Basic Life Support Training Course

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Course Administration
Emergency procedures Facilities first aid, prayers, refreshments and toilets Documentation: class roster and HSE passports Restrictions: smoking, telephones and pagers Introductions: name, company, position and expectations of course
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Course Aims
The aims of the course are to provide attendees with knowledge, understanding and skills: of basic life support use of first aid equipment and materials to administer first aid to stabilise casualties

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Course Objectives
On completion of the course attendees will be able to: recognise a medical emergency list three general steps in an emergency plan describe how to summon help by telephone demonstrate casualty vital signs checks demonstrate victim conscious and unconscious checks explain breathing and heart emergencies signs demonstrate care for victims not breathing, obstructed airways, or in cardiac arrest

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Course Objectives (continued)

demonstrate placing casualty in recovery position demonstrate use of pocket mask demonstrate control of bleeding recognise an injury or sudden illness explain burns injury care describe heart emergency care demonstrate muscle, bone and joint injuries care describe sudden illness care demonstrate movement of casualty from accident site to nearest medical facility
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First Aid
Definition: First aid is the immediate but temporary assistance or treatment provided to a person injured or suddenly becoming ill

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First Aid
The principles of first aid are to: preserve life prevent deterioration of casualty promote recovery of casualty

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Precautions
Treating a casualty: wash hands before and after treatment wear protective latex gloves cover cuts or abrasions with waterproof plasters avoid touching open wounds or wound dressings place soiled dressings in plastic bag clearly marked contaminated waste

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Immediate Response
Initial actions in event of casualties: remain calm assess situation control situation comfort casualties check vital signs diagnose injury or illness evaluate situation summon assistance provide treatment and or transportation
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Urgency
Immediate attention essential if no breathing and no pulse Otherwise within: 4 - 6 minutes brain damage possible 6 - 10 minutes brain damage probable more than 10 minutes severe brain damage or death

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Life Threatening Conditions

Life threatening conditions: asphyxia heart attack severe bleeding shock unconsciousness

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Sudden Illness
Sudden illness may be caused by: brain stroke epilepsy diabetes hysteria or fainting

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Primary Assessment
Assessment: Safety of site Casualty: consciousness airway breathing circulation bleeding injury
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Vital Signs
Primary assessment vital signs: Breathing cycles per minute : Adult 10 - 20 Child 20 - 30 Infant 30 - 40 Pulse beats per minute : Adult 60 - 80 Child 80 - 100 Infant 100 - 140
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Pulse
The rhythmic pulsation of the arteries which can be felt where an artery passes over a bone: radial pulse felt at the wrist carotid pulse felt at the neck

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Consciousness
Levels of consciousness: fully conscious drowsy stupor coma

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Unconsciousness
Causes of unconsciousness: diabetes, heart attack or stroke head injury asphyxia shock, seizure or convulsions bleeding poisoning or allergies heat stroke or hypothermia alcohol or drugs
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Secondary Assessment
Head to toe assessment: Injury or bleeding to: head and neck chest abdomen upper limbs lower limbs and signs of abnormal temperature or skin colour and sweating

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Respiratory Failure
Respiratory failure may be caused by: lack of oxygen airway obstruction swallowing tongue or foreign body chest compression stab wound strangulation or suffocation

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Choking

Choking conscious:

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Choking

Choking unconscious:

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Artificial Respiration

How to perform artificial respiration: 1 breath every 5 seconds (12 per minute)

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Heart Attack
Signs and symptoms of heart attack: severe chest pain radiating to neck, arm and jaw sweating pale, cold, clammy skin rapid, shallow breathing nausea or vomiting sudden collapse
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Heart Attack
Treatment for heart attack: lay casualty down make comfortable and provide reassurance immediately summon medical assistance if unconscious check airway, breathing and pulse if not breathing commence artificial respiration if no pulse commence cardio-pulmonary resuscitation transport casualty to hospital as soon as possible

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Cardio-Pulmonary Resuscitation
Airway Breath Circulation (pulse)

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Cardio-Pulmonary Resuscitation
How to perform CPR: 15 chest compressions and 2 breaths summon medical assistance when casualty stable

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Recovery Position

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Stroke
Stroke is: a cerebral haemorrhage caused by blocked blood vessel in brain or burst blood vessel casualty losses consciousness probable slurred speech possible impaired limb movement possible partial paralysis

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Stroke
Treatment for stroke: lay casualty down loosen tight clothing immediately summon medical assistance if unconscious, check airway breathing and pulse if not breathing, commence artificial respiration if no pulse, commence cardio-pulmonary resuscitation transport casualty to hospital as soon as possible

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Diabetes
Diabetes is inability of pancreas to create sufficient insulin to transfer sugar from blood to cells: diabetics require insulin intravenously to balance bodys sugar requirement if diabetic has too little sugar, can cause insulin shock if diabetic has too much sugar, can cause diabetic coma

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Diabetes
Diabetes signs and symptoms: pale skin colour and sweating rapid pulse confused or aggressive behaviour unconsciousness look for cards, tags or bracelets identifying casualty as diabetic

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Diabetes
Treatment for diabetes lay casualty down make comfortable and provide reassurance if unconscious, check airway breathing and pulse if conscious, treat for shock transport to medical assistance

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Shock
Shock caused by: blood or fluid loss heart attack electrocution lung damage chest injury choking toxic atmosphere allergic reaction

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Shock
Shock signs and symptoms: pale cold skin colour and sweating weakness or giddiness nausea or vomiting thirst rapid shallow breathing rapid weak pulse anxious or confused unconscious or dead
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Shock
Treatment for shock: lay casualty down elevate lower limbs above level of heart make comfortable and provide reassurance loosen clothing summon medical assistance do not give casualty anything to drink avoid overheating or cooling

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Seizure
Seizures are: epileptic fits or convulsions characterised by twitching spasms: can be inherent brain abnormality or caused by: head injury narcotics

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Seizure
Signs and symptoms: unconsciousness falls to ground rigidity jaw spasm temporarily stops breathing in cycles over several minutes with varying degrees of severity

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Seizure
Treatment for seizure: lay casualty down protect casualty from harm check airway, breathing and pulse loosen tight clothing place casualty in recovery position do not place any object between teeth summon medical assistance if casualty does not recover within ten minutes

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Head Injury
All head injuries are serious even if casualty appears normal because: condition may change casualty may become unconscious concussion may develop accumulating blood may cause brain compression all head injury casualties losing consciousness even briefly, must be taken to hospital

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Head Injury
Head injury signs and symptoms:
Concussion Skin Skin colour Cold or clammy Pale Compression Hot or dry Flushed

Pupils
Pulse Breathing Consciousness

Equal
Weak, rapid movement Shallow, rapid Temporary loss

Unequal
Full, slow movement Deep, slow, noisy Deteriorating

Recovery

Gradual

Deteriorating

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Head Injury
Treatment for head injury: check airway, breathing and pulse if breathing, place casualty in recovery position if not breathing, commence artificial respiration if no pulse, commence cardio-pulmonary resuscitation if bleeding from ear occurs, place head on side to drain transport casualty to hospital in recovery position

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Skin

Skin: epidermis dermis fatty tissue

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Blood
Blood circulates the body through: arteries veins capillaries Bleeding occurs when arteries, veins or capillaries are damaged

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Bleeding
Signs and symptoms of external bleeding: bleeding apparent at the source arterial bleeding - bright red, spurts to the pulse rate venous bleeding - dark red, constant flow capillary bleeding mid red, oozes to the wound surface

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Bleeding
Signs and symptoms of internal bleeding: from orifices pale, clammy skin possible bruising and swelling rapid, weak pulse shallow, rapid breathing possibly in pain excessive thirst confusion

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Bleeding
Treatment for external bleeding: apply direct pressure to wound for at least 10 minutes to stop bleeding elevate source of bleeding above level of heart to reduce blood loss excessive bleeding apply pressure to pressure point apply dressing treat for shock monitor pulse, respiration and consciousness transport casualty to medical attention

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Internal Bleeding
Internal bleeding may be caused by: fractured bones skull fractures penetrating trauma crush or compression injury to internal organs medical conditions such as ulcers

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Internal Bleeding
Treatment for internal bleeding: lay casualty down make comfortable and provide reassurance elevate lower limbs above level of heart check for other injuries monitor pulse and breathing transport to medical assistance

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Bleeding from Ears

Bleeding from the ears is indicative of a: blast head injury skull fracture

Signs and symptoms: pain inside the ear history of head injury small amount of blood, may be accompanied by straw coloured fluid
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Bleeding from Ears

Treatment for bleeding from the ear: DO NOT stop the bleeding position casualty so that blood can flow out freely cover the ear with a clean pad securing lightly with bandage of adhesive strapping

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Nose Bleed
Bleeding from the nose is indicative of: sneezing, picking or over enthusiastic nose blow a blow to the nose, or a fractured skull

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Nose Bleed
Treatment: sit casualty down with head well forward pinch the soft part of the nose for 10 minutes instruct casualty to breathe through the mouth and to spit out any blood in the mouth

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Pressure Points

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Wounds
Wound is a break in skin exposing tissue to risk of infection: Wound types: contused laceration incised puncture

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Wounds
Types of wound: Contused Laceration

Incised

Puncture

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Burns
Skin burn injury may be caused by: Thermal burns hot dry burns from naked flames, cigarettes or friction cold burns from liquid nitrogen or carbon dioxide wet scalds from hot liquids or steam Electrocution from electricity or lightening strikes Acid or alkali chemical burns

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Burns

Degree of burn injury: superficial burns partial burns full burns

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Percentage of Burns

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Burns
Treatment for burns: stop burning process if unconscious, check airway breathing and pulse flood affected area with cold water for a least 10 minutes to dissipate heat gently remove restrictive jewellery to minimise infection cover area with clean dry dressing transport to medical assistance

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Electrical Burns
Treatment for electrical burns: isolate electrical source check airway breathing and pulse if not breathing, commence artificial respiration if no pulse, commence cardio-pulmonary resuscitation look for entry and exit burns, cool area between both points as internal burns are not visible summon immediate medical assistance

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Chemical Burns
Treatment for chemical burns; wear appropriate PPE remove casualty from chemical source wash affected area with cold running water for at least 20 minutes remove clothing including footwear keep casualty in well ventilated area to dissipate fumes summon immediate medical assistance

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Poisoning
A poison is any solid, liquid or gas substance that is harmful if entering the body

Poisons enter the body via the: lungs - inhalation digestive tract - ingestion skin - injection or absorption

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Poisoning
Damage caused to body depends on the: dose inhaled, ingested, injected or absorbed period of time in the body age of the casualty health of the casualty

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Poisoning
Effects of poison on the body: local - burning, blistering, swelling general - whole body is affected, unconscious, cessation of breathing immediate - seconds, minutes delayed - hours, weeks, years

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Poisoning
Management of inhaled poison: rescuer to ensure own safety remove casualty from toxic atmosphere treat for unconsciousness resuscitate urgently seek or transport to medical attention monitor casualtys condition

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Poisoning
Management of ingested poison: check consciousness if unconscious, treat and seek medical attention if conscious, attempt to discover nature and source of poison burning around the lips indicates a corrosive, administer water or milk to dilute and seek urgent medical attention if non-corrosive, induce vomiting and seek urgent medical attention monitor casualtys condition
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Poisoning
Management of injected or absorbed poison: discover nature and source of poison wash the entry site and apply dressing treat for shock urgently seek or transport to medical attention monitor casualtys condition

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Snake Bite
Treatment for snake bite: apply firm bandage make casualty comfortable and provide reassurance identify type, colour, pattern of snake immediately transport casualty to medical assistance monitor casualty breathing, pulse and consciousness Do not: attempt to suck poison out apply a tourniquet administer any medicine or alcohol
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Jellyfish Stings
Signs and symptoms: immediate and severe pain irrational behaviour skin blistering after 12 hours

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Jellyfish Stings
Treatment for jellyfish stings: rescue casualty from water pour vinegar over sting site remove any tentacles with blunt edge of knife apply broad bandage over area of sting transport casualty to medical assistance Do not: wash sting site with fresh water rub sting site move a seriously affected casualty unnecessarily
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Eye Injury
Eye injury may be caused by: foreign object, dust or sand in eye wounds inflicted by solid fragment chemical burns exposure to arc welding

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Eye Injury
Signs and symptoms: intense eye pain inability to open eye redness and or swelling in or around eye watering of eye

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Eye injury
Treatment for eye injury: prevent casualty from rubbing eye clean affected eye with eye wash sit casualty down and provide reassurance if foreign body in eye cover both eyes without touching affected area transport casualty to medical assistance

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Chemical Eye Injury

Treatment for chemical eye injury: wash affected eye under clean gentle running water for at least 15 minutes if eye in spasm gently pull eyelids open cover affected eye with eye pad do not allow casualty to rub or touch eye transport casualty to medical assistance

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Arc Eye Injury

Treatment for arc eye: place casualty in darkened room bath eyes with eye wash or in gentle cold running water transport casualty to medical assistance

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Heat Illness
Heat related illness: normal body temperature 370C if body temperature falls below 350C or rises above 410C can seriously disturb cell function

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Heat Faint
Heat faint: Symptoms: dizziness and possible fainting Treatment: lay casualty down in cool shaded area loosen tight clothing make comfortable and provide reassurance

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Heat Cramps
Heat cramps: Symptoms: muscle spasms, weak pulse and sweating Treatment: lay casualty down in cool shaded area loosen tight clothing make comfortable and provide reassurance provide water

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Heat Exhaustion
Heat exhaustion symptoms: normal or low body temperature rapid weak pulse moist, clammy pale skin rapid shallow breathing

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Heat Exhaustion
Heat exhaustion treatment: lay casualty down in cool shaded area elevate lower limbs loosen tight clothing make comfortable and provide reassurance provide water

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Heatstroke
Heatstroke symptoms: hot dry skin slow strong pulse rate noisy breathing mental confusion

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Heatstroke
Heatstroke treatment: lay casualty down in cool shaded area remove outer clothing wrap casualty in cold, wet sheet and keep wet cool until body temperature returns to normal replace wet sheet with dry monitor casualty transport to medical facility

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Hypothermia
Hypothermia: body temperature below 350C Symptoms: shivering confusion no shivering stiffening of limbs unconsciousness irregular heart beat death

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Hypothermia
Treatment: if unconscious, check airway breathing and pulse resuscitate as necessary move casualty to enclosed warm environment wrap casualty to prevent further heat loss allow casualty to gradually to return to normal body temperature transport to medical facility

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Muscle Injury
Strain - overstretching or tearing of muscle / tendon Sprain - overstretching or tearing of ligament at joint Signs and symptoms: pain swelling bruising loss of function Treatment: support, elevate and rest injured limb(s) apply cold compress
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Bones
Fracture types: closed open complicated

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Bone Fractures
Signs and symptoms: pain swelling bruising deformity loss of function

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Bone Fractures
Managing fractures: do not move or straighten limb control bleeding cover open wounds immobilize injured area apply treatment for shock seek or transport to medical assistance

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Joint Dislocation
Dislocation is the displacement of bones at a joint: do not attempt to relocate immobilize injured area apply treatment for shock seek or transport to medical assistance

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Upper Limb
Anatomic
Rigid

Soft

Sling

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Lower Limb
Anatomic

Rigid

Soft

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Spinal Injury
Treatment for spinal injury: do not attempt to move casualty immediately summon medical assistance gently support casualties head with both hands do not release casualties head unless someone else takes over keep casualty warm and provide reassurance do not move casualty, wait for medical assistance

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Managing Multiple Casualties

Summon emergency services Secure scene of accident Determine: life threatening injury casualties airway - breathing difficulty casualties weak or no pulse casualties uncontrolled or severe bleeding casualties unconscious or unresponsive casualties treat in order of priority
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Managing Multiple Casualties

Priority of treatment: Urgent care immediate treatment Delayed Care minor injury Mortally wounded - unlikely to survive

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Moving Casualty
Important factors: do not harm further in moving only move if necessary move as little as possible seek help in moving casualty move entire body as a unit use correct lifting techniques only one person gives commands

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Moving Casualty
Moving techniques: human crutch cradle lift single person snatch and drag two, three of four-hand seat two-man fore and aft lift

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Human Crutch
Human crutch rescue: if not seriously injured assist casualty to stand rescuer places one arm of casualty around rescuers neck and shoulder securely holding casualtys wrist rescuer places free arm around casualtys waist as support remove casualty to safety

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Cradle Lift
Cradle lift rescue for unconscious, not seriously injured, lightweight casualties such as a child: rescuer places one arm behind casualtys back under opposite armpit and around chest rescuer places free arm underneath casualtys legs behind knees from a knees bent crouching position rescuer lifts casualty remove casualty to place of safety

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Single Person Snatch

Single person snatch rescue used when urgent need to move casualty from imminent danger: lift casualty into sitting position from behind support casualty with one leg against middle of casualtys back from a knees bent crouching position, rescuer places legs either side of casualty rescuer places hands under both arms and around casualtys chest lift and remove casualty to place of safety
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Single Person Drag

Single person drag rescue lift casualty into sitting position clasp both hands together or securely grasp clothing lean back taking casualtys weight using legs stand into upright position lifting casualty moving backwards drag casualty to place of safety taking care of obstacles and rescuers personal safety
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Two-Handed Seat
Two-hand seat rescue used with two rescuers: place casualty in seated position rescuers crouch facing each other either side of casualty both rescuers place one hand under casualtys thigh grasping partners hand in a hook grip rescuers place free arm around casualtys back using legs rescuers simultaneously lift casualty remove casualty to place of safety

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Three-Handed Seat
Three-handed seat rescue used with two rescuers used when one limb needs support: place casualty in seated position rescuers crouch facing each other either side of casualty one rescuer places both hands under casualtys thigh, partner places one hand interlocking in three hand grip partner places free arm around casualtys back using legs rescuers simultaneously lift casualty remove casualty to place of safety
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Four-Handed Seat
Four-handed seat rescue used with two rescuers to support heavy casualty capable of using both arms for support: place casualty in seated position rescuers crouch facing each other either side of casualty each rescuer grasps own left wrist with right hand and with free left hand grasps partners right wrist interlock place both hands under casualtys thigh, using legs rescuers simultaneously lift casualty remove casualty to place of safety
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Four-Handed Seat

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Two-Man Fore &Aft Lift

Two-man fore and aft lift rescue used by two rescuers where exit route has obstacles: one rescuer places hands under both armpits of casualty partner rescuer adopts position between casualties legs with knees bent both rescuers simultaneously lift casualty taking care of obstacles and rescuers personal safety remove casualty to place of safety

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