Warm-up

1. Warm-up • What does “Good Samaritan” mean? • Overdose GS Law • AED GS Law • CPR GS Law

2. Unit 4 First-Aid and CPR

3. First-Aid

4. Warm-up • What do you think of when you hear the words first aid?

5. LEQ • What is the purpose of assessing the scene before helping someone? What do you look for?

6. First-Aid • First Aid: is the initial help and care given to a sick or injured person • Calling 911 • Controlling bleeding from an open wound • CPR • Must be able to determine emergency • Could mean life or death! • Who do you think provides the most first-aid?

7. Consent • Before providing first aid, you need to get client’s permission/ consent • Verbal consent from conscious adults capable of making a sound decision • Consent from unconscious is implied • A child’s parent/guardian should give consent if possible. Why?

8. Responsibilities of First-Aid Providers • Recognize an emergency exists • Based on client’s appearance, behavior or surroundings • Make a decision to help • Remember your own safety! • Call EMS if necessary (what info?) • Provide dispatcher with location, number injured/sick, and nature of emergency • Safely gain access to client and “diagnose” • Provide first aid • Stay with client until EMS arrives – you are obligated!

9. Sizing up the Scene • Determine safety threats to you, client, or bystanders. • If you believe it is too dangerous, do not lend your help. Call 911 • Determine nature/cause of illness/injury/ # • Call EMS if necessary and report findings • Read Safety box on page 90

10. The Initial Assessment • If client is speaking, ask questions • Use answers to determine responsiveness • What would you ask? • Speaking normally = breathing • Ask yourself: • How do they look? Behavior? In distress or pain? Bleeding? Color? • If you detect conditions that compromise client’s ability to breathe or circulate blood, correct them immediately (clear airway, abdominal thrusts, rescue breaths, control bleeding, etc.)

11. Focused Examination • After initial assessment • Head: check skull for deformities, wounds, swelling; ears/nose for blood; mouth for loose teeth/bleeding • Eyes: open eyes, compare pupils • Neck: look/feel for deformities, wounds, depressions, tenderness, swelling, bleeding (check for medical alert necklace) • Chest: Look/feel (d,w,d,t,s,b) • Abdomen: Look/feel • Pelvis: L/F, press down & in for pain • Legs: L/F , check color/movement/sensation; wiggle toes • Arms: L/F, check color/temp/sensation; wiggle fingers • Back: Slide hand under back and L/F

12. In groups of 3… • Practice the focused assessment • (be mature and participate) • You must be a victim, a bystander, and a first responder • Go in order and skip the inappropriate steps!

13. Answer LEQ • What is the purpose of assessing the scene before helping someone? What do you look for?

14. Warm-up • Why has the American Heart Association continuously changed the steps of CPR for the average lay person?

15. LEQ • What is the goal of CPR?

16. CPR • CPR = cardiopulmonary resuscitati0n • Cardiovascular disease=leading cause of death in US • 1 million die each year in US from heart attacks or related causes • ½ of those die from sudden cardiac arrest • Usually caused by abnormal heart rhythm (ventricular fibrillation [VF]) • If you knew someone was HIV positive, would you perform CPR on him/her?

17. Chain of Survival • Early access to EMS • Includes recognizing emergency, knowing warning signs of sudden cardiac arrest, heart attack, stroke, choke and seeking medical assistance • Early CPR • Buys time and improves survival chances • Early Defibrillation • Defib: restoration of normal heart rhythm • EMS use automated external defibrillators (AEDs) • Chances of living decrease 10% with each minute • Early advanced care • Trained EMS (paramedics) provide drugs, airway management and defibrillation to increase chances for people suffering cardiac arrest, heart attack, stroke and choking

18. Barrier Devices/Face Masks • Follow appropriate infection-control procedures (gloves and barrier devices) • Bag-valve mask (BVM): • A self-inflating bag and one-way valve attached to face mask • EMS / hospital staff prefer this device • Difficult for 1 person to get an airtight seal • Ideal with 2 rescuers

19. CPR • Sudden cardiac arrest causes blood flow to stop which deprives heart, brain, & other vital organs of oxygen • Three Red flags (symptoms) to look for: • 1. No response: to touch or sound • 2. No breathing or inadequate breathing • 3. No signs of circulation: no coughing, no movement, no pulse. • If all red flags are present, begin CPR! • 6th Grade CPR

20. Foreign Body Airway Obstruction(FBAO) • Aka: CHOKING! • Can occur in clients of ALL ages • Common adult occurrence involves alcohol and food in social situations • Infants and children often choke on small objects such as toys but also can choke on food • 911 3 year old • Heimlich Brothers

21. Performing Abdominal Thrusts… • 1. Ask “Are you choking?” • How will you most likely know? • 2. Ask if you can help (don’t leave!) • 3. Have client stand • 4. Position yourself behind client • 5. Place your fist against abdomen just above the navel • 6. Grasp fist with other hand and thrust upward and inward into the abdomen. • 7. Continue until object is expelled or victim becomes unresponsive. • 8. Then what????

22. Other circumstances to consider…?? If the client is pregnant, you will need to adjust the placement of your hands If unable to perform standing abdominal thrusts, you have the client lie down. When would you do this? If you are alone, you can use a chair to perform abdominal thrusts. What is the alternative? Any other special situations???

23. Mini-quiz • Name one type of assessment and explain why a first aid responder would need to follow it. • Why do you start with the head when conducting a body check? • What makes MINOR wounds minor? • Who can perform First Aid? • What is the purpose of obtaining consent?

24. Answer LEQ • What is the goal of CPR?

25. Warm-up • Have you ever had to deal with an emergency? If so, explain. If not, how do you think you would act? • Make a list of qualities that are important in a first-aid responder.

26. For today… • Warm-up – What are the 2 most important qualities to have when dealing with an emergency? Why for each? • Bring $3 by WEDNESDAY for lunch at HF • Bring back tri-fold by WED, completed! • Index cards for labs…

27. LEQ • How can you tell that someone is having a heart attack?

28. First-Aid for Specific Emergencies • Take good notes! • You will complete a lab for each first-aid emergency. • This is your chance to ask questions/understand how to do it! • You will be tested on the steps on a lab for the unit test. • If you cannot handle the labs, you will be given an alternate assignment!

29. Heart Attack • Heart muscle deprived of oxygen-rich blood and nutrients • Coronary arteries become blocked via plaque/cholesterol • Signs: • Chest discomfort, pressure for > 3-5 min • Pain in left arm, neck, shoulder • Light-headed, dizzy • Sweating, fainting • Nausea/vomiting • AKA myocardial infarction = MI • Heart Attack 911 Call

30. Stroke • Brain attack • Artery supplying blood to brain becomes blocked • 3rd leading cause of death in US • Signs: • Numbness/weakness on face/one side of body • Facial droop • Confusion • Difficulty in walking/balance • Stroke 911

31. HEART ATTACK/STROKE LAB • Look over procedure 4D • When you feel comfortable, check off self-practice • Speak aloud • Practice with partner • Go through steps using partner as victim • Speak aloud • Peer testing • In groups of 4 • Two people perform, one person grades • Speak aloud

32. Minor Wound Care • Wash with soap/water to avoid infection • Shallow = wash (with what?) • Deep = medical assistance • Doctor should remove impaled object

33. MINOR WOUND CARE LAB • Look over procedure 4E • When you feel comfortable, check off self-practice • Speak aloud • Practice with partner • Go through steps using partner as victim • Speak aloud • Peer testing • In groups of 4 • Two people perform, one person grades • Speak aloud

34. Answer LEQ • How can you tell that someone is having a heart attack?

35. Warm-up: Review • List 5 words associated with stroke and heart attack. • What is the point of an initial and focused assessment? • When would a person need to see a doctor for wound care?

36. LEQ • Why is it important to control bleeding?

37. Controlling External Bleeding • Occurs when object penetrates, tears, avulses, severs or scrapes outer layer of skin • Why is controlling bleeding important? • Arterial: most serious; spurting • If untreated, can lead to significant blood loss, death • Least likely to clot • Venous: from vein; flows steadily/gushes • Easier to control • Capillary: most common; oozes; bright red • Not serious, easily controlled

38. CONTROLLING EXTERNAL BLEEDING LAB • Look over procedure 4F • When you feel comfortable, check off self-practice • Speak aloud • Practice with partner • Go through steps using partner as victim • Speak aloud • Peer testing • In groups of 4 • Two people perform, one person grades • Speak aloud

39. Internal Bleeding • Blunt/penetrating force applied to skin; results in trauma to one or more organs • Difficult to recognize • FA providers need info about force or signs/symptoms • Redness, bruises later • If from non-traumatic causes, signs may be: • Painful, rigid, tender abdomen • Vomiting, coughing up blood • Dark, bloody stools

40. INTERNAL BLEEDING LAB • Look over procedure 4G • When you feel comfortable, check off self-practice • Speak aloud • Practice with partner • Go through steps using partner as victim • Speak aloud • Peer testing • In groups of 4 • Two people perform, one person grades • Speak aloud

41. Answer LEQ • Why is it important to control bleeding?

42. When someone says “I was in shock”, does that mean the same thing as medical shock? What are the differences? Warm-up

43. What are the signs to anaphylaxis? LEQ

44. Circulatory system *Failure = shock • Heart (pump) • Damage to pump affects ability to move blood • When heart is damaged, i.e. MI • Blood (fluid) • Significant loss of blood • Excessive external/internal bleeding, excessive vomiting, diarrhea, sweating, burns • Blood vessels (pipes) • Vessels become enlarged, no enough fluid to fill them • Injury to nervous system, i.e. spinal injury Shock and Circulation

45. Occurs when too little oxygen and nutrients reach body’s cells, tissues, organs • Travels through circulatory system • Involves what? Shock

46. Signs: • Change in level of responsiveness • Pale/bluish skin • Cool/clammy skin • Rapid/weak pulse • Rapid/shallow breathing • Drop in BP Shock

47. A client who has no visible injuries was recently in a fight and shows signs of shock. • A client is having chest pain and shows signs of shock. • A client in a wheelchair shows signs of shock. What was the cause? Why?

48. Look over procedure 4H • When you feel comfortable, check off self-practice • Speak aloud • Practice with partner • Go through steps using partner as victim • Speak aloud • Peer testing • In groups of 4 • Two people perform, one person grades • Speak aloud SHOCK LAB

49. Type of shock with severe life-threatening consequences • Severe allergic reaction • Exposure by contact, injection, ingestion • List 5 common allergens with your face partner • Hitch Anaphylaxis

50. Occurs within minutes -> hours • Signs: • Difficulty breathing • Sneezing, coughing • Hives • Swelling of face/eyes/ lips/neck/hands/feet • Increased HR • Altered level of consciousness Anaphylaxis