First Aid

CPR-BR Level C
Emergency Action Plan (EAP)
1. Primary Survey (Hastey assessment)
– Check for life threatening problems
– SRABC:
• Safety, Responsiveness, Airway, Breathing and
Circulation

2. Secondary Survey
– Check for non-life-threatening problems
• History
• Vitals
• Head-to-toe
Primary Survey

SRABC:
Survey the scene for safety
– Fire, wire, glass, gas, drugs, thugs
• Unsafe situations:
– call for EMS (emergency medical services)
• Safe situation:
– continue with Primary Survey
PPE (Personal Protective Equipment)

• All open wounds should be covered.

• Breathing apparatus, pocket mask or shield
should be used.

This Photo by Unknown author is licensed under CC

BY-SA.
Primary Survey

SRABC:
• Responsiveness
– Verbally ask the casualty
– Tap and shout – don't get too close and don't
shout in each ear
• Place hand on forehead while tapping and shouting so
they won't sit up and attack you.
– Casualty responds
– get help if needed – move to secondary survey
– Casualty does not respond
– call EMS (emergency medical services)
– Get AED Machine (If available)
 Emergency Medical Service
Call EMS
• Most important step of CPR
• Send a bystander or go for medical help
– Bystander:
• “Hey You (be descriptive) in the blue shirt”
• (What to do) “Call 911”
• (What’s wrong) “We have an unconscious adult”
• (Location) “2240 grant avenue at Shaftesbury High School”
• “Report back to me when you are done” (This way you know
EMS has been called)
• Get the AED Machine
• Get first aid kit
• “Do you understand?”
Primary Survey

SRABC:
• Airway – open the airway
– Look in the mouth
– Open the airway -head tilt, chin lift

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Primary Survey

SRABC:
• Breathing
– 10 to 15 seconds breathing check
– Cold weather exposure 1 minute check
– Look and listen (don't feel)
• Look for the chest rising and falling
• Listen for breathing
• Beware of death breath, when you head tilt chin lift there
might be air escaping that was trapped in the lungs, which
is not considered a breath.

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Primary Survey

SRABC:
• Circulation
– Check the body for signs of life:
• Skin condition
• Bleeding
• Signs of shock

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If the Casualty is breathing....

• Put casualty in the recovery position

and monitor breathing until EMS arrives
Recovery Position
 If the casualty is not breathing,
perform CPR
30 Compressions, 2 breathes repeat
Compressions:
– Middle of chest (sternum), chin over the chest
– Use…
Adults (8 years and up) and children (1-8 years)
• 2 hands and 1/3 chest or 2 inches
Infants (0 to 1 year)
• Two fingers or thumbs and 1.5 inches or 1/3 chest
 If the casualty is not breathing,
perform CPR
30 Compressions, 2 breathes, repeat
Breathes: use a mask or protective barrier
– Open the airway
• Put the heel of your hand on their forehead, 2 fingers
under their chin and tilt.
– Adult (8 years and up)
– Child (1 to 8 years)
– pinch their nose and seal your mouth completely around their mouth
– Fill your lungs with air then breath into the victim twice
– Infant (0-1 year)
• Seal your mouth around their nose and mouth
• Fill your cheeks with air and breathe into them twice
Two Person CPR

• One person breathes, one

person compressions.
• Switch every five minutes or earlier if the first
aider is tired.
• Makes sure to be on opposite side of the
causilty.
• Each person requires their own mask.
AED: Automated External Defibrillator
• Used on unconscious, non-breathing victims
 Steps to use an AED machine
Automated External Defibrillator

1. Turn on AED (Follow AED directions)

2. Connect electrodes
• One pad on right side next to breastbone below collarbone
• Other pad on the opposite side below left nipple
• Toddlers and Infants – one pad on the chest, one pad on the back

3. Press analyze (If the AED has an analyze button

otherwise AED will automatically analyze)
– do not touch patient as AED is analyzing)

4. Press the shock button,

– If AED states a shock is indicated
– clear rescuers and bystanders from patient

5. Resume compressions after delivery of 1 shock

6. Push analyze button after 2 minutes of compressions
– If no analyze button, AED should automatically reanalyze patient’s rhythm
Special Considerations for AED use:

• Remove patient from water or metal surface

• Sweat or hair may affect adherence of pads
• Remove any medication patches
• If you know or suspect a pacemaker implanted in the
area where one of the electrodes is intended to go
(small scar and a matchbox size lump in the chest),
reposition the electrode approximately 1 inch away
• PADS FOR TODDLERS AND INFANTS GO ON
FRONT AND BACK
Only stop CPR if…
• EMS arrives
• Scene becomes unsafe
• Another trained first aider arrives and takes over
• Qualified help arrives and takes over
• You become physically unable
• Casualty shows signs of recovery

(Mr. Bean Video)

Stats

• 17% resuscitation rate outside the hospital.

• 35% resuscitation rate in the hospital.
• Above 50% for children outside the hospital.
• Significantly higher in the hospital.
• AED significantly improves these stats.
 What is the purpose of CPR?
• CPR serves as an artificial heartbeat and an artificial respirator
providing oxygenated blood to the brain and the heart long
enough to keep vital organs alive until emergency equipment
arrives.
Cardio = heart
Pulmonary = lung
Resuscitation = revive, revitalize

• When a person experiences cardiac arrest the heart goes from a

normal beat to an arrhythmic pattern called ventricular
fibrillation, and eventually ceases to beat altogether.
• When the heart stops beating this prevents oxygen from
circulating throughout the body, rapidly killing cells and tissue.

• If CPR is started within 4 minutes of cardiac arrest and an AED is

provided within 10 minutes, a person has a 40% chance of
survival.
Practice Emergency Action Plan:
1. Primary Survey: SRABC
– Survey the scene for safety: Fire, wire, glass, gas, drugs, thugs
– Unsafe - call EMS
– Safe - check responsiveness

– Responsiveness: squeeze and shout

– responds - get help if needed and secondary survey
– no response - call EMS, get AED and first aid kit

– Airway: head tilt, chin lift and check air way for obstructions
– Breathing: look and listen for breathing for 10-15 seconds
– Circulation: check for signs of life
– Skin condition
– Bleeding
– AED machine, 30 compressions, 2 breathes and repeat
What is first aid?
• First Aid is emergency help given to an
injured or suddenly ill person using readily
available materials.
• The objectives of first aid
– Preserve life
– Prevent the illness or injury from becoming worse
– Pain relief
– Promote recovery
Good Samaritan Act

• Differs from Province to Province

– No protection in New Brunswick
• Manitoba is covered by the Good Samaritan Act
• Protects you from being sued or being held liable for
injuries sustained while providing first aid.
• If you offer help you need to stay until they refuse
care, medical care takes over, until they do
not require further help, or too tired to do so.
• You don't have to help someone if you choose not
too... Except in Quebec
Consent
• If a situation arises where you are giving first
aid to strangers, adults can and may refuse
first aid for themselves, or for children or the
mentally impaired for which they are
guardians

• If someone refuses help, call EMS (911)

• You have implied consent if they are

unconscious or children without
guardians.
Emergency Action Plan
2. Secondary Survey – check for non-life-threatening problems
• History
– Signs and symptoms
– Allergies
– Medication
– Past medical history
– Last oral intake (this includes drugs or alcohol)
– Events leading to the situation
If they are unconscious look for medical alerts
• Vital Signs (every 5 to 20 minutes)
– Level of consciousness/response
– Breathing – rate, rhythm, quality
– Skin – temperature and condition
• Head–to-toe
– Visually (deformities, bleeding, contusions etc.)
– With your hands if you have gloves
 Choking
State of Casualty Signs and Symptoms Care and Treatment

Partial -Difficulty breathing -Encourage them to cough

-Wheezing -Place small children and
-Coughing infants face down
-Blue skin -Call 911 if blockage cannot be
CAN MAKE NOISE cleared
Conscious -Hit them on the back

Complete -Unable to breathe -Call EMS

-Unable to speak or cough -Adults & Children:
-Agitated and distressed - 5 back blows
-Gripping throat - 5 abdominal thrusts **Elbows
-Blue skin flared out**
-Rapid loss of (Heimlich maneuver)
consciousness -Infant:
CAN NOT MAKE NOISE -5 back blows
-5 chest compressions
Repeat
Unconscious -nonresponsive -Call EMS
-SRABC
-Compressions
- Faster chest compressions
Choking

• Conscious to unconscious
– Start right at compressions
• Conscious
– SRABC
• 30 compressions (rapid – faster than cardiac arrest)
• 1 breathe, reposition head tilt chin lift if it doesn’t go in
and give the second breathe
• Repeat 30 compressions, 2 breathes without
repositioning
• If you are choking and by yourself
– Take your phone, and a chair and get to a public
space
– Call 911, even if you can't speak
Shock
• Inadequate circulation to the body tissues
• It results when the brain and other vital
organs are deprived of oxygen
• Can be gradual or rapid
• Can be life threatening
Causes of Shock
• Loss of blood
• Breathing problems
• Severe bleeding (external or internal)
• Severe burns
• Spinal cord injuries
• Heart attack
• Medical emergencies (diabetes, allergies,
poisoning, etc.)
• “Crush” injuries
 Shock
• Signs and Symptoms
– Restless or irritable
– Altered consciousness
– Nausea
– Pale or cool or moist skin
– Rapid breathing and pulse
• Treatment
– Call EMS
– W.A.R.T.S
• Warmth,
• Airway,
• Rest & Reassurance,
• Treatment
• Semi-prone position
 Severe Bleeding
External Bleeding Internal Bleeding
Treatment: Treatment:
• Call EMS • Call EMS
• Direct pressure • Ice
• If bleeding does not stop • Treat for shock
from direct pressure only
use a tourniquet.
• Once tourniquet is on
write down the time and
that tourniquet must
remain on until a medical
professional evaluates
the injury.
 Nose Bleeds
• Nose bleeds are rarely dangerous but may be a symptom of a
serious injury
– a fall
– a strike to the nose
– head injury

• Treatment:
– Have the person sit or stand upright to slow down the flow of blood
– Pinch the nostrils for 5 to 10 minutes
– Do NOT tilt the victim's head backward

• Avoid blowing nose for at least an hour after bleeding stops

• If the victim's nose continues to bleed for more than 20 minutes

or if the blood flow appears to be excessive, or if the victim feels
weak or faint call EMS or take them to the nearest emergency
room.
 Sprains, Strains & Fractures
• Sprain - injury to a ligament (connects bones)

• Strain - injury to a muscle or tendon (connect bone to muscle)

– Treatment for sprains and strains: RICE

– Rest the injured limb or body part
– Ice the area
– Compress the area with an elastic wrap or bandage
– Elevate the injured limb or body part if possible to prevent swelling

• Fracture - broken bone

– Typical symptoms of a fracture are:

• Immediate and excessive swelling
• Injured area appears deformed
• Slight movement or contact to the injured area causes excessive pain

– Treatment: call EMS

Sling

- tip to the hip, long line to the spine

-under injured arm, across the body
- knot tied on the injured side or in the middle of
the back of the neck
Head Injury
Natasha Richardson – news article

• Usually caused by a fall or a strike to the head

• Major head injuries can be fatal
• Casualty may appear unaffected, but may have bleeding in the brain
Symptoms of a Major head injury:
– headache
– nausea and/or vomiting
– loss of consciousness
– prolonged disorientation or apparent memory loss
– blurred or double vision
– unequal pupils
– “black eyes” – bruising
– excessive bleeding from an open wound
– clear fluid from nose and ears (CSF Cerebro-spinal fluid)
Treatment:
– Primary Survey
– call EMS
– if the wound is bleeding, treat for an external bleed- Direct pressure
– do NOT leave the victim unattended
– if the victim loses consciousness, you may need to perform CPR
– No devices for at least a month as it causes the brain to swell more
Spine Injuries
• Signs & Symptoms:
– Inability to move arms and/or legs
– Tingling, unusual or absent feeling in limbs
– Unnatural posture
– Slow pulse
– Pale, cool, clammy skin
– In shock

• Care & Treatment:

– Primary Survey
– Call EMS
– Maintain casualties head position
– Stabilize neck and head
– Treat for shock
– If movement is required, log roll and use assistants
– Do not remove equipment (helmet) unless you need to
perform CPR or equipment is impeding airway
Burns
TYPE SIGNS/SYMTOMS TREATMENT
1st • Top layer of skin • Clean, cool and cover
• Red, dry, painful
2nd • Top and 2nd layer of skin • Clean, cool and cover
• Red, blisters, painful
3rd • All 3 layers of skin • Call EMS
• Brown/black and
underneath looks
white/grey
Chemical • Call EMS
• Flush area and cover
• Remove contaminated
clothing
• Treat for shock
Medical Emergencies

• Diabetes
• Seizures
• Drug Overdose
• Anaphylaxis
• Asthma
• Heart Attack
• Stroke
Diabetes
High Low
• dry mouth • headache
• thirsty • dizziness Tired
• weak • hostile
• rapid pulse • hungry
• breath smells fruity or sweet • sweaty
• abdominal pain • rapid pulse
• vomiting • feel faint
• difficulty breathing • cool, clammy pale skin
• confusion • drooling
• drowsiness

Treatment Treatment
• Call EMS • Call EMS
• Check ABC’s • Give sugar under the tongue
• Treat for shock • Check ABC’s
• Treat for shock
Seizures
Signs and Symptoms:
– muscle spasms
– eyes may roll upward
– face and lips may turn blue
– foaming at the mouth
– may lose bladder and bowel control
– vomit

Treatment:
• Call EMS
• DO NOT…
– restrain the person
– place anything between the person's teeth
– move the person unless he or she is in danger or near
something hazardous
– give the person anything to eat or drink
Asthma
• Asthma Attack:
– Triggers (dust, pollens, animals, tobacco smoke
and exercise) cause airways to swell and narrow,
causing wheeze, cough and difficulty breathing.
• Treatment
– Sit the person comfortably upright
– Be calm and reassuring
– Give medication, wait 5 minutes
• if no improvement give medication again
• Still no improvement – call EMS
 Anaphylaxis
Anaphylaxis is a severe allergic reaction can be life-threatening.

Signs & Symptoms: Treatment:

• itchy, red, raised skin (hives) • Call EMS
• wheezing • Check for special medications
• dizziness – Epinephrine – EpiPen – temporary
• swelling of the face and/or tongue • remove safety cap
• press the auto-injector against
• inside of throat might swell outer thigh
• difficulty breathing • hold it in place for 10 seconds
• trouble speaking
• confusion
• loss of consciousness
• shock
Heart Attack & Stroke
• Heart Attack Signs and Symptoms:
– Chest shoulder, arm or jaw pain (uncomfortable pressure)
– Difficulty breathing
– Skin: sweating, pale, cool,
– Nausea
• Stroke Signs and Symptoms:
Face Arms Sentence Time
Treatment is the same for both:
• Call EMS
Heart Attack & Stroke
Treatment is the same for both:
• Call EMS
• Position in a comfortable position
• Loosen tight clothing and keep warm
• Do NOT give anything to eat or drink
• Monitor vitals
• Be prepared to do CPR

For a heart attack you can give 1 aspirin if they

are not allergic
Stroke
Drug Overdose

• Narcan kits.
• Two kinds:
– Nasal and injection.
• May need multiple doses.
• One dose in one nostril
and wait, then one in the
other.
• Continue to alternate
nostrils until EMS arrives.
• Insert fully into the nose
and administer the dose.
Environmental Conditions
• Hypothermia
Signs & Symptoms
– Pale, cold skin – fingernails
– Slow pulse
– Slow shallow breathing
– Absence of shivering
– Blurred or double vision

Care & Treatment

– Call EMS
– Actively warm casualty
– Shelter from cold, rain and wind
– If wet, change clothing
– If conscious, give warm drink
– DO NOT rub affected area or expose to excessive heat
Heat Signs & Symptoms Care & Treatment
Conditions
Dehydration & -Pale, cool, clammy skin -Rest in cool area
Heat Exhaustion -Rapid breathing -Remove unnecessary
-Profuse, prolonged sweating clothing
-Thirst -Cool water to drink
-Cramps in limbs and abdomen -Cool by sponging water
-Loss of skin elasticity (pinch back of -Seek medical help if
hand) severe
-Children – sunken eyes and soft spot

Heat Cramps -Pale, cool, clammy skin -Rest in cool area

-Sweating from exertion -Gently stretch affected
-Cramps in limbs and abdomen muscle
-Nausea -Apply ice
-Uncontrolled spasms in affected -Cool water to drink
muscle -Do not massage muscle
-Avoid activity
Heat Stroke -Flushed hot dry skin -Call 911
-Ceased sweating -Cool casualty
-Irrational -Rehydrate
-Fatigue
-Vomiting
-Seizure
-Coma
The most important part of first aid and CPR….

• Call EMS
– Unconscious or altered level of consciousness
– Breathing problems (difficulty breathing or not
breathing)
– Persistent chest pain or pressure
– Severe bleeding
– Vomiting or passing blood
– Poisoning
– Convulsions, severe headache, or slurred speech
– Injuries to head, neck or back
– Broken bones
THE END!

Practical Test
Written Test
Test Review

1. What is first aid?

2. What are the 4 objectives of first aid?
3. What is the primary survey and when should it be used?
4. What is the Secondary survey and when should it be used?
5. What does SAMPLE stand for and when is it used?
6. When should you call EMS?
7. When do you put someone in the recovery position?
8. When do you perform CPR?
9. When do you use J-strokes?
10. How do you determine if someone is having a stroke? What is the
treatment?
Test Review

11. How do you treat…

1. External and internal bleeds
2. Shock
3. Nose bleeds
4. Sprains, strains & fractures
5. Burns
6. Drug overdose
7. Head injury
8. Spinal injury
9. Asthma
10. Anaphylaxis
11. Heart attack
12. Stroke
13. Diabetic high and low?
14. Seizure