First Aid - CPR First Aid - First Aid Guide - CPR Guidelines

New CPR Guidelines 2010

2010-10-18T16:03:59Z

New CPR Guidelines – 2010

The AHA today previewed the new CPR guidelines 2010. The new cpr guidelines put a preference on compressions first over the traditional ABC’s or Airway, Breathing, and Circulation.

The new guidelines now use the C-A-B approach. Persons finding a person in suspected cardiac arrest should:

New CPR Guidelines 2010

1. Assess the victim
2. Call for help
3. Being Chest Compressions.
- Push Hard and Push Fast
- Perform Compressions at the rate of 100 CPM
- If trained in CPR, after 30 compressions, open the airway and give 2 breaths.
- If not trained or if you do not feel comfortable, continue compressions without interruption until other help arrives.

We will have more information on the new cpr guidelines later today.

What do you do if a patient wakes up during CPR?

2010-10-17T02:41:30Z

If a patient begins to move, wake up, or show signs of life while performing CPR, you should immediately stop compressions and reevaluate the patients Airway, Breathing, and Circulation. You should continue treat as indicated. Be prepared to resume compressions if needed. Do not remove an AED if in place as the patient may go back into a shockable rhythm.

Compression Only CPR Recommended

2010-10-17T02:36:33Z

Emergency dispatchers should advise bystanders to use chest-compression-only CPR on heart attack victims, rather than the standard protocol of chest compressions and mouth-to-mouth ventilation, according to a new study. The findings echo the results of other recent reports that have compared the two strategies. Continuous, uninterrupted chest compressions may be the key to successful CPR, according to this team of American and Austrian researchers. “By avoidance of rescue ventilations (mouth-to-mouth) during CPR, which are often fairly time-consuming for lay bystanders, a continuous uninterrupted coronary perfusion pressure is maintained, which increases the probability of a successful outcome,” they wrote in the Oct. 14 online edition of The Lancet. In addition, chest-compression-only CPR is easier to perform, which increases the likelihood that bystanders will be willing and able to help heart attack victims, the team said. “This confirms that chest compressions save lives. And there is no need for mouth-to-mouth,” said one expert, Dr. Tamara R. Kuittinen, director of medical education in the department of emergency medicine at Lenox Hill Hospital in New York City. “It simplifies the process for the person who witnesses a cardiac arrest to rescue and possibly save a life. You just need to learn and remember how to do chest compressions, how many (and shout for someone to help you by calling 911),” she said. In their study, the researchers analyzed data from three randomized trials involving more than 3,000 patients who received CPR from bystanders guided by emergency dispatchers. The survival rate was 14 percent for those who received chest-compression-only CPR and 12 percent for those who received standard CPR. This means that the relative chances of survival increased 22 percent with chest-compression-only CPR. The absolute increase in survival was 2.4 percent, which means that one life would be saved for every 41 patients who received chest-compression-only CPR. “Our findings support the idea that emergency medical services dispatch should instruct bystanders to focus on chest-compression-only CPR in adults with out-of-hospital cardiac arrest,” the researchers concluded. The new findings echo those of recent studies. For example, in September a team from the University of Michigan reported that patients who experience sudden cardiac arrest outside of a hospital setting fare just as well when treated with chest compressions before being treated with an electrical defibrillator as they do when getting immediate defibrillation. That study appeared in the journal BMC Medicine. Larger version Ask America: Learn. Listen. Be heard. Ask America Election forum The Fast Fix Map snapshot And in July, two studies published in the New England Journal of Medicine each found that chest compression alone was equal to compressions plus mouth-to-mouth when it came to helping people experiencing a heart attack.

CPR Compression to Breath Ratio

2010-10-14T01:30:29Z

The current American Heart Association Guidelines establish a universal compression to breath ratio of 30 to 2 for Adults, Infants, and Children when performing CPR with rescue breaths. Compressions should be performed hard and fast at the rate of 100 compressions per minute. In healthcare settings, 15 to 2 may be used on infants and children when multiple rescuers are available. 15 to 2 increases the amount of delivered oxygen and may be effective in improving survivability for respiratory/hypoxic induced cardiac arrest in pediatric victims.

Compound Fracture Picture

2010-09-19T18:58:49Z

What if I have broken bone coming out of the skin?

2010-09-19T18:58:09Z

A broken bone which protrudes or breaks the skin is an open fracture (or compound fracture) and requires emergency medical evaluation and treatment. In first aid, if you are faced with a compound fracture attempt to position the injury in its position of function (normal position), treat any bleeding/cover any open wounds, and splint the affected area to prevent further injury. Do not push any protruding bone back into the skin. When repositioning the injured site or while splinting, commonly the protruding bone may retract inside the skin and this should be expected. Open fractures often require surgical intervention and medical management to prevent systemic infection.

Also See: Compound Fracture Picture

Does a victim instantly recover after a shock?

2010-09-19T04:48:11Z

Answer: No, recovery (if any) from defibrillation after suffering from a shockable rhythm is a delayed process. Time down before defibrillation has been shown to be equatable to potential recovery time after a shock.

What does a flatline mean?

2010-09-19T04:33:17Z

A flat-line on a cardiac monitor indicates a asystolic heart rhythm. Asystolic or Asystole means that there is no electrical heart activity. Unlike TV, in real life, use of a defibrillator provides no valid treatment for asystole or a flatline. You can not shock a flatline (or asystole) back into a regular rhythm or restart someones heart with a shock when in a flatline.

Cardiopulmonary Resuscitation – CPR Guide – CPR Steps – CPR Guidelines – How To Perform CPR

2011-06-07T19:21:20Z

Cardiopulmonary resuscitation (CPR) is an emergency procedure for a victim in cardiac arrest. Cardiac arrest is when a persons heart quits beating.

CPR involves rescuer provided physical interventions to create artificial circulation for a victim who is unconscious/non responsive, not breathing, and does not have a pulse.

The main purpose of CPR is to maintain a flow of oxygenated blood to the brain and the heart. Effective CPR helps by delaying tissue death and provides an opportunity for a successful resuscitation without permanent brain damage if initiated quickly and effectively. Permanent cellular damage and death start to occur within 3 to 5 minutes of collapse.

The sooner we initiate the steps of CPR – the higher chances of survivability. Roughly 300,000 individuals suffer cardiac arrest outside of a hospital each year in the United States. Only an estimated 6% of that 300,000 survive. Knowing how to perform CPR may make the difference between life and death for someone else.

Quick Guide of Steps CPR: (Click on Topic for Information)
Scene Size Up / Ensure Personal Safety
Assess Victim (Tap and Shout)
Call 911 / Get Additional Resources

Circulation: Checking for a Pulse

Circulation: Chest Compressions
Circulation: Rib Fracture
Ciculation: Compression Only / Hands Only CPR
Airway: Open the Victims Airway
Breathing: Assess / Provide Breathing
Breathing: Mouth to Mouth
Breathing: Mouth to Mask
– Child CPR & Infant CPR –

CPR Differences for Infants and Children
When to call 911 or get help in Infant CPR & Child CPR
Steps of Infant CPR / Steps of Child CPR
–Healthcare Provider CPR –
Healthcare Provider BLS CPR Considerations
– Automated External Defibrillators –
How to use an AED

Special Considerations Using an AED

–

CPR Test

2010-09-17T03:20:26Z

First Aid: Nature of Emergencies

2010-09-18T02:49:51Z

Nature of Emergencies

Emergencies by nature are stressful and take a toll on everyone involved. To be able to help someone else you must remember to remain calm. You must make rational decisions based upon processing rapid information related to the situation you are in without influence of emotion. Failure to remain calm and/or separate emotion may cause you to make poor decisions. These poor decisions may cost you or someone else their life. Calm rescuers also equate to calm victims.

First Aid Kits – Recommend Supplies

2010-09-18T02:50:01Z

Emergency Preparedness

2010-09-18T02:50:13Z

Emergency Preparedness

Before an emergency happens is the proper time to start preparing for it. Once the situation occurs there is little opportunity for planning and organization. In your daily life, look around and think about common situations that may occur and how you should respond to them.

What would you do if a coworker collapsed while at work? Do you know the address to your workplace? Do you have an AED or First Aid Kit available? If so, where are they located? Are you familiar with their contents and operations?

Simply taking a few minutes to figure what resources you have, where they are located, and how they work today — before you need to use it for a real emergency — may make a difference.

Legal Considerations of CPR & First Aid

2010-09-18T02:50:28Z

Legal Considerations of CPR & First Aid

When providing CPR or First Aid you should consider the legal ramifications of your actions.

Generally, lay persons have no legal duty to act to aid someone else in need. Election to help someone else is guided by an internal moral compass of what is reasonable and expected. When performing care do what you feel comfortable and do what seems reasonable. If you are unsure what to do you should call 911 and do the best you can until other help arrives.

Most states have good samaritan laws that are designed to protect individuals from law suit when acting in good faith. Remember that despite these laws you may be still subject to law suit or legal action even if you did everything correctly.

Do not let the fear of legal action keep you from helping someone in need but simply help you remember to do your best as you feel comfortable and as you would want done for you if you were the victim.

Healthcare Providers should review their legal duty to act with their state licensing agency and remember to always perform care to the level of their training and resources available to mitigate potential legal action.

Outside Resource: United States Good Samaritan Laws

First Aid: Documentation & Incident Reporting

2010-09-18T02:50:37Z

First Aid: After the Emergency

2010-09-18T02:50:47Z

After The Emergency

After the initial rush of an emergency is not uncommon to feel unappreciated, sad, or even guilty once other rescuers have taken over. Remember that you should do your personal best to make the outcome potentially better for the victim. People will not always have a positive outcome and some may die. You should talk with other rescuers or seek professional advice if you feel needed to effectively deal with these feelings. There is nothing wrong with asking for emotional help or support after an emergency.

Additionally after an emergency you must maintain confidentiality about what occurred. You should only tell information to need to know parties and limit sharing information with others. Remember to keep private things private. Document events and complete appropriate forms according to your policies and procedures to maintain a legal record of what occurred. When documenting be very detailed. If you fail to write it down initially – it did not happen if later reviewed in a court of law.

Universal Precautions & Bloodborne Pathogens

2010-09-18T02:51:14Z

Universal Precautions & Bloodborne Pathogens

Your personal safety is your number 1 priority in any situation. Bodily fluids such as blood and saliva may contain pathogens that may cause disease or illness. You should attempt to isolate direct contact with bodily fluids to limit your risk of exposure to these pathogens. Pathogens can enter your body through the skin, eyes, nose, or mouth. Common bloodborne pathogens include: HIV/AIDS & Hepatitis.

Use personal protective equipment (PPE) anytime there is a potential for exposure and PPE is available. If PPE is not available, improvise with what is available to limit exposure as possible.

Common Personal Protective Equipment:
Gloves: Used to protect hands.
Eye Protection: Used to protect exposure through contact with eyes.
CPR Masks: Used to protect you from exposure if providing rescue breathing.

Always use PPE when it is available.

Properly dispose of all used PPE or items that contain bodily fluids in a biohazard bag if available. You should not place biohazard items in the regular trash. You should follow your internal policies when applicable on how to dispose of biohazard items. If you do not have internal policies or resources for disposal, contact your local EMS service, Fire Department, or Hospital as they will be able to assist you in disposing of your items correctly.

Remember the following: P.A.C.T.

Protect yourself from blood: Remember to PPE at all times when available. Limiting exposure limits risks.

Act quickly and safely: If you are exposed to a pathogen you must act quickly to mitigate that exposure. Follow your internal exposure policy. Flush the area with large amounts of water and soap if possible. Consider getting evaluated by a healthcare professional in a timely manner.

Clean all exposed areas to hazardous pathogens properly: Clean all exposed area with appropriate cleaning solutions while wearing PPE. Commercial disinfectant products should be used to ensure proper cleansing of all areas. Dispose of all exposed materials in a appropriate manner.

Tell or Report the incident to the appropriate person: Immediately contact your supervisor or reporting person after any exposure to any pathogen. You may be required to fill out paperwork or seek professional medical evaluation. Failure to report may limit your ability to prove exposure or obtain appropriate medical treatment.

Hand Washing: Hand Washing can help limit exposure to pathogens before and after an event. To properly wash your hands: 1.) Turn on the faucet with a paper towel. 2.) Wet your hands and apply soap. 3:) Lather soap for a least 20 seconds and rinse with a large amount of water. 3.) Dry your hands with a paper towel and use that paper towel to turn off the facet.

Hand sanitizers can be used as a alternative solution until you are able to properly wash your hands with water and soap.

Site Specific Training: You should review your internal policies, procedures, and exposure control plans at least annually to ensure you know how to respond at your facility or workplace.

First Aid: Poisonings

2010-09-18T02:52:23Z

Poisoning

A poison is anything a person swallows, breaths, or gets into their eyes that causes sickness, injury, or death. Many common everyday products can be poisonous to a person. Evaluate any potential poisoning situation with due regard for you own personal safety. Wear PPE if appropriate and available. Move the victim from the scene of the poisoning if possible. Call 911 and contact the poison control center for information on how to treat the poisoning situation. Poison control can be contacted at 800-222-1222 or at www.aapcc.org. Your 911 dispatcher may be able to contact poison control for you in many situations.

If you can identify the substance, MSDS or Material Safety Data Sheets may provide information to help identify potential hazards and symptoms or effects.

Remove the poison from the victims skin and clothing if possible. If faced with a dry chemical, brush it off the skin with a gloved hand and do not apply water as it may activate the substance. If believed safe, flush the skin, eyes, and contaminated areas with water for at least 20 minutes or until emergency personnel arrive. If dealing with an eye exposure and only one eye is affected, make sure you have the affected eye lower than the unaffected eye when flushing to keep from cross contaminating. Never induce vomiting or give the victim anything by mouth.

First Aid: Temperature Emergencies

2010-09-18T02:53:19Z

Temperature Emergencies

Heat Emergencies: Victims exposed to heat may experience symptoms that may be minor to life threatening. To avoid heat related emergencies you should remember to drink plenty of fluids and dress appropriately for the conditions. Upon discovering someone suffering from a heat related emergency you must act quickly to avoid further progression of the situation.

General Heat Sickness: Victims suffering from heat related illness will have muscle cramps, headache, nausea, weakness, and dizziness. Victims should be actively sweating during this stage. To treat persons with these symptoms: move them to cool or shaded area, loosen and remove layers of clothing, have the victim drink cool to cold fluids, fan the victim. Monitor the victim for signs of confusion or abnormal behavior. If the victim does not recover or show improvement call 911 immediately.

Heatstroke: Heatstroke is a life threatening condition that requires immediate medical attention. Signs of heatstroke is confusion, vomiting, inability to drink, red, hot, and dry skin, abnormal breathing, or seizures. Victims of heatstroke may stop sweating. If you suspect someone is suffering from heatstroke call 911 immediately, provide care as you would for general heat sickness.

Never ignore the signs of heat sickness or heatstroke. Never rapidly cool victims with submersion in ice cold water. Never allow a victim to eat or drink if they are confused, vomiting, or have had a seizure.

Cold Emergencies: Cold emergencies may be systematic or isolated to one part of the body depending on the extent and nature of the exposure. An isolated injury is usually referred to as frostbite while a system emergencies is refereed to as hypothermia.

Frostbite is common to fingers, toes, nose, and ears. Frostbite occurs typically outside in cold temperature but may occur indoors when working with cold materials. Signs of frostbite include skin that looks white, waxy, or grayish. The area is usually hard and numb of sensations. To treat frostbite remove the victim from the cold to a warm place. Call 911 immediately or activate your emergency response system. Remove any wet or tight clothing and jewelry. Never attempt to “thaw” a part of the body unless access to a medical facility is limited.

Hypothermia is life threatening condition that occurs when the body temperature drops. Hypothermia may occur even the temperature is above freezing. Signs of serious low body temperature include cold hard skin, bluish skin, be confused or acting strangely, and have muscle rigidity. Shivering may stop after the body cools considerably. As body temperature drops the victim may become more unresponsive, have shallow or absent breathing, or appear dead. To treat hypothermia remove the victim from the cold to a warm place, remove wet clothing and dry the victim, cover them with blankets, and call 911 immediately. If you are a long distance from help or a hospital you may start to actively rewarm the victim by placing them by a heat source or placing heat packs on the body in areas such as the armpits and groin.

First Aid: Insect Bites and Stings

2010-09-18T02:53:49Z

Insect bites and stings are typically minor in nature and only cause mild pain and discomfort. If someone has a known severe allergy to an insect bite or sting you should call 911 and treat them according to the allergic reaction protocol. To treat a victim of a insect bite or sting evaluate the situation and attempt to identify the origin of the bite or sting. If bee or related sting look for the stinger near the affected area. If you find it, scrape it away using something will a dull edge such as a debit card. This removes the stinger without causing more venom to enter the body. Wash the site of the bite or sting with soap and water. Place ice on the area to control and reduce swelling. Monitor the victim for at least 30 minutes for signs of severe reaction after the event.

First Aid: Head, Neck, and Spine Injuries

2010-09-18T02:54:15Z

Head, Neck, and Spine Injuries

You should be concerned for potential head, neck, or spinal cord injuries with any traumatic event. There is a potential risk for serious injury including paralysis if treated inappropriately. Common mechanisms of injury that produce head, neck, and spine injuries are falls from height, blows to the head, diving injuries, electrocutions, car crashes, and other significant traumatic events. You should suspect these injuries if a victim is unresponsive, is confused, vomits, complains of a headache, has vision problems, has difficultly walking or moving a part of the body, or has a seizure. Victims may also have tingling or complain or strange sensations in their body. Any person who is under of the influence of alcohol or drugs should be assumed to have a head, neck, or spine injury after a traumatic event as they may not feel pain or report pain appropriately.

If you suspect a victim has a head, neck, or spine injury you should take steps to attempt to limit further injury. Immoderately call 911 and get additional resources. Tell the victim to lay still and not to move. Hold the victims head so the head and neck does not move or twist. When speaking to the victim rescuers should stand where the victim can see them so they do not out of reflex attempt to move their head to see the person speaking to them. Also, remind the victim to verbally answer “Yes or No” instead of shaking their head.

If the victim is in danger, vomits, or goes unresponsive a priority should be placed on treating those problems over protecting their head, neck, and spine. You must treat life threats first. If the person needs moved due to danger or is vomiting attempt to move the person in a straight line when possible. You may be able to roll the person while holding the head if needed with the help of a second rescuer.

First Aid: Bleeding

2010-09-18T02:55:08Z

Bleeding

Bleeding is a common first aid situation due to scrapes, cuts, and lacerations. Bleeding should be treated as a life threatening condition if you are unable to control the bleeding through first aid procedures, there is a large amount of blood loss, or blood is squirting from the wound. You should call 911 immediately for any of these situations.

Basic steps of bleeding control include Direct Pressure, Elevation, and Bandaging. You should remember to wear PPE when appropriate and available. Evaluate victims continuously for signs of serious injury or ill effects from blood loss.

If the victim is able, have them apply direct pressure over the wound with their hand or a clean dressing. Continue to apply pressure to the wound. Most bleeding can be controlled through this step. If the bleeding continues, apply more pressure and add a second dressing to the wound. Never remove dressings once in place as this may remove clots and increase the amount of bleeding. Dressings can be gauze or any other clean piece of cloth. Try to keep the wound covered and clean. If bleeding is severe and does not slow with direct pressure, you may elevate the affected area above the heart (if possible) which may help slow the bleeding process. Layperson’s should not apply a tourniquet or apply pressure points unless specially trained and indicated. After the bleeding is reasonably controlled apply a bandage to the wound to maintain pressure so you can remove direct pressure provided by you or the victim.

Nosebleeds: Nosebleeds are a common occurrence. You should consider nosebleeds to be like other types of bleeding. Apply pressure to both sides of the nostrils while the victim sits and is leaning forward. Apply consistent pressure for a few minutes. If the bleeding continues, press harder. Call 911 if the bleeding continues for longer than 15 minutes, is bleeding heavily or is gushing, or the victim is having trouble breathing.

Punctures: If a person suffers a wound from a puncture such as a knife or sharp object treat is as other bleeding. Never remove any object stuck in the body.

Amputations: If a part of the body is amputated you should attempt to save the object as it may be possible to surgically repair or reattach the amputated body part. Treat the bleeding as other types of bleeding. Rinse the amputated part with clean water. Cover or wrap it in a sterile dressing or clean cloth. Place the amputated part (while wrapped) in plastic bag or container. Place the bag in or on ice to keep the amputated part cool and transport with the patient.

First Aid: Shock

2010-09-18T02:55:39Z

Shock

Shock is a medical condition that develops due to a deviation in efficient blood and oxygen circulation throughout the body due to a heart condition, blood loss, or allergic reaction. A person suffering from shock will feel weak, faint, or dizzy; have pale, cool, clammy, sweaty skin; and may act restless, confused, or agitated A person suffering from shock are unstable and may collapse, go unconscious, or suffer cardiac arrest unexpectedly.

To care for a victim suspected of suffering from shock immediately call 911, have the victim lie on their back, if there is no suspected traumatic injury – lift the victims legs above the victims heart, use bleeding control technique to stop or slow any viable bleeding, cover the victim with a blanket to keep them warm.

Symptoms of shock are involuntarily and occur to internal reactions to poor circulation and condition in an attempt to keep the vital organs viable. If you see symptoms of shock – you must act quickly.

First Aid: Seizure

2010-09-18T02:56:16Z

Seizure

A seizure is a medical condition in which the victims brain experiences hyperactivity which causes problems in attentiveness and functioning. Seizures may be related to a chronic disorder called epilepsy or acutely due to head injury, low blood sugar, poisoning, other neurological disorder, and sometime other illnesses. During a seizure a person may loose consciousness, shake, convulse, or move uncontrollably, act strangely, or be confused. Seizures could be a sign of a life threatening condition. Victims who have a history of seizures or have a diagnosis of epilepsy may have frequent seizures who not need medical attention each time they have a seizure. If in doubt of a known history or unsure what to do call 911 immediately. Also call 911 for any seizure lasting longer than 10 minutes regardless of seizure history.

To care for a victim having a seizure you should do your best to protect the victim for further injury during the convulsions. Never attempt to hold the victim down or stick anything in their mouth. Holding the victim down may cause further injury to the victim. Sticking an object in the victims mouth may cause it to become lodged or stuck and cause an airway obstruction. Stay with the victim until the seizure stops and the victim recovers. A victim who has a seizure will often be confused, scared, or unable to communicate for up to an hour after the seizure ends. Reassure the victim that they are okay and tell them that they have had a seizure. If the victim does not show signs of improvement call 911 immediately.

Not all persons have a seizure will convulse. Some victims have “absent” seizures and may appear to be staring off or unresponsive to stimulus. Treat these victims as any other seizure victim.

First Aid: Storke

2010-09-18T02:56:52Z

Stroke

Stoke is a condition in which the brain is deprived of oxygen and blood flow do to a clot or bleed inside the brain. A person suffering from a stroke will have neurological symptoms or deficits usually isolated to one side or part of the body. They may become confused, be unable to speak, or disorientated. Many victims will be unable to use one side of their body. Often victims will have reported or complained of a headache prior to the event. If you think someone is having a stroke you should call 911 immediately. Time is very important as certain treatments can only be given in the first few hours of a stroke. Like heart attack, many victims will be in denial that they are suffering from a stroke. You as a rescuer must act if they fail to act for themselves.

First Aid: Diabetic Emergencies / Low Blood Sugar & High Blood Sugar

2010-09-18T02:57:32Z

Diabetic Emergencies

A diabetic emergency is a situation in which a victim is ill due to a problem with their blood sugar. Any victim with an altered mental status should always be evaluated for a potential diabetic emergency. Persons with diabetes are unable to properly regulate or manage their blood sugar levels. A victim may have high or low blood sugar. Most commonly persons who experience acute diabetic emergencies have low blood sugar. Therefore we assume that most people having signs of a diabetic emergency have low blood sugar and treat it accordingly.

Low blood sugar may occur if a person has not eaten or has vomited; has not eaten enough food in proportion to their activity; or has mismanaged their insulin. Insulin is a hormone inside the body that is used to help turn sugar into energy. Some diabetics may have to inject insulin into their body to help regulate their blood sugar. Signs of a diabetic emergency include: a change in behavior, change in level of mental status, confusion, aggression, hunger, weakness, sweating, pale or other abnormal appearance. Persons suffering from a diabetic emergency will not act themselves and may have trouble communicating or speaking.

If you suspect a person is suffering from a diabetic emergency and has low blood sugar you should act quickly and attempt to help to raise their blood sugar if possible. If the victim is able to sit up and swallow you should give the victim a beverage containing simple sugars; such as regular soda or orange juice. The simple sugars will help rapidly raise the victims blood sugar. To maintain an elevated blood sugar over time you should give the victim more complex sugars, carbohydrates, and proteins. A peanut butter and jelly sandwich is a great quick complex meal that will be broken down by the body into sugar over an extended period of time. If the victim does not respond or get better after being given sugars or is unable to speak, swallow, or sit up you should active 911 immediately.

Some diabetics may become hostile or violent when having a diabetic related emergency. Use caution.

Fist Aid: Fainting / Dizziness

2010-09-18T02:58:16Z

Fainting

Fainting is an occurrence were an individual looses consciousness. Fainting may be an indication of a serious medical condition. Many times however a person faints after standing or moving too quickly; or after standing without moving for a long period of time. This occurs due the capacity of the heart not meeting the demand of the body and brain due to the effects of gravity.

A fainting situation should be evaluated upon the factors related to the situation. If a person faints and regains consciousness & soon returns to normal – that person has likely experienced a non life threatening fainting episode. Usually the person recovers upon collapsing due to the appropriate return of blood flow to the brain.

If a person collapses and doesn’t start to feel better within a few minutes you should be concerned about other potential more serious causes. Evaluate the person and call 911 if you are unsure what to do. Have the person lay still and not to attempt to get up if dizzy or nauseous.

What is a Heart Attack?

2010-09-18T02:58:45Z

First Aid: Heart Attack / Chest Pain

2010-09-18T02:59:18Z

Heart Attack

A heart attack is a life threatening medical emergency in which the heart muscle suffers an event in which part of the heart is damaged or dies. A person having a heart attack may have chest discomfort, pain, or pressure; discomfort in the upper body including the arms, back, neck, or jaw; shortness of breath; cold sweat; nausea; or lightheadedness. The pain or discomfort is usually lasting. Pain is felt throughout the upper body as it is deferred from the brain as it may be confused as where the pain signals are coming from.

Women, the elderly, and people with diabetes may have less obvious signs of heart attack. They may complain of not feeling well or become nauseous, sweaty, or short of breath without the classic chest discomfort.

If you suspect someone is having a heart attack call 911 immediately. Many people suffering from chest discomfort may be in denial that are having a medical emergency. You must act quickly even if they fail to act for themselves. Time is again the enemy. Delays in seeking medical attention may limit medical treatments or lead to permanent injury or death. After calling 911 have the victim rest and not move or exert themselves. If there is an AED available bring it near the victim, monitor them, and be ready to start CPR and/or use an AED if needed.

If you suspect someone is having a heart attack and they are not allergic to aspirin; you should have the victim chew two baby aspirin or one regular adult aspirin if available. Aspirin has proven to be beneficial during a heart attack. Chewing the aspirin helps get it into the bloodstream faster.

First Aid: Allergic Reactions / Using an EPI Pen

2010-09-18T03:00:25Z

Allergic Reactions

Allergic reactions can range from minor to life threatening. Many people have allergies to environmental substances, bee stings, and foods (such as peanuts). All allergic reactions have the potential to become life threatening. Signs of a serious allergic reaction include: red raised itchy skin, trouble breathing, swelling of the tongue and face, and loss of consciousness or altered mental status. If you believe someone is having a serious allergic reaction call 911 immediately, ask the patient if they have had this reaction in the past, and attempt to gain as much information as possible. Ask the patient if they have an EPI-Pen which can be used to help the victim. Be prepared to start the steps of CPR if needed. Gather as much information as possible to assist responding rescuers to help the victim.

Epinephrine Pen: Some states and organizations allow first aid rescuers to assist or administer an EPI-Pen to a person who is experiencing a severe allergic reaction. An EPI-Pen is a spring loaded device that delivers a low dosage of epinephrine which will help the victim’s condition from worsening until trained rescuers arrive.

To use an EPI-Pen remove the safety cap and follow the instructions printed on the EPI-Pen. As standard practice, never place your hand over either of the device to avoid getting stuck with the needle.

Grasp the EPI-Pen in the palm of one hand and press the injection end hard in to the victims thigh below the waist and above the knee. The device is designed to go through clothing and into the victims body. Hold the EPI-PEN in place for several seconds so that all the medication enters the victims body. Rub the area of the injection to speed the absorption into the body. Properly secure the device in a sharps container if available or in a location so that no other person gets stuck by the exposed needle. Be sure to give the used EPI-Pen to EMS personnel when they arrive. Note the time the injection was given and continue to monitor the victim.

First Aid: Asthma Attack / Using an Inhaler

2010-09-18T03:01:16Z

First Aid: Breathing Problems – Shortness of Breath

2010-09-18T03:01:59Z

Breathing Problems

Any person suffering from severe difficulty breathing should be treated as suffering from a life threatening condition. The body requires oxygen to work properly. Signs of severe breathing difficulty include: an inability to speak in complete sentences; has noisy breathing; irregular breathing rate, rhythm, or quality; or is turning blue. People with breathing problems will often sit in a tripod position. This allows them to breath easier and should be encouraged. Many people with chronic breathing problems will know about their condition and may be able to assist you in assisting them. You should call 911 anytime you suspect someone is having severe difficulty breathing or you are unsure what to do. Keep the person in a position of comfort and try to calm the person until help arrives.

What is First Aid?

2010-09-18T03:02:33Z

First Aid is the initial medical care delivered to a person in emergency need before the arrival of more qualified rescuers and healthcare professionals. Anytime you provide first aid you should remember to protect yourself FIRST, then care for the victim. Your personal safety is the #1 priority. When providing care do your best with the resources available. Call 911 anytime you are unsure what to do or believe that the situation may be life threatening. Do want you can to make the situation better until other rescuers arrive and take over.

First Aid for Choking: Heimlich Maneuver – Adult Choking / Infant Choking

2010-09-18T03:03:32Z

Choking is a common medical occurrence and typically does not require emergency intervention. Rescuers should initiate care in cases of severe choking such as when a person is unable speak, makes the universal choking sign, or is turning blue. When witnessing someone believed to be in severe choking you should ask them if they are okay. If they are unable to respond, initiate care without delay.

In adults the most effective way to relieve severe choking is to deliver abdominal thrusts by performing the Heimlich maneuver.

The Heimlich maneuver uses abdominal thrusts to place pressure on the diaphragm simulating a coughing reflex in the choking victim to help expel the object. To perform the Heimlich maneuver stand behind the victim and wrap your arms around their abdomen. Create a fist with one hand and place the thumb side against the victim’s stomach above the belly button but below the rib cage. Place your other hand over the fist and thrust inward, hard and fast, until the victim begins breathing or goes unconscious.

IF the victim goes unconscious and falls to ground, begin the steps of CPR with one exception. When opening the airway, look and see if you see an object inside the victims airway. If you see an object and you feel comfortable you may perform a finger sweep to attempt to remove the object. If you do not see something, are uncomfortable, or think you are unable to sweep the object out – do not attempt a finger sweep. Continue CPR until professional help arrives.

The Heimlich maneuver can be applied to any person or child who is unable to stand. For children you should kneel down to perform abdominal thrusts.

Choking Relief for Infants: Choking relief for infants must be modified from the methods used on adults due to their small size. To relieve severe choking in an infant, place the child face down on your arm while supporting the head with the palm of the hand. Perform 5 back slaps, striking the infant between the shoulder blades, with sufficient force to attempt to dislodge the object. Turn the child over and perform 5 chest compressions with the two finger chest compression technique. Repeat 5 back slaps and 5 chest compressions until the infant begins breathing normally or goes unconscious.

If the infant become unconscious, begin the steps of CPR with one exception. When opening the airway, look and see if you see an object inside the victims airway. If you see an object and you feel comfortable you may perform a finger sweep to attempt to remove the object. If you do not see something, are uncomfortable, or think you are unable to sweep the object out – do not attempt a finger sweep. Continue CPR until professional help arrives.

Pregnant & Large Adults: For persons who are pregnant or of large size, choking relief may have to be modified. Chest thrusts may be used instead of abdominal thrusts when faced with these situations. Hand technique should be the same with placement being moved to the middle of the chest on top of the sternum.

CPR – Special Considerations when using an AED

2010-09-18T03:03:53Z

1:) Hairy Chest: If the victim has a hairy chest you will need to remove the hair prior to placing the AED pads on the victims chest. You may do this with a razor that is typically found with an AED or by attaching one set of AED pads and pulling them off forcibly removing the hair. You should ensure you have another set of AED pads prior to using one set to remove hair or you may not be able to use the AED. Leaving hair in place may cause the AED pads not make contact with the patients chest and cause the shock to be ineffective.

2:) Medication Patches: If the victim has a medication patch on their skin in the area the AED pads are to be placed you must remove them prior to attaching the AED pads. Use gloved hands to remove the medication patch. Medications patches may divert the shock or represent a burn hazard if not removed.

3:) Covered in water: If the victim is covered in water or sweat attempt to dry the chest prior to applying the AED pads. Moisture may divert the shock from the heart.

4:) Implanted Pacemakers or Defibrillators: If the victim has an implanted pacemaker or defibrillator continue to use an AED as otherwise indicated for other patients. Ensure the AED pads are at least an inch away from the victims device prior to delivering a shock. You continue to use an AED as it is unknown if the implanted device is functioning correctly. An implanted pacemaker or defibrillator will look like a small lump underneath the skin usually on the upper left side of the chest near the heart.

5:) Pediatric Patients: An AED may be used for any victim over the age of 1. Pediatric pads deliver a smaller shock and should be used if available. If pediatric pads are not available, use the adult pads as long as they do not overlap or touch. Many AED’s will not have pediatric pads.

6: ) Fully Automated AEDS: Fully automated AED’s are devices they do not require a rescuer to push a button to deliver a shock to a victim once applied. It is imperative to always listen to an AED and follow the instructions given. If using a fully automated AED it may deliver a shock at anytime and pose injury or death to you or other rescuers if touching the victim when a shock is delivered.

CPR – Automated External Defibrillators or AEDs

2010-09-18T03:04:10Z

Automated External Defibrillator’s (or AED’s) are devices that treat the most common cause of sudden cardiac arrest by delivering a electrical shock to a persons body.

What an AED treats is an abnormal heart rhythm called Ventricular Fibrillation (or V-Fib) that causes the heart to stop circulating blood. V-Fib is a heart condition in which the heart quivers instead of mechanically pumping the blood throughout the body. The most effective treatment for V-Fib is CPR and use of a defibrillator. The longer it takes for CPR and an AED to be used, the less likely a person is to survive V-Fib. CPR should be stopped and an AED applied and used as soon as it is available.

Automated External Defibrillators are designed to allow anyone to use them regardless if they have been formally trained on their operations. AED’s accomplish this through use of voice instructions, pictures, and prompts. An AED will only deliver a shock if indicated and is safe when used correctly.

Quick Guide to Using an AED:
Open AED and Turn Unit On.
Attach AED Pads to victims bare chest.
Ensure AED Pads are attached to AED.
Follow Prompts of the AED.
Clear the Victim when Analyzing and Deliver Shocks.
Continue CPR starting with Chest Compressions for 2 minutes.
Follow AED instructions until emergency personnel arrive.

AED’s function by taking an EKG of the victims heart to analyze the electrical activity in an attempt to determine if the victim is in V-Fib or another heart rhythm. If the AED analysis indicated V-Fib a shock will be indicated and may be delivered by the rescuer and AED according to the device’s operating instructions. If the AED analysis finds any other rhythm than V-Fib a “No shock” instruction will be issued and the AED will not allow a shock to be delivered.

Pad Placement: AED pads typically go around the heart and are placed on the upper right side of the chest below the collar bone and on the lower left side below the nipple line near the armpit. The electricity delivered by an AED will travel in both directions between these two pads.

Rescuers using an AED must always listen to the instructions of an AED. The AED will advise not to touch the patient while it is analyzing the victims heart and again if a shock is indicated. If the victim is touched or moved during analysis the AED may interrupt those movements and cause a potential false positive for V-Fib. If any person is touching the victim when a shock is actually delivered, they may receive some of the shock which may cause injury or even death. If you are operating an AED verbally yell and physically look head to toe to make sure no person is touching when the victim when the AED advises not to touch the victim.

The electricity delivered by an AED during a shock stuns the heart in an attempt to stop the abnormal rhythm. Think of an AED as a TASER for the heart. It temporarily stuns it, stops what the heart is doing, and allows it to potentially recover.

An AED does NOT restart the heart or fix a “flat line” as often shown on television. A flat line represents that there is no heart electrical activity at all. A flat line usually represents clinical death as it is rare to recover from a flat line rhythm. Recognize an AED attempts to correct electrical system of the heart that is malfunction – not jump start it. If an AED recognizes a “flat line” it will indicate “No Shock Advised” and instruct you to resume CPR. Shocking a flat line will NOT benefit the patient.

If a shock is indicated and delivered, the heart may take up to 10 minutes to recover from the cardiac arrest. Therefore, immediately after delivering a shock (or a “No Shock” indication) the rescuers must resume CPR with compressions to help mechanically get the heart beating again. Effectiveness of a shock is greatly affected by how well CPR is performed immediately thereafter. Do 5 sets of 30:2 or 2 minutes of CPR. The AED will automatically stop and give instructions exactly every 2 minutes. Repeat the process of operation and perform the tasks indicated by the AED. Remember when resuming CPR after AED usage to always being CPR with chest compressions.

When a shock is delivered the victim will often convulse. You may always witness an arch of electricity travel across the victims body, smell burning hair or skin, or see smoke. This is normal as a large amount of electricity is entering the victims body. Continue with CPR and AED usage as indicated.

Once an AED is placed, never remove the pads from the victims chest or turn the AED off until instructed to by trained healthcare professionals. If the victim wakes up or recovers they may suffer from V-Fib again and require additional AED treatment.

Next: Special Considerations when using an AED.

CPR – AHA BLS Healthcare Provider CPR

2010-09-17T01:51:30Z

BLS CPR Information

CPR – AHA Heartsaver CPR, Heartsaver AED, and Heartsaver First Aid

2010-09-17T01:51:00Z

HS CPR information

CPR – Types of Certification

2010-09-17T01:50:17Z

Online

Traditional

Mixed Format

Class Description Links…

CPR – Healthcare Provider CPR Considerations

2010-09-18T02:37:17Z

Healthcare Provider Considerations:

Healthcare Providers when performing CPR should consider the following considerations:

Use of BVM or Bag Value Mask: A bag valve mask is a device that is commonly used in healthcare settings to deliver rescue breathing to person who is not breathing or is breathing ineffectively. A BVM delivers positive pressure ventilation and forces the volume of the air in the device into the victims lung. The device may be used with or without oxygen. If used with oxygen, high flow oxygen (greater than 10 liters per minute) should be used. Room air contains approximately 21% oxygen with high flow oxygen attached to a BVM approximately 90% oxygen is delivered with each breath.

The mask supplied with a BVM is similar to that used in a pocket mask. With one hand use the thumb and index finger to grasp the mask. Place the thumb over the raised portion of the mask. This visually looks like the letter C. Standing at the victims head, place the pointed end over the bridge of the victims nose. Place the remaining three fingers on the victims chin. This visually looks like an E. This technique is called the EC clamp technique and is the preferred method of using a BVM.

With the second hand attach the bag portion of the device to mask and squeeze slowly touching finger to finger to deliver the majority of the volume of air within the bag device. Upon delivering a breath and seeing the chest rise, slowly release the bag allowing it to refill while holding the mask firmly on the victims face. Deliver additional breaths as indicated. Do not hyperventilate or forcefully squeeze the bag.

BVM’s come in Adult, Pediatric, and Neonate sizes – You should use the most appropriate sized mask/device dependant on patient size.

Checking for a Pulse: Healthcare Providers should check for a pulse if they feel comfortable before performing chest compressions on a victim in cardiac arrest.

For Adults and Children, a pulse should be assessed in the carotid artery for 5 to 10 seconds. The carotid artery is assessed due to it being central and likely to be palpable if a pulses exists. During cardiac compromise the body shunts circulation to the heart, lungs, and brain as they are most important for survival of life. Therefore it is possible a carotid pulse may be present while a peripheral pulse such as the radial may not. In an infant, a brachial pulse should be assessed as it will be larger and easier to evaluate.

Ratio of Compressions for Infants and Children: Healthcare Providers should recognize that children likely are hypoxic and are in need of oxygen during CPR. Therefore, in a healthcare setting with two or more rescuers present, compressions should performed at the ratio of 15 compressions to 2 breaths instead of the traditional 30:2. By using 15:2, the victim receives breaths twice as frequent, increasing the overall oxygenation of the patient. This method is used when multiple rescuers are present to help reduce fatigue. If alone, use 30:2 until additional rescuers arrive.

Compressions for Infants with two or more rescuers: Healthcare providers providing CPR to an infant in a healthcare setting may use an alternative technique to the standard two finger compression method.

The alternative method is called the two thumbs encircling technique and allows for more effective compressions when working with another rescuer. The compressing rescuer encircles the infants body with both hands as in going to pick up the child. The rescuer compresses the chest while on a hard firm surface with both thumbs. The second rescuer delivers breaths every 15 compressions. The compressing rescuer never removes the hands from the victims body while breaths are being delivered to allow for immediate resumption.

Advanced Airway: When an advanced airway such as an ET or Combitube is placed CPR changes slightly. Compressions are performed at the rate of 100 compressions per minute without interruption and breathing is performed every 6 seconds (10 times per minute) continually. Compressions and breaths are performed simultaneously once an advanced airway is in place.

Next: AED’s

CPR – Mouth to Mask

2010-09-18T02:42:16Z

Mouth to Mask Breathing is the delivery of rescue breaths through a barrier mask to protect the rescuer from becoming exposed to the victims bodily fluids. Barriers devices such as a pocket mask should be used to provide rescue breathing when available and delivering rescue breaths. Pocket Masks are usually made of plastic and contain a one way value designed to limit exposure to the rescuer to exhaled air, bodily fluids, and disease process.

To use the mask, place it on the victims face with the pointy end over the bridge of the nose. Place one hand over the top of the mask holding it firmly on the face, Place the second hand on the bottom portion of the mask while grasping the chin; perform a head tilt/chin lift. Deliver breaths as in mouth to mouth breathing instead place your mouth on the one valve. Deliver each breath for about 1 second; looking for the chest to rise.

Next: Circulation and Chest Compressions

CPR – Child and Infant CPR

2010-09-18T02:34:08Z

ABC’s of Life for Children (1 to Puberty):

Airway: Same as an Adult except look in the airway for a potential choking object that potentially could be removed.

Breathing: Same as an Adult. If giving rescue breaths, give a lower volume of air when giving breaths. Give just enough breath to see the chest rise.

Circulation: Same as an Adult. Remember to Push Hard and Push Fast. Do not hesitate or restrict compressions due to the smaller size of the child. Recognize that performing poor compression equates to poor circulation and cellular injury and death. Attempt to push 1/2 to 1/3 the chest depth of the child. If the child is small in size, you may use one hand instead of two when performing compressions. You may use the second hand to maintain an open airway and stabilize the child during compressions.

ABC’s of Life for Infants (Birth to Age 1):

Airway & Breathing: Same as a Child.

Circulation: Compressions have to performed differently for infants than they would be for larger children and adults due to their smaller size.

To perform compressions on an infant, place the infant on a flat hard surface, face up, and locate the middle of the chest between the breasts. Place two fingers of one hand on top of the sternum about a fingers tips length below the nipple line. Place the second hand the infants head to maintain an open airway and to stabilize the victim. Push on the chest using the two fingers at the rate of 100 compressions per minute at a depth of 1/2 to 1/3 the chest depth. If giving CPR with rescue breathing perform 30 compressions to 2 breaths (30:2 ratio).

Next: Healthcare Provider CPR Considerations

CPR – When to Call or Get Help for Children and Infants in Cardiac Arrest

2010-09-18T02:32:24Z

Due to children and infants going into cardiac arrest most likely to respiratory cause; one must consider the value of outside resources in the life saving effort. You should recognize that time is the enemy, especially in pediatric victims, and delay in treatment or care may result in a poor outcome. The sooner care is initiated for a child or infant – the higher the chance of survivability. Therefore there are special guidelines for when to obtain or call 911 when faced with a pediatric cardiac arrest.

If you are ALONE and FIND an infant or child in cardiac arrest: Perform the steps of CPR immediately without delay for 2 minutes or 5 sets of 30:2 before leaving the pediatric victim to get help or call 911. Due to finding the child and the unknown time involved since collapse, delaying starting CPR may result in cellular injury or death. By performing the steps of CPR for 2 minutes or 5 cycles of 30:2, we circulate blood and oxygen potentially restarting the clock on a poor outcome. This allows us to build the pediatric victim back up with oxygenation before leaving to call 911 or obtain help without fear of causing more harm (at least for a few minutes).

If you witness the pediatric victim collapse or have someone else around: Treat the victim as an adult. Get additional resources and Call 911 (or have someone else do it) immediately then return to the victim and begin CPR.

Cell Phones: If you are alone and have a cell phone it may be possible to call 911 & begin the steps of CPR at the same time regardless if you witness the arrest or not. Remember that time is the enemy.

Next: ABC – Child CPR / Infant CPR

CPR – Differences in CPR for Children & Infants

2010-09-18T02:30:35Z

Defining a child: A child is a victim who is over the age of 1 and up to the age of puberty. Puberty is defined as breast development in females and underarm or facial hair in males. Puberty is used as the establishment of adulthood as developmental changes may effect aspects of CPR. In addition to puberty the overall size of the victim should be considered due to the current epidemic of obese children in the United States. If the victim is the size of an adult – treat them as an adult and not a child – regardless of age or puberty status. An infant is defined as any victim under the age of 1.

Reason for Cardiac Arrest in Children/Infants: Children and Infants suffer from cardiac arrest typically as a result of a respiratory event such as choking or respiratory arrest. Not from a cardiac condition – It is uncommon to hear of a child or infant having a heart attack. Children and Infants typically do not have a history of high blood pressure, smoking, or other conditions that are applicable to adults.

Due to children and infants likely going into cardiac arrest due to respiratory event, we must recognize that oxygenation and circulation need to be initiated as quickly as possible for these age groups.

Hypoxia (or lack of oxygen inside the body) is a reversible cause of cardiac arrest. If oxygenation and circulation are performed quickly and effectively the cardiac arrest may improve or allow the person to recover.

Next: When to Call or Get Help for Children and Infants in Cardiac Arrest

CPR – Rib Fracture

2010-09-18T02:43:06Z

Rib Fracture: While performing CPR, rib fracture is common. You may feel ribs break, feel or hear bone rubbing on bone, or see free floating ribs on the victims chest. Chest compressions should continue without delay or modification. If the person survives the cardiac arrest their ribs will heal. Saving their life out weighs the risk of rib fracture.

CPR – Checking for a Pulse

2010-09-18T02:43:30Z

Checking For A Pulse: Layperson rescuers should not check for a pulse while performing CPR. The average person has little practice in obtaining a pulse therefore it is unrealistic to expect accuracy during an emergency situation. You should assume that unless the victim wakes up during your assessment or shows signs of life during CPR that the person is pulseless and needs CPR to be continued. Healthcare Providers or persons trained in checking for a pulse may do so if they feel comfortable. When checking for a pulse, you should check the carotid pulse (due to sympathetic response). If you check for a pulse and do not feel a pulse or are not sure if a pulse is present begin CPR immediately.

If a person is unresponsive, has a pulse, and CPR is performed: no ill effect (other than rib fracture) or cardiovascular damage will occur. Therefore, always err on the side that the victim is pulseless and begin CPR as soon as possible.

Next: Hands Only CPR

CPR – Circulation and Chest Compressions

2010-09-18T02:43:41Z

The fundamental principle of CPR is that we want blood and oxygen circulating throughout the body at all times. Circulation equates to potentially prolonging and mitigating cellular injury and death. The primary intervention to be performed for circulation is Chest Compressions. Chest Compressions circulate blood and oxygen. When performing CPR with rescue breathing, give 30 compressions followed by 2 breaths (30:2 Compressions to Breaths Ratio). Transition from compressions to breaths and back to compressions as quickly as possible. Your goal should be not to delay compressions for more than 10 seconds to give breaths.

To perform chest compressions effectively remember:
1.) Push Hard and Push Fast
Pushing hard and pushing fast helps keep circulation moving.
2.) Continue CPR continuously without delay or pause unless needed.
Reasons to stop or pause CPR include: The person wakes up/shows signs of life, someone else takes over, to use an AED, or you can no longer continue.
3.) Aim for the rate of 100 compressions per minute.
Think “Staying Alive”

How to Perform Chest Compressions

Make sure the victim is laying flat on their back, face up, on a HARD FIRM SURFACE. The floor is typically the best option in most situations. The transition of the victim from their location to the floor does not have to be a graceful one. You must get them on the floor (or other firm surface) as quickly as possible. Recognize that if the victim is not on a firm surface compressions will likely move the body up and down and not compress the chest (Visualize doing compressions on a waterbed).

Next, quickly remove any clothing covering the chest. This allows us to find the correct location to perform compressions and use an AED when it arrives.

Locate the center of the chest, between the breasts and place the palm of one hand on top of the sternum. Place the second hand on top of the first hand in a manner that is comfortable for you. You may overlay or interlock your fingers. Position yourself over the victim and use your entire body to push up and down on the persons chest. Keep you elbows locked and think of moving at the waist. This ensures you use your entire body to perform compressions. If you use your arms and not your body – your arms will become fatigued quickly and you will not be pushing at the right rate and depth.

Compress the chest at the rate of 100 compressions per minute. Think of the beat of the song “Staying Alive” by the Bee Gees. The beat of “Staying Alive” is 100 beats per minute. If you match compressions with this song – you will be performing compressions at the right speed. Remember to pace yourself so not to get fatigued. After each compression, allow the chest to return to its normal position before compressing again. This chest recoil allows the heart to refill with blood and provide the most effective CPR possible.

If performing rescue breathing, perform 30 compressions, perform a head-tilt/chin-lift, give two rescue breaths (looking for chest rise and fall) and resume compressions as quickly as possible. If performing “Compression Only CPR” simply compress the chest at the rate of 100 compressions per minute without interruption or delay.

Remember that when CPR is not being performed, blood and oxygen are not circulating, and cellular injury and death may occur.

2 Rescuers Present: If another rescuer is arrives or is present during the rescue effort perform CPR as described above expect you may alternate and switch roles as needed. One rescuer should perform 30 compressions and the second rescuer provide 2 rescue breaths. You should change roles every 2 minutes (or 5 sets of 30:2) or as needed to prevent fatigue. When working with another rescuer counting out loud when doing compressions will allow them to know when to give breaths. Teamwork is very important and each rescuer should evaluate the rescue effort and provide feedback as needed.

Next: Checking for a Pulse?

CPR – Mouth to Mouth

2010-09-18T02:17:55Z

Mouth to Mouth breathing is considered the easiest and most readily available option as it does not require any special equipment to perform. Mouth to Mouth breathing is performed by opening the victims airway (head-tilt/chin-lift), covering the victims mouth completely with your mouth, pinching the victims nose (to keep the oxygen from escaping back out the nose), and giving a regular breath for about 1 second into the victim. When giving the breath you should see the chest rise. Let the victim exhale and give the second breath just as you did with the first breath.

If you do not see the chest rise and fall with each breath, readjust the head, making sure you have the airway open and attempt the breaths again. If the breaths do not make the chest rise and fall for a second time – move on to circulation and compressions.

Despite the typically low risks of exposure during mouth to mouth breath many people are hesitant to provide mouth to mouth breathing to someone who they do not know. Mouth to Mouth breathing risks are real and may expose the rescuer to viral infections such as H1N1, the Flu, or Herpes. Rescuers should use their judgment and internal comfort when considering who and when to provide rescue breathing.

Next: Mouth to Mask

CPR – Breathing

2010-09-18T02:16:50Z

ABC’s of Life

A = Airway, B = Breathing, C = Circulation

Breathing: While maintaining an open airway, lower your head down and LOOK at the victims chest, LISTEN for coming out the victims mouth and nose, and FEEL for movement on the victims chest. You should Look, Listen, and Feel for 5 to 10 seconds. If the victim is NOT breathing you should consider giving two rescue breaths.

Rescue breaths are the process of giving artificial breathing to someone who isn’t breathing on their own. When giving rescue breathing, give just enough air (volume) to see the chest rise. Giving too much volume may cause harm to the victim. Simply think of lungs as nothing more than balloons. If you over inflate/hyperventilate a balloon it pops; the same is true with a human lung.

Rescue breaths can be given Mouth to Mouth, Mouth to Mask, or with a BVM or Bag Valve Mask.

In addition to causing injury to the lung over inflation and hyperventilation may cause air to enter the stomach which may induce or cause vomiting. Vomiting is dangerous as it may lead to aspiration and development of pneumonia if the victim survives.

Next: Mouth to Mouth

CPR – Opening the Airway

2010-09-18T02:15:03Z

ABC’s of Life

A = Airway, B = Breathing, C = Circulation

Airway: When a person becomes unconscious, they loose all muscle tone. The tongue being a muscle relaxes and may block the airway (trachea/windpipe) of the victim. The tongue is the most common cause of airway obstruction in an unconscious adult. To mitigate this and reopen the victims airway, we must perform a physical intervention to lift and move the tongue out of the way. The maneuver used to open a victims airway is called a head tilt/chin lift.

With the victim laying face up on a hard firm surface place one hand on the forehead of the victim while grasping the bony portion of the chin with the other. Tilt the head and lift the chin at the same time. This lifts the tongue and creates a pocket for oxygen to travel.

When you open the victims airway you may hear sounds of oxygen or gasses escaping and/or may see fluid, vomit, or froth escape from the victims mouth. Anything blocked from the tongue in the trachea will potentially escape when the airway is opened. Do not confuse this with breathing or stop CPR if this occurs.

Next: Breathing (Assessment & Rescue Breathing)

CPR – Call 911 / Getting Additional Resources

2010-09-18T02:12:52Z

Call 911 / Getting Additional Resources: If your assessment of the victim determines that they are unconscious & unresponsive or not acting appropriately you must call 911 and/or obtain additional resources. If you fail to call 911 or obtain additional resources you will be responsible for providing care indefinitely. An ambulance does not magically appear when someone is injured, hurt, or in cardiac arrest. You must remember to activate Emergency Medical Services (or other appropriate resources) as soon as possible.

Next: Opening the Airway

CPR – Assessing the Victim

2010-09-17T00:20:35Z

Assess the Victim: Upon finding a suspected victim of cardiac arrest and insuring your own safety – you should assess the victim for responsiveness and determine the appropriate actions for that person.

You must remember that things may not be as they appear. Is every person found laying on a sidewalk or in a public place in need of CPR? They may be simply asleep, or under the influence of drugs, alcohol, perhaps be homeless, or even mentally ill. You must determine what situation you are faced with before taking any other actions.

To assess the victim you should tap and shake the victim physically and yell at the victim “ARE YOUR OKAY?”. You want to use enough stimulus that would awaken an average person. The victim may be deaf or hard of earring – by physically shaking and tapping the victim we know with certainty their status.

Check for Medical Information Jewelry: Some victims may have a necklace, bracket, or other item on them that details a known medical condition. You should look for medical information jewelry on all unresponsive victims.

Next: Calling 911/Getting Additional Resources

CPR – Scene Assessment & Personal Safety

2010-09-17T00:15:17Z

Scene Assessment/Personal Safety: You must make your personal safety the top priority in any emergency situation. If you become injured or killed you will not be able to do any good for anyone else. You becoming injured will take resources away from the original victim possibly worsening their outcome. Things may not be as they appear. Evaluate the scene to make sure there is no risk to yourself. Never put yourself in a situation you are not comfortable with. Think BEFORE Acting/Responding. After insuring your safety, evaluate the scene for clues, resources, and additional victims as your approach. Having good situational awareness helps you better help others. Remember whose emergency it is.

THERE IS NO WAY OF CHANGING THE PAST OR REVERSING WHAT HAS HAPPENED TO ANY VICTIM.

YOU WANT TO MAKE THINGS BETTER – NOT WORSE. TRY TO REMAIN CALM.

Next: Assessing the Victim

Hands Only CPR / Compression Only CPR

2010-09-18T02:28:50Z

If you are faced with a victim in cardiac arrest and you do not feel comfortable providing rescue breaths “Compression Only CPR” is an available option to provide care without the risks of expose associated with mouth to mouth breathing. Compression Only CPR is as it sounds. Rescuers perform the steps of CPR without giving breaths to the victim. Compression Only CPR works by circulating the oxygen inside the victim before they collapsed. The oxygen inside the victim will vary based upon the situation but may afford the person a greater chance of survival over doing nothing. In many situations, compression only CPR will be adequate until trained responders arrive. There is little difference in survivability, at least initially, for an out of hospital witnessed cardiac arrest with compression only CPR vs. CPR with rescue breaths.

For more information: How to perform CPR

Next: CPR for Infants and Children

ABC’s of life

2010-09-16T19:25:29Z

What is Cardiac Arrest?

2010-09-16T19:06:33Z

Answer: Cardiac Arrest is when a persons heart stops functioning, beating, and maintaining perfusion.

Insect Bite Pictures

2010-09-16T17:21:06Z

First Aid for Insect Bites

2010-09-16T17:11:45Z

First Aid for Fractures

2010-09-16T17:11:06Z

What is Epistaxis?

2010-09-16T08:01:05Z

Answer: Epistaxis is a nosebleed.

First Aid for Nosebleeds

2010-09-16T08:02:00Z

How to treat a nosebleed

Nosebleeds are a common occurrence. You should treat nosebleeds like other types of external bleeding. Apply pressure to both sides of the nostrils while the victim sits and is leaning forward. Leaning forward helps the blood escape out the nose reducing chances of the blood causing a breathing problem or getting into the victims stomach. Apply consistent pressure for a few minutes. If the bleeding continues, press harder. Do not pack the nose. Call 911 or seek medical attention if the bleeding continues for longer than 15 minutes, is bleeding heavily or is gushing, the victim is having trouble breathing , or is on blood thinners.

What is the number to posion control?

2010-09-16T07:49:55Z

Answer: The number for poison control in the United States is 1-800-222-1222. This universal number will connect you to your local poison control center.

What does a head tilt chin lift do?

2010-09-15T08:13:20Z

Answer: The tongue is the most the common cause of airway obstruction in an unconscious adult. A head tilt chin lift applies tension to the tongue through repositioning of the head and creates a small pocket for oxygen to pass through the trachea or windpipe unobstructed.

What is Emergency Medical Dispatching?

2010-09-15T08:03:54Z

Answer: Emergency Medical Dispatching (or EMD) is a system designed for 911 operators to to assess and approach emergency calls for emergency medical services in an efficient manner. Dispatcher’s trained in EMD gather detailed information regarding the medical event, determine, classify, and dispatch the appropriate emergency responders, and provide pre-arrival instructions to aid the caller in providing care to the patient until the arrival of trained help.

Calling 911

2010-09-16T07:46:21Z

If presented with an emergency situation that exceeds your available resources or you are unsure what to do – someone needs to call 911.

911 is a universal number across the United States that should connect you to your local Police/Fire/EMS dispatch center. When you call 911 remember to stay calm and answer each and every question asked to the best of your ability.

Remember Who, What, Where, and How!

Who? This includes who you are and who needs help.
What is going on? This determines if a fire truck, police officer, or ambulance is needed.
Where? Give the complete address if known. If not, describe the location by looking around and giving any information you can see.
How to reconnect? Always give the telephone number in which you are calling from or can be reached at should you become disconnected.

In addition the 911 dispatcher may ask you a seemingly endless list of questions. Try to remember to stay calm and patient when talking to a 911 dispatcher. Each question is important and helps deliver the most appropriate help to you and those in need. Based on your answers and the given situation the 911 dispatcher may help walk you through any steps that need to be completed before help arrives.

Remember to listen carefully and do as instructed.
Always ask questions if you do not understand what you are supposed to do.
NEVER PUT YOURSELF IN DANGER.
NEVER HANG UP FROM 911 UNLESS TOLD TO DO SO BY THE DISPATCHER.

Phone Systems: In some environments you may have to dial a number such as 9 to get an outside line.
Remember that you may have to dial 9-911 in these situations.