CPR/AED and Emergency Response

CPR/AED Overview

• CPR stands for Cardio-Pulmonary Resuscitation.

Scene Size-Up

• First, determine if the scene is safe
• Assess the mechanism of injury and/or the nature of the illness
• Determine if additional resources are needed
• Ascertain how many patients are involved
• Conduct triage if needed, giving priority to life-saving measures rather than triage

Personal Protective Equipment (PPE)

• PPE includes gloves, eyewear, face and mouth shields, and breathing barriers

Good Samaritan Laws

• Volunteer responders are not liable as long as they adhere to their training
• Volunteers should avoid causing harm, cutting, or administering medication

Steps in CPR

• First, check the scene, make sure it is safe
• Ask, "Are you OK? May I help you?" as assessment
• This is implied concent, since you are asking consent
• Next, activate the emergency response plan by calling 911 and sending for a defibrillator
• Use universal precautions
• Remain calm

Patient Assessment

• Trust your instincts when assessing a patient
• Survey the patient for injuries, looking for anything abnormal
• Assess responsiveness
• Look for medical bracelets, necklaces, or cards that may provide vital information
• Look for I.C.E. (In Case of Emergency) information in the patient's cell phone
• Observe vital signs such as skin color, temperature, and respiration
• Do no harm and update EMS

Adult CPR (Ages 8 and Older)

• Establish unresponsiveness
• Have someone call 911
• Have someone retrieve the AED if available
• Immediately start chest compressions
• Provide continuous compressions only
• Use two hands in the center of the chest
• Press down at least 2 inches to reach the heart
• Press at a rate of 100 chest compressions per minute, following the beat of "Staying Alive"
• Open the airway by tilting the head back
• Give 2 rescue breaths for every 30 compressions, continuing until help arrives or the person breathes independently

Child CPR (Ages 1-8)

• Establish unresponsiveness
• Direct someone to call 911
• Begin CPR immediately
• Use one hand in the center of the chest
• Provide 30 compressions
• Open the airway
• Administer 2 rescue breaths, repeating the 30:2 compression-to-breath cycle

Infant CPR (Birth to 1 Year)

• Establish unresponsiveness
• Start CPR immediately
• Get someone to call 911
• Use 2 fingers in the center of the chest
• Give 30 compressions
• Open the airway
• Provide 2 rescue puffs
• Repeat a 30:2 compression-to-breath cycle

Automatic External Defibrillator (AED)

• Can be used from ages 1 and older
• Retrieve the AED unit
• Remove clothing from the patient's chest
• Turn on the AED
• Follow the device's directions
• Shave and/or wipe the skin dry at the pad placement areas
• Do not touch or allow anyone to touch the patient when the device is reading or if a shock is advised

Types of Bleeding

• Common Bleeding: Arterial, Venous, Capillary
• Nose/Mouth Bleeds
• Puncture/Abrasion/Laceration
• Amputation
• Eye Injuries

Controlling Bleeding

• Apply Direct Pressure
• Use Pressure Bandage
• Elevate

Shock

• Shock occurs due to the body's failure to provide enough blood to all vital organs
• Signs and Symptoms include irregular breathing, cold clammy skin, excess sweating, weakness, nausea/vomiting, extreme thirst, dizziness, and altered mental status
• Treatment involves activating EMS, maintaining CAB's (compressions, airway, breathing), placing the patient in a comfortable position, and keeping the patient warm with a blanket
• If the face is pale, raise the feet higher than the heart which is sometimes referred to as "raise the tail."
• If the face is red, raise the head
• Keep the patient calm and do not give fluids

Hypothermia

• Hypothermia occurs when body temperature drops below 95°F (35°C)
• When body temperature drops, the heart, nervous system, and other organs can't function normally
• Hypothermia can lead to complete failure of the heart and respiratory system and to death if left untreated
• It's most often caused by exposure to cold weather or immersion in a cold body of water
• Primary treatments involve warming the body back to a normal temperature

Fractures

• Open fractures occur when the bone end has broken through the skin, and in this case, you must never push the bone end back into the skin
• Angulated fractures occur when the bones are broken under the skin causing deformity in the area
• Internal fractures occur when the bone is fractured under the skin, causing discoloration, swelling, and pain

Muscle and Bone Injuries

• Treat all injuries as breaks
• Splint as you see the injured part presenting
• Splint in a position of comfort
• Immobilize joints above and below the injury
• Never try to reduce or "fix" the injury
• RICE is an effective treatment plan for injuries, which means:
  • Rest: Completely immobilize the injured area
  • Ice: Put ice in a cloth on the injured area
  • Compression: Apply a snug bandage on the area to slow bleeding
  • Elevation: Raise the injured area above the heart

Burns - Thermal

• For 1st-degree burns, flush with cool water until pain subsides, then cover loosely to prevent contamination
• For 2nd-degree burns, flush with cool water until the pain subsides, cover loosely to prevent contamination, do not pop blisters, and seek medical care
• For 3rd-degree burns, call 911, cover the burn with a clean cloth, do not remove clothing stuck to the skin, and treat for shock until help arrives

Burns - Chemical

• Remove as much chemical as possible by brushing it off if dry, or rinsing off if wet
• Flush the affected area with cool water for at least 30 minutes
• Repeat the cool water flush if the burn sensation returns
• Seek medical care if the person shows signs of shock, has extreme pain, is burned through more than the top layer of skin, or is burned on the eye, face, hands, feet, groin, or a large body area

Burns - Electrical

• Call 911 in the event of an electrical burn
• Ensure the victim is no longer in contact with the electrical source
• Check for vital signs and start CPR if needed
• Cover burns with a clean cloth
• Treat for shock
• Burns may be internal or external, so be gentle

Fainting

• If a patient appears faint, place them in a seated position and lower their head between their knees
• If a patient has fainted, place them on their back, elevate their feet 10-12 inches, establish an airway, and loosen any tight clothing
• Assess for life-threatening injuries
• Activate EMS

Seizures

• Stay calm when someone has a seizure
• Move objects out of the way to protect the person from injury
• Do not restrain the person
• Do not put anything in the person's mouth
• Protect the airway and roll the patient if vomiting
• Activate EMS

Breathing Problems

• Asthma
• Anaphylactic shock can result from foods, stings, or inhaled substances
• Activate EMS
• Have an EpiPen if available

Diabetic Emergencies

• Diabetes results when the body fails to produce sufficient amounts of insulin; Insulin helps regulate blood sugar level
• Signs include altered mental status
• When in doubt, give sugar
• Activate EMS

Poison Pathways

• Poison can enter the body through ingestion, ocular exposure, dermal exposure, inhalation, or bites and stings

Snake Bites

• Determine if the snake is poisonous
• Move away from the snake
• Have the patient lie down and remain calm
• Keep the bitten area lower than the heart
• Clean the area with alcohol, soap/water, hydrogen peroxide, or a mild antiseptic

Choking

• The universal sign for choking is wrapping your hands around your throat

Heimlich Maneuver

• The Heimlich Maneuver helps a choking victim
• If someone is choking but conscious, you must get their consent (permission) before treating them

Adult/Child Choking (Conscious)

• Ask if they need help
• Stand behind the victim with your arms around their waist
• Place the thumb side of your fist onto the top of the victim's abdomen, using the belly button as a landmark
• Place your other hand on top of the fist
• Pull up and in repeatedly until the object is expelled or the victim becomes unconscious

Adult/Child Choking (Unconscious)

• Open the victims airway by usuing the head-tilt chin-lift and look for a foreign object in their mouth
• If you see an object, REMOVE IT!
• Continue CPR until the object is expelled or professional help arrives, starting with compressions

Infant Choking (Conscious)

• Check for serious breathing difficulties, ineffective cough, or weak or absent cry
• Support the infant on your knee or lap, keeping the head lower than the feet
• Give 5 back blows between the shoulder blades with the heel of your hand
• Turn the infant over and provide 5 chest thrusts
• Continue until the object is expelled or the baby becomes unconscious

Infant Choking (Unconscious)

• Open the victim's airway by using the head-tilt chin-lift and look for a foreign object in the mouth
• Remove any visible object
• Continue CPR until the object is expelled or professional help arrives