Emergency First Aid and Response

Study Notes

Sudden Cardiac Arrest (SCA)

SCA is a major killer worldwide, with over 250,000 deaths per year in the US alone.
Only 5-10% of its victims survive.
Every two minutes, someone suffers from SCA.

Incidence of SCA vs. Other Main Causes of Death

SCA accounts for more than 50% of cardiac mortality.
Autopsies revealed that 90% of victims have Coronary Artery Disease (CAD).
The incidence of SCD is 150 per 100,000 persons annually in industrialized countries.
40% of SCDs occur in people with no prior history of heart disease.

Risk Factors of Sudden Cardiac Death (SCD)

Prior episode of Ventricular Tachycardia (V.TACH)
Low Left Ventricular Ejection Fraction (LVEF)
Previous Myocardial Infarction
Coronary Artery Disease
Family History of SCD
Cardiomyopathy
Congestive Heart Failure
Long QT Syndrome
Right Ventricular Dysplasia

Treatment of SCA

"Chain of Survival" consists of:
- Early access
- Early CPR
- Early defibrillation
- Early advanced life support

Early CPR

Determine if the patient is conscious or not by placing one hand on the patient's forehead and shaking their shoulders gently with another hand.
If the patient is not responsive, start CPR.
Steps preceding CPR include:
- Determining the A, B, C of Basic Cardiac Life Support (BCLS)
- Airway:
  - Head tilt
  - Finger sweep
  - Jaw Thrust
- Breathing:
  - Look: down the line of the chest to see it rise and fall
  - Listen: at the mouth and nose for breathing sounds
  - Feel: for expired air at the patient's mouth and nose
- Circulation:
  - Feel: carotids

Cardiac Compressions

Locate the correct chest compression site, 2 fingers above the xiphoid.
Place the heel of the other hand on the lower end of the breastbone.
Fingers should be off the chest wall.
Continue compressions until the AED is available.

Early Defibrillation

CPR saves time, but the most common cause of SCA is Ventricular Fibrillation (VF), which can only be treated with defibrillation.
The treatment goal is to defibrillate within 3 minutes anywhere in the hospital.
Time is the enemy: the success rate of defibrillation decreases by 7-10% every minute delayed.

Automated External Defibrillators (AEDs)

AEDs are well-suited for use by non-traditional responders, such as flight attendants, firefighters, and corporate emergency response teams.
Today's AEDs are more practical for use in the workplace and public places, with voice prompts and self-tests that are virtually maintenance-free.
Types of AEDs:
- Semi-Automatic: analyzes the patient's rhythm and advises if a shock is needed; the operator must press the "shock" button to deliver the shock.
- Fully Automatic: analyzes the patient's rhythm and delivers the shock if required, all by itself.

Importance of Early Defibrillation

The American Heart Association (AHA) expanded its early defibrillation standard of care to include AEDs for in-hospital first responders in 1990.
Resuscitation committees often emphasize the arrival of the core team rather than the delivery of the first shock.
Treatment goal: defibrillation within 3 minutes anywhere in the hospital.

Description

This quiz covers emergency first aid and response procedures for various situations, including cardiac arrest, drowning, injuries, and poisoning. It also covers practical skills such as artificial respiration, external cardiac massage, and transportation of injured patients.