GUIDELINES IN GIVING EMERGENCY CARE

PROCEDURE:
1. Plan of Action
    ** Orientation of team leader and member
2. Gathering needed materials
    ** First Aid Kit should be visible
3. Initial Response
    ** ask for help
    ** intervene action
    ** do no further harm
4. Instruction to helpers
    ** proper instructions politely

EMERGENCY ACTION PRINCIPLE:
1. Survey the scene
2. Do a primary survey of the victim
    ** check consciousness
    ** check the airways
    ** check the breathing
    ** check the vital

- check consciousness 
    ** tap the shoulder 2x or 3x
          > feel the skin
          > pain

- airway
    ** head tilt - chin lift
    ** jaw thrust - spinal chord injury
        (manual stabilize the victim)

- check the breathing
    ** 10 seconds
    ** counting
         1 - 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010
        (if negative breathing, give 2 initial ventilation)
    
Breathing
  L - Look
  L - Listen
  F - Feel

    ** internal obstruction
         > to check internal obstruction: check the:
             *** circulation - 10 seconds
                   adult - carotid pulse
                   child - brachial pulse

    ** Finger Swift

3. Do secondary survey
** ask information to the victim
    > location
    > contact number

ASSIST SAMPLE HISTORY
Signs and Symptoms
Allergies
Medications
Past Medical History
Last Meal Intake
Event Prior

Head to Toe Examination:
  ** check the pupils of both eyes.

CARDIAC ARREST & CARDIOPULMONARY RESUSCITATION (CPR)

OBJECTIVES

* Describe Cardiac Arrest

* Enumerate the criteria  for not starting CPR and when to STOP CPR.

PSYCHOMOTOR

* Demonstrate  how to provide  Cardiopulmonary Resuscitation to an adult, child and infant who have cardiac arrest .

CARDIAC ARREST

   > Is the condition in which circulation ceases and vital organs are deprived of oxygen.

*** Approximately  50% of deaths from cardiovascular  disease occur as SUDDEN CARDIAC ARREST.

*** Sudden Cardiac Arrest is the most common mode of death in patients with coronary artery disease.

*** Almost 80% of out-of-hospital  cardiac arrests occur at home and are witnessed by a family member..

*** Only 4-6% of sudden cardiac arrest victims survive because majority of those witnessing the arrest do not know how to perform CPR.

CARDIOPULMONARY RESUSCITATION (CPR)

   > This is  a combination of chest compression and rescue breathing. 

      This must be combined  for effective resuscitation  of the victim of cardiac arrest.

CRITERIA FOR NOT STARTING CPR

** All patients in cardiac arrest  receive resuscitation unless:

         -- the patient has a valid Do Not Attempt Resuscitation

         -- the patient has a sign of irreversible death: 

             *** Rigor Mortis, Decapitation or Dependent Lividity

WHEN TO S.T.O.P. CPR?

1. SPONTANEOUS signs of circulation are restored.

2. TURNED over to medical  services or properly  trained and authorized personnel.

3. OPERATOR is already exhausted and cannot continue CPR.

4. PHYSICIAN assumes responsibility (declares death, take over, etc.).

TABLE OF COMPARISON ON CPR FOR ADULT , CHILD & INFANT

_________________________________________________________________________

CPR SEQUENCE

STEP 1:

  Survey the scene.

  "The scene is safe!"

  "I found one victim lying on the ground."

    presumed unconscious

  "Give way! 2x

  "I am ___________, a trained first aider. Can I help?"

           --(Granted)--     

STEP 2:

  Check the consciousness.

  "Hey, Hey, Are you ok? 2x"

          --(Unresponsive)--

STEP 3:

  Activate Medical Assistance or Transfer Facility.

  (Get AED if available)

  "Call for medical assistance or transfer facilities  and Report back to me

    while I'm helping  the patient."

STEP 4:

  Check the signs of life by palpating the carotid pulse and the rise and fall of the    patient's chest not more than ten seconds.

  Counting: "1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010"

          --(NO PULSE, NO BREATHING)--

  Note:

    ** For Adult: initial 2 ventilation (Rescue Breaths) eliminated except in cases of drowning or other Respiratory Emergencies.    

    ** For Child and Infant: Retain 2 initial rescue breaths with the exception of a witnessed            sudden collapse in which case you would skip the 2 initial rescue breaths.

STEP 5:

  Start CPR - if patient has No Pulse and Not Breathing

  "Give 5 cycles of 30 compression and 2 ventilation for 2 minutes."

  Counting: 1*2*3*4*5*6*7*8*9*10*11*12*13*14*15*16*17*18*19*20

      1*2*3*4*5*6*7*8*9 and 1 ... Breath... Breath (1 Cycle)

STEP 6: 

  RE-CHECK FOR CIRCULATION after 2 minutes of RB/CPR

  Counting: "1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010"

          --(HAS PULSE, HAS BREATHING)--

STEP 7:

  If patient has REVIVED, PLACE IN RECOVERY POSITION and give needed care.

  Note: 

    ** If at any time an obvious sign of life is found, stop RB/CPR place in recovery position            and monitor breathing.

________________________________________________________________________

HANDS ONLY CPR

(COMPRESSION ONLY CPR)

*** If a person is unwilling or unable to perform mouth-to-mouth ventilation for an adult  victim, chest compression only CPR should be provided rather than no attempt at CPR being made. 

*** If a bystander is not trained in CPR, the bystander should provide Hands-only (Compression-only) CPR for the adult victim who suddenly collapses, with an emphasis to "push hard and fast" on the center of the chest, or follow the directions of the EMS dispatcher. The rescuers should continue  Hands-Only CPR until an AED is available and ready for use or an EMS provider or other responder takes over care of the victim.

*** For witness sudden collapse of any person , steps of opening the airway is eliminated.

STEPS: 

1. Check for consciousness

2. Call local emergency number and get AED

3. Quickly look normal breathing

4. If no breathing give continuous chest compression

5. Push hard and fast

AED

A-AUTOMATED

E-EXTERNAL

D-DEFIBRILLATORS

SOURCE: PHILIPPINE RED CROSS Davao del Norte Chapter 

GOLDEN RULES IN GIVING EMERGENCY CARE

What to DO:
* Do remember to identify yourself to the victim
* Do respect the victims modesty  and physical privacy
* Do be as calm and direct as possible
* Do care for the most obvious injuries first
* Do loosen tight clothing

What Not to DO:
* Do not let the victim see his/her own injury
* Do not leave the victim alone except to get help
* Do not assume that the victim's obvious injuries are the only ones
* Do not make any unrealistic promises
* Do not trust the judgement of a confused victim and require them to make decision.

FIRST AID

FIRST AID  is an immediate care given to a person  who has been injured or suddenly ill.

FIRST AID is available if physician is not yet arrived.

RULE AND RESPONSIBILITIES:
* Bridge between the victim and physician
* Ensures personal safety  for the patient and also by the bystanders
* Gain access to the victim
* Determines and treats to patients life
* Summon advance medical care needed
* Provide medical care for the patient
* Assist emergency technician ambulance and other personnel
* Records all assessment and care given to the patient

OBJECTIVES: 
* To alleviate suffering 
* To prevent added injury and danger
* To prolonged life

CHARACTERISTIC OF GOOD AIDER:
* Gentle
* Resourceful
* Observant
* Tactful
* Impathetic
* Respectable

HINDRANCES:
* Unfavorable surroundings
* Presence of the crowd
* Pressure for the victim and relative

TRANSMISSION OF DISEASES:
* Direct contact
* Indirect contact
* Air burn
* Vector (Ex. Mosquito bites - Malaria)

BSI (BODY SUBSTANCE ISOLATION)
Total Protection of Self:
* gloves
* googles
* facemask
* lab gown

BEFORE AND AFTER FIRST AID:
* wash hand
* protective equipment (PPE)
* equipment cleaning
* disinfecting

FIRST AID KIT CONTENT:
* forcip
* cotton
* gauze pad
* plaster
* scissor
* band aid
* pen light
* gloves
* triangular bandage
* betadine
* occlusive dressing
* tongue depressor
* elastic ruler bandage

DRESSING
      > sterile cloth, used to cover the wound.

USES OF DRESSING:
* controls bleeding
* protect from infection
* absorb liquid  water plasma

BANDAGES
      > any clean cloth material, sterile or non-sterile

USES OF BANDAGES
* control bleeding
* ties splints in place
* immobilize body part
* arm support use as sling

STANDARD SIZE OF BANDAGE --- 40 X 40 X 56

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