First Aid 2007

                                                                                   Lukas Dadak, MD

                                                               St. Ann's University Hospital, Brno

                                                                                15740@mail.muni.cz

                                          How to survive?

•     Do not kill the patient.



•     Reason of lectures
- to pass the exam
- to know important information for life

                                           How to survive

•     D

•     R

•     A

•     B

•     C

                                               Danger

                                               Danger

•     to you

•     to other

•     to the casualty

•     make sure that no one elso gets hurt. You will not be able to help if you are also a casualty

•     only proceed if it is safe to do so.





                                               Danger

•     look & listen & feel

  –   vehicle on the street

  –   gas in the house

  –   fire

  –   poison, infection

  –   electricity



•     Position the patient on their back.

                                         Basic Vital signs:

•     RESPOND = consciousness

•     A+B       breathing

•     C            circulation

                                           Resposiveness

●      Shout  ‚Are You O.K.?‘, Can you hear me?' , 'What is your name?

●      Shake Shoulder



●      opening eyes

●      movement

●      words

●      unconsciousness

                                             Airway + B

•     open it and keep it open

•     Tilt the head back

                                     Clear airway if necessary

•     with the casualty supported on the side,
tilt the head backwards and slightly down.

•     Open the mouth and clear any foreign object.
Only remove dentures if loose or broken.



                                            Breathing ?

•      Normal = look & listen & feel

  –    movement of chest wall [reg., 10-20/ min]

  –   air flow

  

•      abnormal breathing - "agonal respiration" and is the result of the brain's breathing center
sending out signals even though circulation has ceased.
The key point - sound like grunting, gasping or snoring. It disappears in 2-3 minutes.

•      No breathing

                                           Circulation ?

Signs:

•     normal consciousness

•     normal breathing

•     movement

•     coughing

•     {PULSATIONS  a.carotis}



•     Any doubt = NO circulation

                                          No consciousness
                                            No breathing
                                       No sign of circulation

Cardio Pulmonary Resuscitation

●      Start Basic Life Support

                                         ABC and what next?

•     managing life-threatening problems - ABC, bleeding

•     (turn the casualty to a stable side position)

•     look for

  –   bleeding

  –   burns

  –   fractures. Note any tenderness, swelling, wounds or deformity

                                        Examine the casualty

●       in the following order:

  -    head and neck

  -    chest (including shoulders)

  -    abdomen (including hip bone)

  -    upper limbs

  -    lower limbs

  -     back

  

●      call medical aid as soon as possible

                                      Adult basic life support

                                         Chest compressions

•      Place the heel of one hand on the
 breastbone -- right between the nipples.

•      Place the heel of your other hand on top of the first hand.

•      Position your body directly over your hands. Your shoulders should be in line with your
hands. DO NOT lean back or forward.



•      Give 30 chest compressions. 100/minute

•      Continue cycles of 30 chest compressions followed by 2 breaths.

                  EAR expired air resuscitation (mouth-to-mouth ventilation)  = O2

1.      Knee beside the casualty.

2.      Keep the casualty's head tilted back.

3.      Pinch the casualty's nostrils with your fingers

4.      Lift the jaw forward with your other hand.

5.     Take a normal breath and open your mouth wide.

6.     Place your mouth firmly over the casualty's mouth making an airtight seal.

7.     Breathe into the casualty's mouth.

8.     Remove your mouth and turn your head to observe the chest fall and listen or feel for exhaled
air.

9.     If the chest does not rise and fall, check head tilt position first, then check for and clear
foreign objects in the airway.

10.   Give 2 breaths, then 30 compressions

                                  3 thinks are the most important:

●      Compressions

●      Compressions

●      Compressions