CPR/AED VIDEO Professional Rescuer 3 mins 1. Professional Rescuers (PR) have a duty to act. (see p.1) 2. The purpose of CPR is to provide cardiac and resp. support until more advanced help arrives. 3. see p. 3 4. Protect people who willingly provide emergency care without accepting anything in return. PR are not protected because they have a “duty to “act”. 5. Ask a conscious victim, ask a parent of a child

CPR/AED To obtain consent: State your name You are trained in CPR/1st aid ask if you can help Explain that you would like to assess them Explain what you plan to do

CPR/AED 6. Implied consent: pt. is unconscious confused or seriously injured 7. If the pt. refuses, get more advanced help Do you touch the victim?? What if they become unconscious before help arrives? Can you provide care?

Scenario 2 CPR/AED You enter a travel agency office and the secretary is slumped over her desk and doesn’t acknowledge you when you enter. What would you do in this situation? How do you obtain consent?

CPR/AED 3 step process to evaluate an emergency: CHECK CALL CARE What is the first step in an emergency? “CHECK” or “size up the scene” Why is this the 1st step??? What are you checking for???

Send bystanders to call 911 CPR/AED Send bystanders to call 911 Once you see the scene is SAFE, what is the next part of “CHECK” CHECK THE VICTIM How would you “CHECK” your travel agency worker?? How do you determine consciousness?? Tap. “Are you OK”? Gently shake an infant OR flick the bottom of their foot

CPR/AED Video Initial Assess 6 mins You have determined unconsciousness so what do you need to do??? Perform an initial assessment Video Initial Assess 6 mins “CHECK” for “signs” of life: ABC’s of life AIRWAY BREATHING CIRCULATION

CPR/AED You can see the person is breathing and you check and find a pulse, WHAT position should you place the victim in while you call for help? Recovery position Why do you angle the head towards the floor? allows fluids to drain from the mouth

CPR/AED What if you think the victim has suffered a neck/spinal injury? H.A.I.N.E.S. High arm in endangered spine

“Call First” and “Care First” CPR/AED The next step in the sequence for emergency care is: “CALL” Describe the differences between “Call First” and “Care First” Call First call 911 before providing care Care First provide 2 mins. of care, then call 911

Sudden collapse of a child that has been witnessed CPR/AED CALL FIRST Sudden cardiac arrest Sudden collapse of a child that has been witnessed An unconscious adult An unconscious child/infant with known heart problems or at risk for heart problems

CPR/AED CARE FIRST These are related to RESPIARTORY emergencies verse cardiac emergencies WHY would you want to give 2 mins. of care before calling 911 An unconscious infant/child <12 Drowning, near drowning victim Cardiac arrest with known trauma Drug overdose

So HOW do you determine an adult, child and infant?? CPR/AED So HOW do you determine an adult, child and infant?? Adult >12 years old Child 1-12 years old Infant <1 year old

WHEN should you move a victim??? CPR/AED While you are waiting for help to arrive, do you MOVE a victim???? You can do more harm/injury WHEN should you move a victim??? Scene becomes unsafe You need to reach another victim who is more seriously injury You need provide proper care i.e. victim on staircase

What are the ABC’s of CPR?? CPR/AED The next step in the sequence for emergency care is: “CARE” What are the ABC’s of CPR?? Airway Breathing Circulation

CPR/AED (A) AIRWAY HOW would you check for an open airway?? LOOK LISTEN FEEL WHAT are you looking, listening and feeling for???? How long should you assess this?? No more than 10 secs.

CPR/AED If there are no signs of breathing you may need to open the airway How do you open an airway???? Head tilt/chin lift method Adult: tilt head backward as far as it will go Child: tilt back slightly past neutral position WHY??? Infant: keep in a neutral position

Use the head tilt/chin lift method CPR/AED How would you open the airway of a suspected neck/spinal injury victim??? Jaw thrust maneuver Why??? What should you do if the jaw thrust maneuver does not open the airway??? Use the head tilt/chin lift method WHY????

CPR/AED (B) BREATHING We have established an airway. What should we do next???? GIVE 2 RESCUE BREATHS VIDEO Rescue Breathing 3 mins Rescue breathing provides O2 needed to survive until help arrives ADULTS: 1 breath every 5 secs. ***** INFANTS/CHILD: 1 breath every 3 secs.

Enough to make the chest rise and fall CPR/AED How much air should you breathe into the victim???? Enough to make the chest rise and fall What will happen if you over inflate the lungs? Air will escape into the stomach and they will vomit

CPR/AED Personal Protective Equipment (PPE’s) for CPR VIDEO masks 3 mins 1. Resuscitation Masks They create a complete seal over mouth/nose Can be connected to O2 Prevent against disease transmission while giving rescue breaths 2. Gloves

Reposition the head and try 2 more rescue breaths CPR/AED What would you do if you can not get air to go into the lungs????? Reposition the head and try 2 more rescue breaths If the breaths will still not go in, what must you assume??? Airway obstruction

Most common cause of respiratory emergencies CPR/AED AIRWAY OBSTRUCTUION Most common cause of respiratory emergencies What is the universal sign of someone who is choking?? Clutching the throat

CPR/AED Conscious Choking Adult/Child If victim is coughing/wheezing or able to speak, they can still move air into the lungs ENCOURAGE THEM TO CONTINUE TO COUGH If victim can not speak or cough, Airway is totally obstructed

CPR/AED CONSCIOUS Choking Infant Page 38-39 Support infant’s head/neck Lower infant onto your thigh Keep head lower than chest WHY??? Deliver 5 back blows Deliver 5 chest thrusts Continue until object is dislodged

Total Obstructed Airway of Conscious Adult/Child CPR/AED Total Obstructed Airway of Conscious Adult/Child 5 back blows 5 abd. thrusts Continue until object is forced out or Victim becomes unconscious

Unconscious Choking Adult/Child Continue until victim recovers CPR/AED Unconscious Choking Adult/Child Page 40-41 Use 2 hands in the middle of the chest Deliver 5 chest compressions Look for the object If you see it, sweep it out with your index finger For a child use your little finger Give 2 rescue breaths Continue until victim recovers

Unconscious Choking Infant give 5 chest compressions CPR/AED Unconscious Choking Infant Page 43-44 Keep 1 hand on the infant’s forehead to maintain an open airway Using 2-3 fingers in the middle of the chest, just below the nipple line, give 5 chest compressions

CPR/AED Look for the object Grasp the jaw and pull it forward If you see an object: Using your little finger, slide it along the cheek If you do not see an object DO NOT DO A FINGER sweep Give 2 rescue breaths and repeat the process until the object is dislodged

CPR/AED Chest Compressions for Airway obstruction AND CPR ADULT: 1 ½ -2 inches CHILD: 1-1 ½ inches INFANT ½ -1 inch

CPR/AED (C) CIRCULATION Video CPR 11 mins We have established an airway Given rescue breaths We now need to check for a pulse

If no pulse is palpable, begin CPR CPR/AED Pulse Checks ADULTS: carotid CHILD: carotid INFANTS: brachial If no pulse is palpable, begin CPR

CPR/AED CPR CHEST COMPRESSIONS One Man CPR 1 cycle = 30 compressions/2 breaths for adult, child and infant CPR This equals 100 compressions per minute

CPR/AED When do you stop CPR???? Another trained rescuer arrives to take over An AED is ready to use The scene becomes unsafe You are exhausted MD says to stop Signs of life return

2-Rescuer CPR Adult and Child CPR/AED 2-Rescuer CPR Adult and Child Video 12 mins Page 56-58 1. As 2nd rescuer arrives, 1st rescuer goes to head to give breaths 2. 1st rescuer gives 2 breaths 3. 2nd rescuer finds hand positions and gives compressions Adult cycle ratio = 30-2 Child cycle ratio = 15-2 Note change!!!!!

CPR/AED Do 2 mins. (about 4 cycles) of CPR and then call for “change” At the end of the compression cycle Switch should take less than 5 secs.!!! Be prepared to move!!!

Rescuer providing breaths should be at top of the head CPR/AED 2 Rescuer CPR INFANT Page 58-59 Same sequence Compression ratio is 15/2 Rescuer providing breaths should be at top of the head Rescuer delivering chest compressions should position at feet and use thumbs

CPR/AED 2 rescuer CPR and/or Rescue breathing can use the Bag-Valve-Mask to deliver breaths Must have a tight seal Advantages: delivers more O2 Can be connected to O2 Protect against disease transmission

CPR/AED Scenario on page 61 To respond effectively to cardiac emergencies you must know the chain of survival Early recognition of emergency Early access to EMS CPR AED Advanced medical care

CPR/AED In the event of cardiac arrest, AED should be used as soon as possible AED = Automatic External Defibrillator Video AED 10 mins Read pg. 63 precautions Water NTG pathces Chest hair Provide 1 shock followed by 2 mins. of CPR Then re-analyze heart rhythm

CPR/AED Apply pads per instructions of the AED Remember special guidelines Instruct everyone to stand clear Analyze rhythm Provide 1 shock if indicated follow with 2 mins. of CPR Then re-analyze heart rhythm