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FIRST AID AND ACCIDENT

PREVENTION

RST YEAR REGULAR


TORY STUDENTS

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CHAPTER ONE

INTRODUCTION
TO
FIRST AID

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Learning objectives
At the end of this chapter the students will be able to

Define first aid

Recognize the reasons why first aid is given

Identify values of first aid

Identify General principles of first aid

Identify general directions for giving first aid

Identify First aid kit


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1.1 Introduction
First aid:- is the emergency care of injured person
before medical care available.
Purpose of first aid
Preserve (sustain) life
Mouth to mouth respiration when breathing has
stopped
Prevent the injuries or illness from becoming
worse(complication). Immobilizing the fractured
bone.
Promote recovery.
Reassure the patient, relief pain
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The need for first aid training is greater than ever
because of population growth through out the
world and due to the increased use of
technological products; such as mechanical and
electrical appliances in everyday use at home,
working place and play areas which make more
people at risk of injury.
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Thus, there is an ever growing demand for first aid
training for personal use.

In general first aid is aimed to help for others,


preparation for knowing what to do during disaster
as well as to help self.

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General principles of first aid
First aid should be confined to
essential only.
Immediate arrest of hemorrhage.
Restoration of circulation and air
way.
Preventing of impending shock and
treatment of shock

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General principles of first aid CON
Immobilization of simple or compound
fracture and dislocation.
Alleviation of pain by simple procedure or
medication.
Assurance of getting well quickly to the victim

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General directions to give first aid
Emergency assessment
Assess the situation- determine what
assistance can be given.
Identify themselves- offer to help.
Assess or diagnose- the condition.
Establish priorities- give appropriate urgent
aid.
Arrange for medical aid.
Prevent cross- infection

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General directions to give first aid
Emergency assessment CON
History taking
Assessment
Be calm him.
Talk, listen, and reassurance the conscious
casualty.
Check safety of casualty and your self
Check breathing, bleeding and level of
consciousness
Get others to help.
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General Direction of First aid con
Problem identification (Diagnosis)
History:-The story of how the accident happened
or the illness.
We can be obtained from:-
The causality ( e.g. I slipped and fall down)
A witness/Evidance
Any history of illness: E.g. Epilepsy, Diabetes
mellitus,
For history of ingested material E.g. Drug,
Alcohol, type of food.
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General Direction of First aid con.
Problem identification (diagnosis)
Symptoms:- sensations and feelings that are
described by the casualty
Eg: I feel pain ,cold, numbness.
Signs:- variations from normal ascertained by
the first- aider.
Eg: Pallor of the inner surface of the eyelids
There may be evidence of poisoning
Eg: Medications, alcoholic smell, bottles and
other containers beside the victims.
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General directions to give first aid
Physical Examination
is included as part of the assessment.
Analysis of bodily function using techniques of
inspection, palpation, percussion & auscultation.
For those who wish to emphasize its importance
analysis may be identified as a separate.

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General directions to give first aid
Physical Examination CON
1. Inspection:-
the act of systematic and deliberate visual observation
to determine the functional status of body parts.
2. Palpation:-
the act of touching and filling body parts with hands in
order to determine texture, temperature, moisture,
motion and consistency of structures.
3. Percussion:-
the act of tapping a portion of the body to elicit sounds
that vary with the density of the underlying structures.
4. Auscultation:-
the act of listening for various sounds

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General Direction of First aid con..
Examining the casualty
Two stages may be required in the examination of
a casualty
Primary examination to determine life-
threatening conditions.
Secondary examination to determine
injuries/illness which normally would not be an
immediate threat to life.

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General Direction of First aid con.
Level of consciousness
Recognition of any change of level of consciousness is important.
1. Full consciousness- the casualty is able to speak and answer
questions normally.
2. Drowsiness- the casualty is easily aroused but lapses in to
unconscious state.
3. Stupor -can be roused with difficulty and the causality
is aware of painful stimuli.
E.g. pin puncture, but not of other external elements like being
spoken to.
4.Coma can not be aroused by any stimuli.

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1.5 Assembling safety equipment and
aids required for emergencies
This is a collection of different materials that used
for giving care for patients in emergency situations
and it includes:-
First aid kit manual: teach you how to treat any
emergency health problems .you should read it
before in order to give first aid immediately in
emergency situations.

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Types of Kits and Supplies
are bags used during cares for an accident.
There are two general types of first aid kits.
A. -unit type kits and
B. -two cabin type kits

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Types of Kits and Supplies CON.
A. Unit - type kits
it has a complete assortment of first aid materials,
put up in standard packages of unit size or multiples of
the unit size and
arranged in case, containing 16, 24 or 32 units
the 16 and 24 unit kits being the most popular
B. Cabinet -type kits
they are made for a wide variety of uses and
range in size from pocket versions to large industrial
kits
they are made to accept packages in different shapes
and sizes.

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Contents of First Aid kits

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First aid kit
1. Alcohol swaps: used to clean wounds before
applying anti-biotic ointment and to sterilize
tweezers.
2. Antibiotic ointment: help to prevent infection.
3. Bandages: adhesive bandages are necessary to
hold a dressing in place.
4. Elastic bandage: to keep injured joints in place
and to prevent further swelling.
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First aid kit
5. Scissors: used to cut medical tapes or an elastic
bandage.
6. Pain reliever: aspirin
7. Instant cold pack: insists in to wound in order to
alleviate swelling. They are for one time use only.
8. Flash light

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CHAPTER TWO

RESPIRATORY AND CARDIAC


EMERGENCIES

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Learning objectives
At the end of this chapter the students will able to:
Define what respiratory distress and failure mean

Identify the respiratory emergencies


Discuss the first aid measure for respiratory
emergencies
Describe and discuss cardiac arrest and its
first aid measure(CPR)

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2.First aid services
Some people under take specific training in order
to provide first aid at public or private events
during filming or other places where people
gather.
They may be designed as a first aider or use
some other title .
this role may be under taken on a voluntary
bases ,use an organization such as the red cross
or as paid employment with a medical contractor.
People performing a first aid role, whether in a
professional or voluntary capacity, are often
expected to have a high level of first aid training .
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2.1 Client management
Priorities for treatment
1. First priority:-
Required immediate treatment and transportation
for condition.

2.Second priority: -
Person for whom treatment and transportation may be
deferred such as: burns, fracture and back injuries.
3.Third Priority: -
Who may receive treatment and transportation last. These
include: minor fracture, minor bleeding, behavioral
disorder.
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2.1 Client management CON
Giving immediate and adequate
treatment
Action: If the cause of the condition is
still active, remove the cause.
E.g. A log of wood on the causalities leg,
contaminated clothing or remove the
causality from the cause, such as traffic,
fire, water, poisonous fumes. etc.
Treatment: Give the treatment you
consider essential to sustain life.
Emergency resuscitation,
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2.1 Client management CON
Promote recovery,
Reassure,
Give any other treatment needed,
Relieve pain,
Control bleeding and shock,
Prevent the condition from becoming worse
(complication),
Cover wounds,
Immobilize fractures, large wounds and any injured
part,
Place the casualty in correct and comfortable
position,
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2.1 Client management CON
Handle gently and carefully at all times,
Move as little as possible,
Protect from cold,
Transport the victim,
Convey the casualty without delay to home or to
hospital,
In a serious case inform a health personal,
A brief written report should accompany the causality
A tactful message should be sent to the family if
necessary to tell the family what was happened and
where he has been taken, unless it has been done by
the police or other authority.

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2.2 Basic ABC rules and procedures
Management of respiratory emergency
Life support includes:- A B C
A= Airway
B= Breathing
C= Circulation

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A. Airway management
Basic techniques for airway patency:
1. Head tilt, chin lift:
One hand is placed on the forehead and the
other on the chin the head is tilted upwards
to cause anterior displacement of the tongue.

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Head tilt, chin lift:

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Airway management...head tilt-chin
lift

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2.Jaw thrust:

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3.Finger sweep:
Sweep out foreign body in the mouth
by index finger (in unconscious patient
only. This is NOT advised in a conscious or
convulsing patient).

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4. Heimlich man oeuvre:
If the pt is conscious or the foreign body
cannot be removed by a finger sweep.
It is done while the pt is standing up or
lying down.
This is a sub diaphragmatic abdominal thrust
that elevates the diaphragm expelling a blast
of air from the lungs that displaces the foreign
body.

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Heimlich man oeuvre:

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Heimlich man oeuvre: for infants

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5. Abdominal trust:

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Airway management
Artificial respiration:- Is the technique of
supplying air to the lungs of a casualty who is
unable to breathe for himself.
When respiratory functions fail for any reason,
it is vital that artificial respiration started
immediately.

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B = Breathing

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Breathing management
1.Mouth to mouth breathing:
With the airway held open, pinch the
nostrils closed, take a deep breath and
seal your lips over he patients mouth.
Blow steadily into the patients mouth
watching the chest rise as if the patient was
taking a deep breath.

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Mouth to mouth breathing:

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2. Mouth to nose breathing:
seal the mouth shut and breathe steadily
though the nose.

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3.Mouth to mouth and nose:
is used in infants and small children.

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Tongue swallowing
If a person loses consciousness, he/she will
lose control of the muscles around the
throat and mouth making them go all floppy,
if they are laid on their back then the tongue
can just flop to the back of the throat and
block air from getting to the lungs.

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Tongue swallowing Management
1. Head tilt chine lift
2. Head tilt neck lift
3. Heimlich maneuver(stomach
pump)This will force the object out.
4. Abdominal thrust

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CHOCKING
It is the inability to breath caused by
blockage of the throat due to
foreign bodies
particularly foods
lodged in the throat
for children-coins
hard candy stuck in their throat.
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Signs and symptoms:
Universal sign of choking is holding
necks with his two hands
Inability to talk
Difficulty of breathing
Inability to cough
loss of consciousness.

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CHOCKING

The universal sign of


choking is when a person
clutches the throat and
appears to be choking or
gasping for breath.

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Chocking management
For babies and small children:
Hold the baby upside-down by the feet and
beat him/her timely between the shoulder
blades.
Lie the child face down over your knee or arm
and beat them(4-5 strokes) sharply
between the shoulder blades.

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Chocking management for babies
and children

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Chocking management
For children (1-8), abdominal thrusts are
used.
As with adults, the abdominal thrusts can
be done with the child standing, sitting, or
supine, but an adult rescuer may need to hold
the child, depending on the childs age and
size.
The procedure is the same as for adults.

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Chocking management

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Chocking management
A different approach is used for infants (<1
year).
Indications of choking include lack of
breathing, gasping, cyanosis, and
inability to cry.
First, position the infant in prone (face down)
position along the forearm with the infants
head lower than the trunk, being sure to
support the head so the airway is not blocked.
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Chocking management For adults
Method A
Tell the patient to lean over the back of a chair
holding on to the seat(bend forward) and the
tenanting him/her sharply 4 to 5 times
between his shoulder blades
Methods B
Hemiliench maneuver or abdominal thrust.

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Chocking management For adults

Heimlinchi maneuver

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Chocking management For adults

Abdominal thrusts

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Chocking management
For unconscious casualty
1. Quickly call out for help to medical aid
2. Place on back on a firm flat surface ,open air
way attempt to ventilate the lung.
3. If un able to ventilate give 5 back blow and
chest thrust.
4. If all does not get into the lung go though
steps again and start artificial respiration.

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Cardio Pulmonary
Resuscitation

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Anatomy of the heart

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How does the heart work?
The right side of the heart receives
deoxygenated blood from the body which it
then pump to the lungs (through the pulmonary
artery) where carbon dioxide is exchanged for
oxygen.

The left side of the heart receives the


oxygenated blood from the lungs (through the
pulmonary vein) which it then pumps through
the atrium to the ventricle; from the ventricle
the blood is pumped through the aorta to the
rest of the body.
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Definition of terms

Coronary Heart Disease the blood supply to a part of


the heart is blocked; that part of the heart not receiving
oxygen begins to die.

Stroke the blood supply to a part of the brain is


blocked; those brain cells not receiving oxygen begin to
die.

Heart attack A sudden severe instance of


abnormal heart function. A heart attack occurs when
the heart is starved of oxygen also called acute myocardial
infarction (AMI).

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Definition of terms
Cardiac arrest
It is abrupt cessation of cardiac pumping
function.
Is a medical emergency

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Definition of terms cardiac arrest
Causes of cardiac arrest
Heart disease
Suffocation
Poisonous gases
Head injury
Drug over dose
Electric shock.

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Cardio Pulmonary Resuscitation(CPR)

What is CPR ?????????

CPR stand for


C = Cardio (heart)

P = Pulmonary (lungs)

R = Resuscitation (recover)
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Cardio Pulmonary Resuscitation (CPR)
Is a combination of mouth-to-mouth resuscitation
and chest compressions that delivers oxygen and
artificial blood circulation to a person who is in
cardiac arrest.

It can be life-saving first aid.

Indicated during cardiac arrest

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Cardio Pulmonary Resuscitation
Most adult cardiac arrests (CA) victims heart is in
ventricular fibrillation (VF) - Abnormal
heart rhythm that prevents the heart from
pumping blood.

CPR will not usually stop VF but plays an


important part in pushing oxygenated blood to
the brain and heart

CPR can double or triple the victims survival


rate
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Cardio Pulmonary Resuscitation
Step one
RAP
Responsiveness-give immediate action
Tap and shout Are you alright?
Activate EMS
If no response Call 911 or send someone
directly to call
Position on back
Place victim supine and on a hard surface.
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Cardio Pulmonary Resuscitation
Step one
RAP
Activate EMS

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Cardio Pulmonary Resuscitation
Step two

Check ABC

Airway

Breathing

Circulation

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Cardio Pulmonary Resuscitation
Step two
ABCAirway
Open the airway using a head tilt lifting of chin.

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Cardio Pulmonary Resuscitation
Step two
ABCBreathing
Tilt the head back and look, listen and feel for signs
of breathing.

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Cardio Pulmonary Resuscitation
Step two
ABCBreathingPinch nose and give two
deep breaths lasting 1 second each.

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Cardio Pulmonary Resuscitation
Step two
ABCCirculation.Check the pulse on
carotid artery using fingers of the other hand.

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Cardio Pulmonary Resuscitation
Step two
ABCCirculation
Assess carotid artery for 5-10 sec
If no pulse start compression

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Cardio Pulmonary Resuscitation
Step three
Compression
Place one palm on the chest between the
nipple line
Interlock your other hand on top of the
hand on the chest
Make sure you have a wide base
Press down firmly and smoothly
(compressing to 1/3 of chest depth) 30
times.
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Cardio Pulmonary Resuscitation
Step three
Compression
Press down 1 -2 inches at a rate of 100
compressions per minute hard and fast
Make sure chest recoils completely
Complete 30 compressions and then
give two breaths.
Until help arrive continue

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Cardio Pulmonary Resuscitation
Step threeCompression

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.

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Cardio Pulmonary Resuscitation
Step four
If available:-Attach automated external
defibrillator

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Cardio Pulmonary Resuscitation
Stop CPR when patient:-
Cough

Open his eyes

Start breathing

Speak

Trained Help arrive


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Cardio Pulmonary Resuscitation
Recovery position
If victim begins breathing and having a pulse then
turn victim to their side with lower arm in front.

Allows them to breathe easily and prevents them


from choking on their tongue or any vomit.

Make sure they are stable, a true left lateral


position, and there is no pressure on the chest to
impair breathing.
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CPR
Recovery Position
Left lateral position (the
reverse of the picture)

First Aid procedure to use if


the person is unconscious,
breathing and have a pulse.

Allows them to breathe


easily and prevents them
from choking on their tongue
or any vomit.
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Cardio Pulmonary Resuscitation
Complications of CPR

Vomiting

Abdominal distension

Rib fracture

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Cardio Pulmonary Resuscitation

CPR for young children and


infants

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Cardio Pulmonary Resuscitation

CPR for young children and infants

CPR steps for children aged eight years or

younger are the same as for adults and older


children, but the technique is slightly different.

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Cardio Pulmonary Resuscitation
CPR for children aged 18 years

Use the heel of one hand only for compressions

Compressing to one third of chest depth.

Follow the basic steps for performing CPR for


adult.

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Cardio Pulmonary Resuscitation
CPR for children aged 18 years

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Cardio Pulmonary Resuscitation
CPR for infants (up to 12 months of age)
Place the infant on their back.

Perform mouth-to-mouth by covering the infants


nose and mouth with your mouth remember to
use only a small breath.

Do chest compressions, using two fingers of


one hand

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Cardio Pulmonary Resuscitation
CPR for infants (up to 12 months of age)

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Respiratory emergencies and artificial
respiration
2.3.1 Definitions
Respiratory emergency- is one in
which normal breathing stops or
in which breathing is reduced so
that oxygen intake is insufficient
to support life.

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Breathing process
Natural breathing is accomplished by
increasing and decreasing the capacity of the
chest and the lung.
Atmospheric air being under pressure,
rushes in and out with the increase and
decrease of chest space.
Respiration: The exchange of gas between alveoli &
blood and blood &cellular.
Inhalation: is the process of bringing air in to the
lungs
Exhalation: is the process of pushing the air out of
the lung

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2.3.3 Causes of respiratory failure
A. Anatomical Obstruction
The most common cause of respiratory
emergency is interference with breathing caused
by the drooping of the tongue back and
obstructing the throat.
Other causes of obstruction that constrict the air
passages are:
Asthma
Diphtheria
Laryngeal spasm
Swelling after burns of the face
Swallowing of corrosive poisons
Direct injury caused by blow
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B. Mechanical Obstruction:

Solid foreign objects lodging in


the respiratory passage e.g.
choking of food
Accumulation of fluids in the back
of the throat (mucous, blood or
saliva)

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C. Air Depleted of Oxygen or Containing Toxic Gases
Asphyxia - may occur due to decreased oxygen in the
air or increased carbon monoxide (CO) or other toxic
gases E.g. mining area, sewer etc.
Explosion hazard-Combustible gases that accumulate
in confined spaces where natural or manufactured
gases are free in the air, and are explosive in certain
concentrations.
The explosion may result if a flame is introduced, if
static electricity is discharged or if an electric switch
doorbell, telephone or other device is used.
Aspiration (Inhalation of vomits)

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D. Additional Causes of Respiratory Failure are:

Drowning
Circulatory collapse (shock)
Heart disease
Strangulation
Compression of the chest e.g. accident
Lung disease e.g. pneumonia
Poisoning by alcohol, barbiturate,
codeine etc.
Electrical shock
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2.3.4 Artificial respiration and
management of respiratory accident
Artificial respiration -is a procedure
for making air to flow into and out of
a persons lungs when his natural
breathing is inadequate or ceases.
Air is moved into and out of the
chest in a process called ventilation.

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2.3.4 Artificial respiration and management
of respiratory accident CON..
A. Objectives:
To maintain an open air way through the
mouth and nose (or through the
stoma/hole)
To restore breathing by maintaining an
alternating increase and decrease in the
expansion of the chest.

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B. General Information
The average person may die in 6
minutes or less if his oxygen supply
is cut off.
Recovery is usually rapid except in
case of carbon monoxide poisoning,
over dosage of drugs or electrical
shock. In such cases, it is often
necessary to continue artificial
respiration for a long time.
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B. General Information con
When a victim revives he/she should be
treated for shock.
A physicians care is necessary during the
recovery period.
Artificial respiration should always be
continued until the victim begins to breath by
himself
He is pronounced dead by a HPs or he is dead
beyond any doubt
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C. Mouth to Mouth (Mouth to Nose) Method
Kiss of Life
Steps in Mouth to Mouth or Mouth to
Nose Respiration:
Determine consciousness by tapping the
victim on shoulder and asking loudly
''Are you OK''?
Tilt the victims head back so that his
chin is pointing upward (fig.1). Check any
blockage in air way

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C. Mouth to Mouth (Mouth to Nose)
Method Kiss of Life con..
Place your cheek and ear close to the victims
mouth and nose. To listen and feel for air to
be exhaled
Look at the victims chest to see if it rises and
falls; for about 5 seconds.
If there is no breathing, pinch the victims
nostrils shut with the thumb and index finger
of your hand i.e. pressing on the victims
forehead.
Blow air in to the victims mouth.
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2.3.4 Artificial respiration and management of
respiratory accident CON..

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2.3.4 Artificial respiration and
management of respiratory accident
CON..
Open your mouth wide.
Take a deep breath
Seal your mouth tightly around the
victims mouth and with your mouth
forming a wide open circle and blow
into the victims mouth (fig.2).
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CON..
Initially give four quick full breaths without
allowing the lungs to fully deflate (empty)
between each breath.
Maintain the head tilt and again look, listen and
feel for exhalation of air and check the pulse for
at least 5 but not more than 10 seconds.
If no pulse and breath do cardiopulmonary
resuscitation (CPR).
If there is pulse and no breath, provide at least
one breath ever
5 seconds or 12 per minute for adults and this
provide sufficient air
If the airway is clear only moderate resistance to
blowing will be felt.
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2.3.4 Artificial respiration and management of
respiratory accident CON..

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CON..
Watch the victims chest to see when it rises.
Stop blowing when the victims chest is
expanded and check for exhalation
Watch the chest to see that it falls.
Repeat the blowing cycle.
For the mouth -to -nose method maintain the
backward head tilt position with the hand on
the victims forehead and use your other hand
to close the victims mouth. (fig.3).

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2.3.4 Artificial respiration and management of
respiratory accident CON..

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CON..
Note: Mouth- to- mouth and -nose resuscitation
are administered for
infants and children as described above except
that the backward head tilt should not be as
extensive as that of adult.
Both the mouth and nose of the infant or child
should be sealed off by your mouth.
Blow in to the infants mouth and nose once
every 3 seconds (about 20 times per minutes).
But in the case of children blow once every 4
seconds (about 15 times per minute).
The amount of air is Determined by the size of
the victim.
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CON..
NB: Nowadays this practice is questioned
by many people as to the possibility of
transmission of HIV/ AIDS and needs
maximum care or needs alternative
procedure to save life in both cases (the
victim and the first aider). Therefore this
needs recent information for better
practice.

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D. Obstructed airway - unconscious victim
If you are not getting air exchange, reposition
the head and again attempt to ventilate.
If you still do not get an air exchange,
immediately turn the victim on his side
towards you, resting his chest against your
knees and administer four sharp blows
between the shoulder blades (fig.4).
Place the victim on his back (supine) and
spread legs wide apart, straddle his hips or
one thigh. This position gives comfort for the
first -aider.
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QUIZ -1
1. Write the Purpose of first aid
2. Write Basic techniques for airway patency:
3. Write Basic techniques for breathing
patency:
4. Write mgt steps of CPR
5. DFN RE.

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