Chapter 4 First Aid and CPR Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc.

Objectives Determine what is wrong with an injured or sick client. Perform an initial assessment and a focused exam. Perform cardiopulmonary resuscitation (CPR) for the one-rescuer adult, child, and infant and two-rescuer adult. Chapter 4

Objectives (cont.) Perform responsive and unresponsive foreign body obstructed airway (FBOA) for adult, child, and infant. Successfully complete 16 first-aid and CPR procedures. Chapter 4

Basics of First Aid 4-1 Consent Responsibilities of First Aid Providers Sizing Up the Scene The Initial Assessment Focused Examination Chapter 4

Basics of First Aid First aid is the initial help and care provided to a sick or injured person. It is not a replacement for medical help. Chapter 4

Consent Consent must be obtained before applying first aid to a conscious adult. Consent is implied for an unconscious person. Chapter 4

Responsibilities of First Aid Providers Recognize an emergency based on the client’s appearance, behavior, or surroundings. Make a decision to help. Call EMS if the situation dictates. Chapter 4

Responsibilities of First Aid Providers (cont.) Safely gain access to the client and determine what is wrong. Provide first aid. Stay with the client until EMS arrives. Chapter 4

Sizing Up the Scene Determine the possibility of threats to yourself, the client, and bystanders. Chapter 4

Sizing Up the Scene (cont.) Determine the nature or cause of the illness or injury. Determine the number of sick or injured. Then call EMS if necessary, and report your findings. Chapter 4

The Initial Assessment For a conscious and responsive client, introduce yourself by name, state that you know first aid, and ask if you can help. Based on the client’s response, you can perform an initial assessment. Chapter 4

The Initial Assessment (cont.) Form an impression of the client by asking yourself the following questions: How does the client look? How is the client behaving? Does the client appear to be in distress or pain? Do you see any bleeding? What color is the client? Chapter 4

The Initial Assessment (cont.) For an unresponsive client, follow these steps: Assuming no neck or back injuries, position the client on his or her back. Check for responsiveness by lightly tapping the client on the shoulder and speaking to him or her. If no response, continue with the ABCs. Chapter 4

The Initial Assessment (cont.) ABCs of an initial assessment A – make sure the airway is open. B – check for breathing. C – check circulation by taking pulse. Chapter 4

The Initial Assessment (cont.) Airway – check by using the head tilt-chin lift method. For suspected neck or back injury use the jaw thrust maneuver. Breathing – check for breathing using the look, listen, and feel method. Circulation – check for signs of circulation. Chapter 4

Focused Examination Conduct a focused exam unless the patient requires resuscitation. The focused exam immediately follows the initial assessment. Focused exams need not be performed on clients with minor injuries or illness. NEVER move a client with suspected neck or back injuries. Chapter 4

Focused Examination (cont.) Have someone hold the client’s head, then perform the following steps: Head – look at and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Chapter 4

Focused Examination (cont.) Eyes – gently open the eyes and compare the pupils. They should be the same size. Neck – look and feel for deformities, bruises, depressions, open wounds, tenderness, and swelling. Check for a medical alert necklace. Bracelet on neck? Chapter 4

Focused Examination (cont.) Chest – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Abdomen – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Chapter 4

Focused Examination (cont.) Pelvis – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Legs – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Compare the skin color, temperature, and size of both legs. Chapter 4

Focused Examination (cont.) Arms – look and feel for deformities, bruises, open wounds, tenderness, depressions, and swelling. Compare the skin color, temperature, and size of both arms. Back – slide your hand under the back as far as it will go, without moving the client. Look and feel for bleeding, deformities, bruises, open wounds, depressions, tenderness, and swelling. Chapter 4

Section 4-1 Apply Your Knowledge When should you move a client with a neck or back injury? Answer: NEVER move a client when you think that the client has a neck or back injury. Chapter 4

Cardiopulmonary Resuscitation 4-2 The Chain of Survival Using Barrier Devices and Face Masks Using a Bag-Valve Mask Cardiopulmonary Resuscitation Foreign Body Airway Obstruction Chapter 4

The Chain of Survival Sudden cardiac arrest occurs when the heart suddenly stops beating. Ventricular fibrillation (VF) occurs when the heart stops beating and just quivers. Chapter 4

The Chain of Survival (cont.) Four links in the chain of survival: Early access to EMS. Early CPR. Improves chance of survival twofold. Early defibrillation, or restoration of normal heart rhythm. Early advanced care. Paramedics provide the necessary combination of drugs, airway management, and defibrillation to improve the chances of survival for clients of cardiac arrest, heart attack, stroke, and choking. Chapter 4

Using Barrier Devices and Face Masks Follow appropriate infection control procedures, including use of latex or vinyl gloves and barrier devices. Chapter 4

Using a Bag-Valve Mask A bag-valve mask (BVM) consists of a self-inflating bag and a one-way valve attached to a face mask. A BVM is most effective when two first-aiders work together and use supplemental oxygen. Chapter 4

Cardiopulmonary Resuscitation Three “red flags” for victims of sudden cardiac arrest: No response when spoken to or touched. No breathing or inadequate breathing. No signs of circulation such as coughing, movement, or pulse. Chapter 4

Foreign Body Airway Obstruction Foreign body airway obstruction (FBAO) can occur in clients of all ages. Perform abdominal thrusts or chest thrusts until object is expelled. Chapter 4

Section 4-2 Apply Your Knowledge Name the four links in the chain of survival. Answer: Early access to EMS. Early CPR. Early defibrillation. Early advanced care. Chapter 4

First Aid for Specific Emergencies 4-3 Chapter 4

Emergencies The most common types of emergencies are: Injuries to bones, joints, and muscles Diabetic emergencies Heat emergencies Cold-related emergencies Poisons Heart attack Stroke Minor wounds External bleeding Internal bleeding Shock Anaphylaxis Burns Chapter 4

Section 4-3 Apply Your Knowledge What are four signs or symptoms of an injured extremity? Answer: Deformity Pain and tenderness Swelling Bruising Chapter 4

Procedures in Student Text 4A1 Using a Face Mask – No Trauma 4A2 Using a Face Shield – No Trauma 4A3 Using a Two-Rescuer Bag-Valve Mask – No Trauma 4A4 Using a One-Rescuer Bag-Valve Mask – No Trauma 4B1 One-Rescuer Cardiopulmonary Resuscitation – Adult 4B2 Two-Rescuer Cardiopulmonary Resuscitation 4B3 Cardiopulmonary Resuscitation for Infants and Children Chapter 4

Procedures in Student Text (cont.) 4C1 Foreign Body Airway Obstruction in a Responsive Adult or Child 4C2 Foreign Body Airway Obstruction in an Unresponsive Adult or Child 4C3 Foreign Body Airway Obstruction in a Responsive Infant 4C4 Foreign Body Airway Obstruction in an Unresponsive Infant 4D Heart Attack and Stroke 4E Minor Wound Care 4F Controlling External Bleeding Chapter 4

Procedures in Student Text (cont.) 4G Internal Bleeding 4H Shock 4I Anaphylaxis 4J Burns 4K Injuries to Bones, Joints, and Muscles 4L Diabetic Emergencies 4M Seizures 4N Heat Emergencies 4O Cold-Related Emergencies 4P Poisons Chapter 4

Additional Procedures in Lab Activity Manual LM4-1 Amputation Chapter 4

Chapter 4 Credits Slides 11, 17, 18, 19, 20, and 21 Aaron Haupt