First aid Z.Rozkydal •First aid • •Simple techniques maintaining •the life and limiting consequenses •of an acute life threatening condition • •Technical first aid •- basic technical measures • •Basic first aid - by everybody - basic management without special • equipment till proffesionals come - calling proffesional service - transport in particular situations - •Proffesional first aid •- by physicians and medical staff •Cardiopulmonal resuscitation CPR • • •Restoration of vital functions: • •Hearth function •Breathing •Brain function •Aim: maintaining of a mininal blood flow • with oxygen in the brain •The brain has an aerobic metabolism •with consumption of 20 % of blood oxygen/min • •Due to complete arrest of the oxygen flow •into the brain happens after 4 minutes: - irreversible damage of brain cells - irreversible damage of brain functions • •There is no regeneration of neurons! •Mutual dependence: • •In breathing arrest - in 2-3 min. cardiac arrest • •In cardiac arrest - in 30-60 sec. breathing arrest • •CPR • •Free airways • •Breathing • •Chest compressions • • •Examination ( 25 sec) • •Consciousness: speech, painful stimulation, • pupils •Breathing: chest movements • expirations air • cyanosis, pailness •Hearth function: • puls in carotic artery • on the hearth • on main arteries in children •CPR • •A- air •B- breathing •C- circulation •D- drugs •E- ecg •F- defibrilation •Breathing disorder- apnoe • 1. Obstruction of airway (blocked airway) • sinking of the tonque • oedema of airways • foreign body in airway 1. •2. Cardiac arrest • •3. Disorder of the brain, spinal cord, poisoning • shock, disorder of lungs, injury of the chest • 1. 1. •Opening of airways • •Cleaning of the mounth •Tilting of the head back •Lifting of the chin •Esmarch maneuver- 3 in one • •Removal of foreign body: •By hand •Back blow •Heimlich maneuver •Breathing • •Breathe in : breathe out = 1 : 2 • •Frequence 10- 12 breath/ min in adults • 12- 20 breath/min in children •Technique •- mouth to mouth - mouth to nose - mouth to nose and mouth (small children) • •Airway obstruction: • •Back blow •Heimlich maneuver- abdominal thrusts •Coniotomy •Coniopuncture • • •Airway plastic tube •Intubation and ventilation •Cardiac arrest • •Cardiac arrest- asystolia •Fibrilation of ventricles •Bradycardia below 30/min • •Causes: myocardial infarction, shock, • pulmonary embolism, injury to the head • electric injuries, poisoning •Symptoms: no pulse, unconsciousness • no breathing, cyanosis, • mydriasis. • •Recommendation of •American Heart Association 2005 • •Chest compression • •Compression to relief 1: 1 • •Compression: ventilation 30 : 2 • •Old technique: •Compression : ventilation 15:2 in children • •CPR 1. person: continuous chest compression 100/min • without a break for breathing • •2. persons: 10 breathes/min • •Exchange of persons after two minutes • •Check up of the pulse •Fibrilation of the ventricules •Compression of the chest • •Breathe in • •Defribrilation: •One shot biphasic 200 J • monophasic 360 J • •Sufficient CPR replaces only 30 % of normal brain perfusion • •Time of CPR till achieving of vital functions • till medical care is available • till exhaustion of persons • •In hospital 30 min •Outdoors 45 min • •No CPR • •Irreversible signs of the death • •Condition non compatible with the life • •Terminal cases of diseases •First aid is a moral duty of every person • •The law • •Not giving first aid in Czech republic •§ 207 •- everybody- jail up to one year -medical staff- jail up to two years -car accident- jail up to three years • • •