1. CPR & Defibrillation National Units of Competency HLTCPR201B – Perform CPR 22101VIC Course in Automated External Defibrillation Paradise First Aid Pty Ltd – Registered Training Organisation 32268 © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

2. Course Induction & Housekeeping © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0 = Picture of real/makeup injury on next slide  Emergency Exits  Mobile Phones  Breaks  Refreshments  Smoking  Toilets  Certification  Assessment  Policies & Procedures  Enjoy!

3. Legal Considerations First-aiders could be expected to; 1: Act in accordance with their level of training and do so to the best of their ability 2: Stabilise the casualty until advanced assistance is available 3: Maintain a consistent level of training  Scope of Practice  First Aid Code of Practice 2004 (Qld)  Duty of Care / Obligation  Consent  Recording  Negligence © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

4. What is First Aid? Immediate and temporary treatment of a person of sudden illness or injury while awaiting the arrival of medical aid Basic lifesaving skills Doing the best you can with the resources you have © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

5. What is First Aid?  Culturally aware, sensitive and respectful  Reassuring  Confidentiality  Skills & Limitations  Australian Resuscitation Council  Debriefing © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

6. Perform a Scene Survey

7. Emergency Action Plan DRS ABCD  D – Danger  R – Response  S – Send  A - Airway  B - Breathing  C – CPR  D – Defibrillation © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0 Help Defibrillator

8. Danger & Safety Hazard – A source or situation with the potential for harm in terms of human injury or ill-health, damage to property, the environment, or a combination of these. Risk – The potential of the hazard being realised  Environmental / Physical Dangers Fire, fumes, fuel, electricity, gas, trip & slip hazards, visibility, sharp objects, chemicals, bystanders/relatives,  Communicable Diseases Diseases or infections transmitted by bodily fluid or touch  Manual Handling Always follow safe manual handling practices when dealing with first aid situations. Use help to lift if available © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

9. Response Is the casualty conscious or unconscious? “Talk & Touch” COWS C – Can you hear me? O – Open your eyes W – What’s your name? S – Squeeze hands / shoulders © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

10. 000 – Emergency number for all emergency services in Australia 112 – International standard emergency number 106 – Text emergency number (deaf) ICE – In Case of Emergency (mobile phone) Send for Help © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

11. Airway  Remember ‘pistol grip’  Check the mouth before performing head tilt / chin lift  Clear the mouth of foreign material if required © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

12. Breathing “Look, Listen & Feel” for NORMAL BREATHING © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

13. Recovery Position All casualties who are unconscious and breathing normally must go into the recovery position regardless of their injuries. Important Points  Head must have full head tilt  Face should be angled towards the floor Spinal Injuries – Use the spinal log roll if possible © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

14. Important note – Pregnant women must be rolled on to their left side © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

15. Cardiac Arrest Recognition of Cardiac Arrest  Unresponsive  Not Breathing Normally Always ensure that the ambulance has been called. Then start CPR! © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

16. What is CPR? Cardiopulmonary Resuscitation its purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage. Defibrillation and advanced life support are usually needed to restart the heart. © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

17. CPR Ratio 30 Compressions - 2 Breaths Depth 1/3 the depth of chest Rate 100 min Same for Adults, Children & Infants © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

18. CPR If during CPR…  the casualty starts to breath normally - put the casualty into the recovery position - monitor airway and breathing  the casualty vomits or regurgitates - put the casualty on their side and clear the mouth - reassess breathing - continue CPR if needed © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

19. CPR If you are unable or unwilling to give rescue breaths, do chest compressions only. “Any attempt at resuscitation is better than no attempt” © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

20. Hands Only CPR Video

21. When to Stop CPR  Another first aider takes over  Professional help arrives  The casualty starts to breath normally  The situation becomes too dangerous to continue  You become too exhausted to continue  A medical Doctor tells you to stop © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

22. CPR Practical © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

23. Children & Babies  Children 1 – 8yrs  Infants 0 – 1yrs Ratio 30 Compressions - 2 Breaths Depth 1/3 the depth of chest Rate 100 min © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

24. Early Access (call for help) Early CPR Early Defibrillation Early ALS Chain of Survival © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

25. Resuscitation Video

26. Choking Mild Airway Obstruction Treatment  Reassure the casualty  Encourage the casualty to lean forward  Encourage the casualty to keep coughing  Call 000/112 if object is not clearing © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

27. Choking Severe Airway Obstruction Treatment  Call 000/112 quickly, but attend to the casualty first if alone  Give up to 5 firm back blows between the shoulder blades  If unsuccessful – give up to 5 chest thrusts  If casualty becomes unconscious, start CPR © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

28. Choking – Children & Babies © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

29. Defibrillation © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

30. Paradise First Aid Pty Ltd 27/05/2010 V1.0 The Heart Located in the centre of the chest behind the sternum. A muscle (myocardium) comprised of four hollow chambers which fill with blood and empty as the hearts contacts and relaxes. Must have a continuous oxygen supply via the coronary arteries to function effectively Has an electrical action and a mechanical action which work together in a normal healthy heart to circulate blood around the body.

31. Paradise First Aid Pty Ltd 27/05/2010 V1.0 The Electrical Action of the Heart Most muscles in the body require an electrical stimulus from a nerve to make then work The heart is a specialised form of muscle tissue that can generate its own electrical impulse without stimulation from a nerve These impulses travel a well defined pathway through the heart muscle called the conduction pathway The heart muscle responds to the electrical impulses with a mechanical action called a contraction

32. Paradise First Aid Pty Ltd 27/05/2010 V1.0 The Mechanical Action of the Heart The heart muscle receives an impulse from the electrical system The muscle contacts in a synchronised and coordinated motion causing the blood in the four chambers to be pumped around the body and to the lungs After each contraction the heart muscle relaxes which allows the chambers to refill with blood ready for the next contraction This contraction of the heart muscle can be felt as a pulse

33. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Normal Heart Function The electrical impulse is generated by the SA node Is conducted normally through the conduction pathway Causes normal contraction of the heart muscle Normal circulation of blood throughout the body Normal Sinus Rhythm (NSR)

34. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Sudden Cardiac Arrest (SCA) Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs. Can happen to people that appear well and healthy, at any age. The patient will be unresponsive and not breathing normally

35. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Ventricular Fibrillation ‘VF’ Electrical activity within the heart is chaotic and not following the conduction pathway The heart muscle has a useless quivering action and is unable to pump blood around the body This is the most common cause of cardiac arrest and the one most likely to respond to treatment by a defibrillator Often a result of a heart attack (Myocardial Infarction)

36. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Ventricular Tachycardia ‘VT’ A very fast heart rate above 130 beats per minute Can be so fast that the heart cannot refill with blood between contractions causing the heart muscle to be starved of oxygen If this rhythm is not treated it will deteriorate into Ventricular Fibrillation (VF)

37. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Shockable Rhythms Ventricular Fibrillation Ventricular Tachycardia These rhythms can be treated by shocking the patient with a defibrillator

38. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Pulseless Electrical Activity ‘PEA’ Pulseless Electrical Activity is caused when the electrical activity is working correctly, but the mechanical activity is not.

39. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Asystole When all electrical and mechanical activity within the heart has ceased Often described as “flat line”

40. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Non Shockable Rhythms These rhythms cannot be treated by shocking the patient with a defibrillator Chance of survival from these rhythms is low Pulseless Electrical Activity Asystole

41. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Causes of Cardiac Arrest  Heart Attack  Airway Obstruction  Massive Blood Loss  Poisoning  Electrical Shock  Drug Overdose  Drowning  Stroke

42. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Treatment of Cardiac Arrest Danger Response Send for Help Airway Breathing CPR Defibrillation

43. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Automated External Defibrillators (AED)

44. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Preparation of Casualty For Defibrillation Fully expose casualties chest. Remove clothing by ripping or cutting. Do not waste time “undressing” the casualty. Remove all metal objects from the casualties chest. If the casualties chest is wet or sweaty, dry with a towel. Remove any medication patches. Remove casualty from metal surfaces. If the casualty is excessively hairy, shave the chest using a disposable razor. (at the location of pad placement) Ensure that CPR continues at all times when preparing the casualty.

45. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Safety Precautions Ensure no person is in contact with the casualty while machine is analysing or when delivering the shock. Be aware of the explosive properties of oxygen and other substances. Do not place pads over medication patches or implanted pacemakers. Ensure that pads are firmly attached to the casualties chest. Only use batteries, pads and cables supplied for the model of AED.

46. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Pad Placement > 25kg (8yrs +) Right Pad To the right of the sternum Between the collarbone and right nipple Left Pad Outside the left nipple Several inches below left armpit If the pads are applied the wrong was around the AED will still work. Do not remove them once applied, as they may not re stick.

47. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Pad Placement < 25kg (0 – 8 yrs) Front Pad Centre of the chest Between the Childs nipples Back Pad Centre of the back Between the shoulder blades If the pads are applied the wrong was around the AED will still work. Do not remove them once applied, as they may not re stick. If no child pads are available adult pads may be used as per the diagram on the pads. Ensure the pads are not touching each other. If the pads are two large use the front back position.

48. Paradise First Aid Pty Ltd 27/05/2010 V1.0

49. D R S A B C CALL 000 / 112 LOCATE DEFIBRILLATOR ANALYSE SHOCK ADVISED NO SHOCK ADVISED DELIVER 1 SHOCK CPR FOR 2 MINUTES IF NO NORMAL BREATHING CPR FOR 2 MINUTES SWITCH DEFIBRILLATOR ON ATTACH PADS – FOLLOW VOICE PROMPTS

50. Paradise First Aid Pty Ltd 27/05/2010 V1.0 Maintenance Refer to manufacturers instructions The unit may be cleaned with a damp cloth. Do not submerge in water. Pads are single use only. Dispose of once used. Always keep a spare set of pads and spare battery with the AED Daily checks should be made to ensure the AED is operational. Including checking battery status indicator

51. Questions © Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0