First Aid Updates

American Heart Association and American Red Cross Guidelines 2010 K S Chew School of Medical Sciences Universiti Sains Malaysia

Why Change From A-B-C to C-A-B? AC‡ Minimize delay (30 compressions should be accomplished in approx 18 seconds) ‡ The A-B-C sequence starts with the most difficult steps! (impediment to initiate CPR)

After delivery of 30 compressions. listen. and feel for breathing has been removed from algorithm. . the rescuer opens the victim s airway and delivers 2 breaths.BLS Algorithm Look.

If the victim shows evidence of shock . If the area is unsafe for the rescuer or victim 2.Positioning of Victim ‡ As a general rule a victim should not be moved ‡ The indications to move the victim include 1. If the victim is face down and is unresponsive 3. If the victim has difficulty breathing because of copious secretions or vomiting 4.

o Call EMS rather than drive themselves to hospital .Chest Discomfort ‡ Assume all chest discomfort is cardiac origin until proven otherwise. ‡ The most important intervention is to CALL FOR THE EMS or AMBULANCE.

recent bleeding. or a stroke. . encourage victim to take a tablet of crushed aspirin provided the patient has no allergy to aspirin or contraindication such as bleeding tendencies.Chest Discomfort ‡ While waiting for the EMS arrival.

1988.2:349 360 ‡ Early pre-hospital administration of aspirin reduces mortality in acute MI . oral aspirin.Aspirin ‡ ISIS-2 study clearly established the beneficial effects of aspirin within the first 24 hours to reduce mortality in patients with acute MI.187 cases of suspected acute myocardial infarction. Lancet. or neither among 17. both. Randomised trial of intravenous streptokinase. ‡ ISIS-2 (Second International Study of Infarct Survival) Collaborative Group.

Poisoning ‡ Do not administer anything by mouth for any poison ingestion unless advised to do so by the Poison Center  (Note: In Malaysia. Tel: +604-657 2924) ‡ There is insufficient evidence that dilution of the ingested poison with water or milk is of any benefit as a first aid measure. the National Poison Center is located in Universiti Sains Malaysia Penang. .

Poisoning ‡ Do not administer activated charcoal to a victim who has ingested a poisonous substance unless you are advised to. . There is insufficient evidence to recommend for or against the administration of activated charcoal in first aid setting although 2 small studies suggest that it may be safe to administer.

.Bleeding Control ‡ Best controlled by applying pressure until bleeding stops ‡ Amount of pressure applied and the time the pressure is held are the most important factors affecting successful control of bleeding.

these unproven procedures may compromise the proven intervention of direct pressure . Why? 1.Bleeding Control ‡ Elevation and use of pressure points are no longer recommended to control bleeding. no effect on distal pulses was found 3. hemostatic effect of elevation has not been studied 2.

.Wounds ‡ Superficial wounds and abrasions should be thoroughly washed. ‡ Irrigate with a large volume of warm or room temperature tap water from a reliable source (with or without soap).

.Wounds ‡ Higher irrigation pressures are more effective than lower pressures ‡ Higher volumes are better than lower volumes (within a range of 100 to 1000 mL) ‡ Tap water is as good as (or better than) any other irrigation solution in reducing infection rates.

this applies for abrasion or a superficial injury only.Wounds ‡ The wounds actually heal better with less infection if they are covered with an antibiotic ointment or cream and a clean occlusive dressing ‡ In first aid setting. do not apply . ‡ Ensure that the victim has no known allergies to the antibiotic if in doubt.

‡ R= Rest (the affected extremity) ‡ I = Ice (cold) compression ‡ C = Compressive bandage ‡ E = Elevate the extremity .Soft Tissue Injuries ‡ RICE remains the main components of symptomatic treatment.

Soft Tissue Injuries ‡ Cold application is more effective than heat application ‡ Cold application by mixture of ice and water is more effective than ice alone ‡ Cold application by mixture of ice and water is more effective than refreezable gel pack. .

Soft Tissue Injuries ‡ Cold application is more effective than heat application ‡ Cold application by mixture of ice and water is more effective than ice alone ‡ Cold application by mixture of ice and water is more effective than refreezable gel pack. .

limit application to 10 minutes . edema.Soft Tissue Injuries ‡ Cold application decreases hemorrhage. ‡ To prevent cold injury. and disability. limit each application of cold to periods 20 minutes. pain. ‡ If that length of time is uncomfortable.

Jellyfish Sting ‡ First aid for jellyfish stings consists of two important actions: 1. pain relief . preventing further nematocyst discharge and 2.

a baking soda slurry may be used instead. ‡ If vinegar is not available.Jellyfish Sting ‡ To inactivate venom load and prevent further envenomation. . jellyfish stings should be liberally washed with vinegar (4% to 6% acetic acid solution) as soon as possible for at least 30 seconds.

Jellyfish Sting ‡ For the treatment of pain. . jellyfish stings should be treated with hot-water immersion when possible. after the nematocysts are removed or deactivated.

as a second choice. dry hot packs or. as soon as possible. dry cold packs may be helpful in decreasing pain but these are not as effective as hot water. for at least 20 minutes or for as long as pain persists. or 45°C if there is the capability to regulate temperature).Jellyfish Sting ‡ Instruct victim to take a hot shower or immerse the affected part in hot water (temperature as hot as tolerated. . ‡ If hot water is not available.

Jellyfish Sting How does hot water immersion work? ‡ Marine venoms consist of multiple proteins and enzymes. Direct heat application leads to inactivation of the venom and deactivation of heat labile proteins. and there is evidence that these become deactivated when heated to temperatures above 50 °C. . ‡ Hot water immersion causes modulation of pain receptors in the nervous system leading to a reduction in pain.

dependent for survival on the others . cannot sustain themselves individually.Jellyfish Sting ‡ The Portuguese Man O War is not a jellyfish ‡ Is a cluster of several organisms each highly specialized.

Sign up to vote on this title
UsefulNot useful