Mini Med School 2013: First Aid Basics Benjamin Lawner, DO Assistant Professor, Department of Emergency Medicine University of Maryland School of Medicine

The Basics of First Aid Bleeding control Airway control CPR

Today’s Lesson Review basic first aid principles Understand bystander CPR Address barriers to first aid and CPR

Barriers to Basics Education Fear of certification Lack of awareness about resources Fear of disease

The First Responder The community! Family and friends Fire department dispatchers People present PRIOR to EMS arrival

Bleeding control Principle of “point” pressure Pressure directly over bleeding wound Use of available material

Bleeding control

Airway control: positioning First do no harm! Avoid obstruction Listen for “snoring” Listen for “gurgling”

Airway control: positioning Turn patient on his/her side Allow secretions to drain Open the airway

Artificial respirations One breath every five seconds Look for chest rise Breathe enough to make chest rise

Cardiopulmonary Resuscitation CPR

The Chain of Survival

The Community’s Role Identify the emergency Call 911 Compress the chest Perform defibrillation, if available

CPR Bystander CPR is one of the most important links in the chain of survival Empowers general public to learn- and perform- CPR Emphasis on compressions

Survival from Cardiac Arrest 5% Survival decreases with every minute Defibrillation less likely to work Advanced care less likely to work Our city can improve!

Compressions Two hands over center of chest Start, do not stop Push hard, push fast 100 / min “Metronome” use important

American Heart Association

British Heart Foundation

What about defibrillation?

The Defibrillator

Defibrillator Readily accessible DOES NOT “jump start” heart Actually “resets” abnormal rhythm Functions as a circuit-breaker Success rates increased when used with CPR

Defibrillator Directions Don’t stop compressions! Uncover and dry chest Apply pads Turn on machine

Defibrillator Directions Machine delivers shock if indicated Will instruct you to resume CPR

Take Home CPR Points Call 911 Push hard, push fast, don’t stop Use of defibrillator if available Learn in person or online

Liability Good Samaritan laws Cannot be successfully sued for acting as prudent layperson

Maryland Law A person…is not civilly liable for any act or omission in giving any assistance or medical care if: 1. The act or omission is not one of gross negligence 2. The assistance or medical care is provided without fee or other compensation; and 3. The assistance or medical care is provided i. at the scene of an emergency ii. In transit to a medical facility; or iii. Through communications with personnel providing emergency assistance

What About Disease ?

Precautions Gloves Commercial barrier devices Hands only CPR Extremely low risk of disease Devices in AED cabinet