EarlyCPR,EarlyDefibrillationandEarlyAdvancedLifeSupport.ThefirstaidercarriesoutthefirsttwolinksandoftenthethirdAEDlink,butifhelpisnotcalledforthenthefinallinkwillnotarrive.

Makesureyoukeepyourself,bystandersandthepatientsafewhenapproachingthesceneofanaccident.Alwaysremembertostop,think,thenact.Checkforanythingthatmaybeadanger,suchasbrokenglass,bodyfluids,electricity,gasortraffic.Rememberthatscenesafetyisyourprimaryconcern.

ChecktheSceneKeyquestionstoask:

• Isitsafeformetohelp?• Whathappened?• Howmanypatientsarethere?• AmIgoingtoneedtocallEMS?• DoIhavemypersonalprotectiveequipmentonandreadytouse?• IsthereanAEDavailable?

CheckthepatientIfitissafetohelp,checkthepatient.

Tapthepatientandintroduceyourself.Ifthereisnoresponse,activateEMS.ToactivateEMS,Call999or112.

IFPATIENTNOTBREATHINGANDYOUAREALONE,PHONEFIRST–ThenstartCPR,donotleavepatienttogolookingforanAED,theEMSwillbringone

IFPATIENTNOTBREATHINGANDYOUARENOTALONE-sendsomeonetocalltheEMSandgettheAED,makesuretheyknowthelocation,whathashappenedandhowmanypeopleareinvolved.

TellthemtocomebacktoyouandtellyouwhattheEMShasadvised.

WhenyoucalltheEMStheywillbeabletogiveyouanyadviceandsupportthatyouneed.Workouthowtousespeakerphoneorhandsfreewithyourphonesoyoucandealwiththepatientwhilegettingadvice.

SceneSafety

TheABCD’sTheABCD’sconceptisdesignedtogivethefirstaideraguidetowhattodofirstinafirstaidemergency,andtoshowalltheprimarycareandlifethreateningconditions.

A-Airway-openthepatient'sairwaybymovingthetonguefromthebackofthethroat,whichoftenblocksbreathing.

B-Breathing-checkforbreathingforupto10seconds.

C-Circulation-iftheyarenotbreathing,administerCPR.

D-Defibrillation-wherethereisnocirculation,usedefibrillationtoadministeranelectricshock.Thisinterruptsacardiacarrestandshouldallowthehearttostartagain.

S-Seriousbleeding,ShockandSpinalinjury-onceABCD’sareok,wemoveontothese.Allthesewillbecoveredinourcourse.

Beforeenteringintoarescuescene,therescuershouldperformaninitialassessmenttoensurethatthesceneissafe.Next,personalprotectiveequipmentshouldbeworntoprotecttherescuerbeforebeginningtohelp.Ifalone,therescuermayneedtoputthepatientintherecoveryposition,iftheyarebreathing,whileleavingtocontactEMS.Ifthepatientisnotbreathing,thenperformCPR.Therecoverypositionallowsthepatienttobreatheeasily,staysafe,andittakesawaytheriskofthemchokingiftheyvomit.

Barriers–GlovesandFaceShieldsThefearofinfectionmaydetersomepeoplefromprovidingemergencyfirstaid.Effectiveuseofbarriers,includingglovesandfaceshields,protectbothyouandthepatientfromtheriskofinfection.Therearespecialrulesinsomeworkplacesforthecorrectdisposalofglovesandotherinfectedmaterials,soitisbesttocheckyourlocalguidelines.

Therearemanytypesoffacemask,suchaspocketmasksorkeyfobmasks.Theycomeindifferentpackagesbutareallbasicallythesame.TheBSiHSEfirstaidkitsintheworkplacenowcontainafacemask.

Alwaysuseabarrierwhendealingwithanyfirstaidemergency

PuttingGlovesOnAlwaysusedisposablegloveswhenprovidingfirstaidcare.Ifyouhavealatexallergy,usealatexalternativesuchasnitrileorvinyl.Beforeprovidingcare,makesuretheglovesarenotrippedordamaged.Youmayneedtoremoveringsorotherjewellerythatmayripthegloves.

Remembertouseskin-to-skinandglove-to-glove.Pinchtheoutsidewristoftheotherglovedhand.Pullthegloveoff,turningthegloveinside-outasyouremoveit.Holditintheglovedhand.Usethebarehandtoreachinsidetheothergloveatthewristtoturnitinside-out,trappingtheothergloveinside.Disposeofglovesproperly.Ifyouhavedothiscorrectly,theoutsideofeitherglovewillnevertouchyourexposedskin.

HowBloodbornePathogensareSpreadBloodbornepathogenscanbespreadinanumberofways:

• Sexualcontactistheprimarymodeoftransmission• Whenacontaminatedsharpobjectcutsorpuncturestheskin.Parenteralexamples

include:needlestick,illegaldrugusage,cutsfrombrokenglass,bites• Whenaninfectedbodyfluidgetsintoanopencutormucousmembrane,forexample

insideeyes,mouth,earsornose• Whenacontaminatedobjecttouchesinflamedskin,acneorskinabrasion

Intactskiniswonderfullycreatedasourfirstdefenceagainstdisease.Bloodbornepathogenscannotsoakthroughnormal,intactskin.

RecoveryPositionCheckthattherearenoinjuriesthatcouldbemadeworsebymovingthepatientandplacethemcarefullyontheirsideusingtherecoveryposition.MonitortheirvitalsignsandkeepthemwarmandcomfortableuntiltheEMSarrive.

Ifyoususpectspinalinjuryandthepatientisinnoimmediatedanger,donotmovethem.Ifyouhavetomovethemontotheirside,asyouhavetoleavethemtogethelportheystarttovomit,thenusetherecoveryposition.

Firstaidistopreventthepatientgettingworseandthiscanbedonewithsomesimpleeasyskillsthatwillbelearntonthecourse.

P-PreserveLife

P-PreventDeterioration-stopthesituationgettingworse

P-PromoteRecovery

HeartAttacksHeartattacksarecausedbyablockageintheheart,starvingitofbloodandoxygen.Theblockagecanbeintheformofnarrowing,plaque,clotsoramuscularspasm,andcanbefatal.HeartattackisthemostcommonformofdeathintheUK.Theyarenotcommonwithchildrenbutitisimportanttoknowaboutthemjustincaseandsoyouknowwhattodowithanadultsufferingfromaheartattack.

Suddencardiacarrestiswhentheheartstops,butaheartattackiswhentheheartisinmajortrauma.Itcouldstopatanytime.

Abigproblemisthatthepatientoftenwillnotacceptthattheyarehavingaheartattackandthisdelaysthetreatment.

Symptoms• Crushingpaininthecentreofthechest,withpainradiatingbetweentheabdomenand

jaw,possiblydownonearm• Labouredbreathing• Rapidorirregularpulse• Nausea/vomiting• Pale,coldandclammyskin• Grey/blueappearance• Feelingofchronicindigestion

Treatment• Calmthepatientandplacetheminthe"W"position,withheadandlegsraised• AlertEMS• MonitorthepatientsABCs• Loosenclothing• BepreparedtobeginCPRifthepatient'sconditionworsens

AspirinGive300mgtablettothepatientforthemtotake.Theymustchewthetablet,notswallowit,asthishelpsthebodytoabsorbitmorequickly.TheAspodholdstwoAspirinsafelyanywhereyougoandisavailablefromyourProTrainingsdashboard.

ControllableRiskFactorsTherearemanythingsthatcanincreasetheriskofheartdisease.Someofthemarecontrollableandothersnot.Factorsinclude:cigarettesmoking,highbloodpressure,obesity,lackofexercise,highbloodcholesterollevels,uncontrolleddiabetes,highfatdietandhighstresslevels.

SignsandSymptoms• Chestdiscomfort• Pressure,tightnessthatlastslongerthantwominutes• Nausea• Sweatingshortnessofbreath• Denial• Feelingofweakness

UncontrollableRiskFactorsRace,heredity,sexandage.

Womenpresentmorewithshortnessofbreath,extremefatigueorflulikesymptoms.Aboutathirdofwomenexperiencenochestpain.

TreatmentRecognisethesignsofaheartattackandactivateEMSbycalling999or112.

• Ifpossibleplacethepatientinthe"W"positionwithheadandlegsraised.• Givenothingtoeatordrink• Keepthepatientcalmandquiet• Prepareincasetheygointocardiacarrest

Angina(Adultsonly)AnAnginaattackisnotaheartattack,andAnginaisusuallycontrolledbydrugsbutcandevelopintoamoreseriouscondition.Anginaiscausedbyabuild-upofcholesterolplaqueontheliningofthecoronaryarteryoracollapsedarterialwall,whichmakesithardforthebloodtoflowfreelytotheheart.Anattackcanoftenfollowphysicalexertionorstress.Medicationrelaxesthewallsofthebloodvesselstoallowbloodtoflow.

SymptomsItwillseemlikeaheartattackatfirst.Patientwillexperiencesuddenweakness,anxietyandfear,andtherewillbeevidenceofstressorphysicalactivity.

TreatmentPositionthepatientinthesamewayasforheartattackpatients.Locateandensuretheytaketheirmedication.Usuallywithmedicationandrest,thepainwillease.Ifitdoesnot,orifthisistheirfirstattack,alertEMS.

OlderChildandAdultCPR

ProvidingCPRcanbeexhaustinganditmaybecomelesseffectiveasyougrowmoretired.Wherepossible,itisbesttosharetheworkwithanotherrescuer.ItisnotimportantiftheotherpersonisCPRtrainedasyoucantellthemwhattodo.Therescuertellstheotherpersonwhattodowhileheisdoingthechestcompressionsandthenwhilehedoesthebreathsthesecondrescuergetsready.Oncompletionofthebreaths,thesecondrescuertakesover.

It'sagoodideatotrytoswapovereverytwominutes.Ifyoubecometiredandnooneisthere,considerjustdoingchestcompressionstohavearestfromthebreaths.

Hands-onlyCPRHands-onlyCPRhelpsencouragelayrescuerstogetinvolvedwhomaynototherwisehelp.ManypeoplearereluctanttogivethebreathsandthisisonereasonwhypeopledonotperformCPR.Withthisnewtechnique,bloodiscirculatedaroundthebody,oxygenatingthebody'stissuesandorgans.

Therescuerdelivers5-6cmdeepcompressionsatarateof100to120compressionsperminutewithouttheneedtodeliverrescuebreaths.Hands-onlyCPReliminatesthefearoftransmittingdiseasebyremovingthemouth-to-mouthcomponentofCPR.

ItisstilladvisedthatyouhandovertoasecondrescuereverytwominutestoensurethatthebestpossiblecompressionsaregivenbeforetheAEDorEMSarrives.

CPRHandovertoaSecondRescuer

AdultCPRisperformedonceyouhavecheckedforpatientresponsivenessandcheckedforbreathingforupto10seconds.Ifthepatientisnotbreathing,activateEMS,perform30compressionsatarateof100to120compressionsperminuteatadepthof5-6cminthecentreofthechest.Compressionsshouldbethesamespeedonthepushandthereleaseandinaregularinterval.Fullrecoilofthechestisvitaltoallowthehearttofillwithblood.

These30compressionsshouldbefollowedbytworescuebreaths.Beforecarryingouttherescuebreaths,makesuretheairwayisopenbytitlingtheheadback,liftingthechinandsqueezingthesoftpartofthenose.Thensealyourmouthoverthepatient’sandblowgentlyforaboutonesecond,youwillseethechestrise.BreathscanbedeliveredasmouthtonosebysealingthemouthormouthtotracheostomyiftheyhaveaStomaintheirneck.

RepeatthecycleuntilanAEDorEMSarrives.Donotwastetimebetweenthecompressionsandthebreaths.Thereshouldbeonlya5-10secondbreakingivingthecompressions.Maximum10secondstoavoiddelaysincompressions.Itisvitaltokeeptheoxygen-richbloodpumpingaroundthebody,whichiswhycompressionsaresoimportant.

FirstAidFlowchart–OlderChildandAdult

ChildCPR–1yeartoPubertyChildCPRisaverysensitiveandworryingthingtothinkabout,letalonetohavetodo.ChildrennormallyneedCPRbecauseofarespiratoryproblemratherthanacardiac(heart)condition,whichismorecommonwithadults.Thisiswhywefirstgivefiverescuebreathsandthen30compressions,followedbytwofurtherbreaths.Youthenrepeat30:2untilyouarerelieved,theEMSarrives,thechildshowssignsofrecoveryoryouaretootiredtocontinue.

Whendoingthebreaths,coveryourmouthoverthechild'sandpinchthenoseclosedoruseafaceshield.Youneedtogentlyblowforaboutonesecond,youwillseethechestrise.

Todothe30compressions,placeonehandinthecentreofthechestandpushdownatleastone-thirdofthedepthofthechestatarateof100to120compressionsperminute.Ifyoucannotdothisthenusebothhands.Onethirdisabout5cmonachild.

Ifpossible,sendabystandertocalltheEMSimmediately.Ifyouareonyourown,youshouldusethe"callfast"approachandcarryoutoneminuteofCPR,thenmakethecallyourself.

InfantCPR–BirthtoOneYearOldInfantCPRisagainaverysensitiveandworryingthingtohavetodo.Infants,likechildren,wouldnormallyneedCPRbecauseofarespiratoryproblem.Firstgivefiverescuebreathsandthen30compressions,followedbytwofurtherbreaths.Youthenrepeat30:2untilyouarerelieved,theEMSarrives,theinfantshowssignsofrecoveryoryouaretootiredtocontinue.

Whendoingthebreaths,coveryourmouthovertheinfant'smouthandnoseoruseafaceshield.Blowgentlyforaboutonesecond,youwillseethechestrise.

Todothecompressions,placetwofingersinthecentreofthechestandpushdownatleastone-thirdofthedepthofthechest.Do30compressionsatarateof100to120compressionsperminute.Onethirdisabout4cmonaninfant.

WithaninfantyoumaybeabletocarryhimcarefullytomeettheparamedicwhilecontinuingCPR,althoughCPRisbestdoneonafirmsurface.

Ifthereisabystander,sendthemtocalltheEMSimmediately.Ifyouareonyourown,youshouldusethe"callfast"approachandcarryoutoneminuteofCPR,thenmakethecallyourself.

FirstAidFlowchart–Child

FirstAidFlowchart–Infant

DrowningYoudonotinhalealotofwaterinmostcasesofdrowning.Anywaterconsumedisgenerallyswallowedandoftenvomitedwhenresuscitationtakesplace.

Makesurethesceneissafe.Usethe"callfast"approachanddooneminuteofCPRbeforegoingforhelpifalone.

Givefiverescuebreathsbeforestartingchestcompressions.Thereasonforthisisthatthepersonisnotbreathingbecauseofarespiratoryproblemratherthanacardiacproblem.

CPRwithadrowningcasecanbemoresuccessfulthanwithasuddencardiacarrest.

Secondarydrowningisaproblemthatcanoccurhoursafteradrowningoraneardrowningcase,soprofessionalmedicaladviceshouldalwaysbetaken.

CardiacArrestSurvivalRatesSomedataonCPRhasbeenreleasedbyZollMedical.Whenacardiacarrestoccurs,onlyhalfofvictimswillneedashock.Theotherhalfwillrequirehigh-qualitycardiopulmonaryresuscitation(CPR).Ageneralfigureisthatforeveryone-minutedelayintheAEDarriving,thepatient’schanceofsurvivaldropsby10%.ThisfigureisbasedonnoonedoingCPR.

IfeffectiveCPRisdelivered,thechanceofsurvivaldropsbyjust3-4%perminute.Toclarifythesefigures,itassumesthatthepersonhas100%chanceofsurvivalatpointofsuddencardiacarrest.

ThisevidencehighlightsthateffectiveandpromptCPRisvitalforthepatient’schanceofsurvival.Assuch,effectivetrainingintheseskillsisessential.

SurvivalratesofwhentheAEDarrivesForabouteveryoneminutetheAEDunittakestoarrive,thepatient’schanceofsurvivaldropsby10%.ThetargettimeistogettheAEDunittothepatientwithinfourminutes,butthisisnotalwayspossibleifthereisnotoneonsite.

ItisvitaltoaskifthereisanAEDunitwhenyoucallforhelp,sothatsomeonecanlooktoseeifthereisonethatcouldarrivesoonerthentheEMS.

WhydoweneedAEDUnitsandwhyaretheyImportant?TheCPReffortsofafirstaiderarethemostimportantstepinsavingapatient’slife.However,whentraditionalCPRdoesnotsucceedinkeepingthepatientalive,anAEDunitwillbeofhugevaluetothefirstaider,whiletheywaitfortheEMStoarrive.

EarlyuseofanAEDunitsaveslivesasitinterruptstheabnormaltwitchingoftheheart(VF),oftenshockingtheheartbeatbackintoanormalrhythm.

AEDunitsareincrediblyeffective,andveryeasytouseastheyhavevoicepromptstotellthefirstaiderwhattodoandwhen.However,trainingfirstaidersintheuseofAEDunitscansignificantlyincreasethechancesofapatient’ssurvivalthroughconfidentandcompetentuseoftheequipment.

TheonlyproblemwithAEDunitsisthattherearenotenoughofthem.Thecostofthemoftenputscompaniesoffbuyingthem,butthisischangingandmoreunitsarebeingplacedwheretheyareneeded.

WherecanyoufindanAEDUnit?AEDunitscanbefoundinmanyplaces,soyouneedtoaskandbeobservant.SomeworkplaceshaveAEDunitsandthesewillusuallybeinacentrallocation.Youwillalsofindtheminpublicplaces,suchasairports,railwaystations,doctors’surgeries,dentists,shoppingcentresorsportsclubs.

Whenyouaredealingwithacardiacarrest,aswellascallingforhelpyouneedtoaskifthereisanAEDunit,assomeonemayknowwhereoneisandtimeiscritical.

HavealookaroundwhenyouareoutandaboutandyouwillbesurprisedhowmanyAEDunitsthereare.

UniversalAEDSignThereisauniversalsignforanAEDunitanditcanbefoundanywherethereisanAEDunitplaced.

ThesignmaybeplacedontheAEDboxoraboveit,soitcaneasilybeseenfromadistance.

ThissignisalsousedtodirectyoutothenearestAEDunit.

Different types of AED

ConsciousChoking–ChildandAdult

Partialobstruction–theycanstillbreath.

Fullairwayobstruction–noaircanpassintooroutoflungs,theycannotbreath.

Ask,"Areyouchoking?"

Ifapersonisunabletobreatheorspeak,treatthepatientasbelow.Iftheycantalkorcough,allowthemtocontinueuntiltheycleartheobstructionoryoufeelyouneedtocalltheEMS.

TreatmentActivateEMS.

ForAdultandChildStandbehindthevictimwithonefootin-betweenthevictim’sfeetandyourotherfootbehindyou.

Performfivebackslapsbetweenthepatient’sshoulderblades.Placetheflatsideofyourfistjustabovethepatient’sbellybutton.Grabthebackofyourfistwiththeotherhandandpullinwardsandupwards.

Continuebackslapsandabdominalthrustsuntiltheobjectisclearedorthepatientbecomesunconscious.Intheeventthatthepatientbecomesunconscious,youwouldperformCPR.

Advisethepatienttoseekmedicalhelpafterwards,eveniftheobjecthasbeensuccessfullycleared.

InfantAdministerfivebackblowsandchestthrustsusingyourtwofingers,untiltheobstructionisclearedorthepatientbecomesunconscious.Placetheinfantonyourlapdownyourlegswiththeheadlowesttoletgravityhelptheobjectcomeout.

SpecialCircumstancesIfthepatientispregnantortoolargetoreacharound,placeyourfistinthemiddleofthechesttoperformchestthrusts.

Neverpracticeabdominalthrustsonarealperson

UnconsciousChokingThisiswheresomeoneis:

• Unconscious• Nosignsoflife• Absentbreathing• Patientmayhavecollapsedafteryouhave

beenperformingbackslapsandabdominalthrusts

TreatmentActivateEMSifyouhavenotalreadydoneso.Ifyouknowthepatientisnotbreathing,startCPR.

Give30chestcompressionsasperCPR,100-120compressionsperminute,5-6cmindepth.

Checkthemouthforaforeignbody.Ifsomethingisvisible,sweepitoutwithafinger.

Neverdoblindfingersweeps

Attempttworescuebreaths-ifthefirstbreathdoesnotmakethechestrise,repositiontheheadandre-attemptbreaths.Ifthecheststilldoesnotrise,repeatthecycleofcompressions,foreignbodycheckandbreathingattemptsuntilthechestrises.

Afterrescuebreathsmakethechestrise,continuecyclesof30compressionstotwobreathsuntilEMSpersonneloranothertrainedpersontakesover,signsoflifeareevident,thescenebecomesunsafe,AEDbecomesavailableoryouaretooexhaustedtocontinue.

GlossaryofTermsABCDs-referstotheprioritysequenceforassessingtheorderofprimarycare.Airway,Breathing,CPR/ChestCompressions,Defibrillatorandthenthe“s”forSeriousbleeding,ShockandSpinalinjury

AED-AutomaticExternalDefibrillator

BP-BloodPressure

BPM-BeatsPerMinute

Child-Agedfromoneyearoldtopuberty

COSHH-ControlofSubstancesHazardoustoHealth

CPR-CardioPulmonaryResuscitation

DRAB-referstotheprioritysequenceforprimarycare.Danger,Response,AirwayandBreathing.Oftenalsowitha“C”forCPR/ChestCompressions

EMS-EmergencyMedicalServices

ERC-EuropeanResuscitationCouncil

FAST-usedinstrokeidentification,Face,Arms,SpeechandTime

HSE-HealthandSafetyExecutive

Infant-Frombirthtooneyearold

ILCOR-InternationalLiaisonCommitteeofResuscitation

PPE-PersonalProtectiveEquipment

RIDDOR-ReportingofDiseasesandDangerousOccurrencesRegulations1995

SAMPLE-usedtorememberthethingstolookforwhenassessingillnesses.Signs/Symptoms,Allergies,Medications,Pre-existingmedicalconditions,LastmealandEvents

Sign-somethingyouseeonapatient

SCA-SuddenCardiacArrest

Symptom-somethingthepatienttellsyou

VF-VentricularFibrillation

VT-VentricularTachycardia

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