Standard First Aid CPR & AED.

What Is First Aid?

• The immediate care for victims of

injuries or sudden illness.
• Does NOT replace the need for
medical care
 Unexpected Scenario Office

You are your desk at work a co worker frantically comes to you saying
a colleague has collapsed and not responding, other workers start
gathering around the fallen person.
• The individual is not responding.
• Another worker says to you he was just outside with them a minute
ago they were taking a smoke break.
• You have to attend to the person.

What will you do ?

 Unexpected Scenario Pt.1

You are your desk at work a co worker frantically comes to you

saying a customer at their counter has collapsed and not
responding, others customers start gathering around the fallen
person. The individual is a female and has a young child with her.

You have to attend to the person.

What will you do ?

 Unexpected Scenario Pt.2

While checking the person you only realize they suddenly stop
breathing.

What are your actions.

Course Introduction
 Importance of First Aid

• It is better to know first aid and not need it that need it

and not know it.
• Goals of first aid:
► Preserving life
► Alleviating suffering
► Preventing further illness or injury
► Promoting recovery
Legal Aspects of First Aid: Agree or Disagree?

1. Before giving first aid to an alert, competent adult, you

must get consent.
2. If you ask an injured adult if you can help and he or she
says “No,” you can still give first aid.
3. People designated as first aid providers by their
employers must give first aid while on the job.
4. First aid providers can be sued.
5. There are laws that provide protection against lawsuits
for first aiders.
 Legal Aspects of First Aid

• Legally you may not have to help another person, but

most people believe it is a moral obligation.
• Good Samaritan laws provide protection against
lawsuits. The following conditions must be met:
► You are acting with good intentions.
► You are providing care without expectation of compensation.
► You are acting within the scope of your training.
► You are not acting in a grossly negligent manner.
First Aid Supplies
 AHA Stats 2018

• Earlier this year, the American Heart Association released statistics

about cardiac arrest fatalities. Incorporating these numbers into your
presentations will reinforce with students that they can save lives
with the training they are receiving. All numbers are for outside-the-
hospital incidents in the U.S.
• Over 356,000 cardiac arrests happen annually (approximately 347,000
adults and over 7,000 children under age 18)
• Nearly 90% of cardiac arrests are fatal
• Overall, 12.4% of cardiac arrest victims survive to hospital discharge
• When bystanders used an AED on a cardiac arrest victim, 49%
survive to hospital discharge
Action at an Emergency
Action at an Emergency
 When to Call 8-1-1
• According to the American College of Emergency
Physicians (ACEP), you should call 8-1-1 for help if you
answer “yes” to any of the following questions:
► Is the condition life-threatening?
► Could the condition get worse on the way to the hospital?
► If you move the person, will it cause further injury?
► Does the person need the skills or equipment of EMS?
► Would distance or traffic cause a delay in getting the person to the
hospital?
 Seeking Medical Care: Agree or Disagree?

1. When unsure about an injury or sudden illness, call 8-1-

1 or seek medical care.
2. When calling 8-1-1 give as much medical information as
you can to the dispatcher.
3. For most bloody nose incidents, would you call 8-1-1.
4. Over 50% of the population in Trinidad & Tobago are
covered by some type of 8-1-1 service.
5. Call 8-1-1 for a person who is vomiting blood.
6. The dispatcher will ask for the person approximate age.
Recognizing Emergencies

• Bystanders are a
vital link between
EMS and the
victim.
Deciding to Act

• Size up the scene

► Are there any
hazards?
► What happened?
► How many victims are
there?
Recognising an Emergency
 Seeking Medical Care

• For serious situations, call

EMS right away.
• To receive emergency
assistance, dial 8-1-1 in
most communities.
 Call 8-1-1 (1 of 2)

• Dispatcher will ask for:

► Your name and phone
number
► Victim’s location
► What happened
► Number of victims
► Victim’s condition
 Call 8-1-1 (2 of 2)

• Do not hang up unless

the dispatcher tells
you to.
• Dispatcher may
advise you how to
provide care.
• However there are
risks involved.
 Disease Transmission (1 of 2)

• Rescuers should understand the risk.

• Precautions can help protect against bloodborne and
airborne diseases.
► Bloodborne: Hepatitis and HIV/AIDS
► Airborne: Tuberculosis
 Disease Prevention: Agree or Disagree?

1. When giving first aid, wear disposable gloves to prevent

contact with blood and body fluids.
2. When possible, wear latex-free gloves.
3. You do not need to wash your hands after giving first
aid if you have been wearing gloves.
4. Use an alcohol-based hand cleaner when soap and
water are not available.
5. Clean a blood spill by spraying or washing the area with
one to ten ratio using chlorine.
Bloodborne Video
 Disease Transmission (2 of 2)

• Protection
► Hepatitis B vaccine
► Personal protective equipment (PPE)

– Medical exam gloves, protective eyewear,

mask, and breathing devices
►Hand washing
HEPATITIS
GLOVE REMOVAL SKILL
Glove removal practical

Finding Out What’s Wrong

 Scene Size-Up: Agree or Disagree?

1. Emergency scenes can be unsafe.

2. Every time you approach an emergency scene, perform
a scene size-up.
3. Most emergency scenes involve multiple people.
4. Move bystanders aside; they are not helpful.
5. While approaching a person, you should have a first
impression of whether the person is injured or ill, or
you should have a good idea of whether the person is
responsive or unresponsive.
 Scene Size-Up

• You should perform a scene size-up every time you

respond to an emergency.
• As you approach the scene, ask yourself:
► Are dangerous hazards present?
► How many people are involved?
► What is wrong?
► What happened?
► Are bystanders available to help?
 Scene Size-Up: Scenario 1

You are the first to arrive at a motor-vehicle crash scene

involving two cars. One vehicle contains two persons who
appear to have minor injuries resulting from the seat belts and
just shaken up . In the other vehicle, the driver appears to be
motionless and unresponsive.
Emergency Removal
 Primary Check

• Responsiveness
► Shout then tap.
• Breathing
► Check at same time as
responsiveness.
► Look at chest and face.
► Abnormal sounds?
• Check for
severe/obvious
bleeding.
 Positioning the Victim

• Unresponsiveness
► Position on the back.
• Vomiting/
secretions
► Position on the side.
– Recovery position
Recovery Position
Secondary Check (1 of 3)

• Physical check
• Look and feel for
abnormalities.
• Use D-O-T-S:
• Deformity
• Open wounds
• Tenderness
© Jonathan Noden-Wilkinson/ShutterStock, Inc.

• Swelling
Secondary Check (2 of 3)

• Gather information.
• Use SAMPLE:
► Signs/Symptoms
► Allergies
► Medications
► Past medical history
► Last oral intake
► Events leading to the injury or illness
Secondary Check (3 of 3)

• Medical information tags

may identify allergies,
medications, or medical
conditions.

© LiquidLibrary
Finding What's Wrong
 Finding What is Wrong: Agree or Disagree?

1. Always do a complete head-to-toe physical exam on an

injured person.
2. “Unresponsive” refers to a person who can open his or
her eyes, talk, or move.
3. Use DOTS to remember what to look for during a
physical head-to-toe exam.
4. Use SAMPLE to help recall what to ask about the
person’s medical history.
5. Look for a medical identification tag for all injured and
suddenly ill people.
Bleeding and Wounds
 External Bleeding (1 of 2)

• Three types
► Capillary (oozing)
► Venous (flowing)
► Arterial (spurting)
 External Bleeding (2 of 2)

• Open wounds
► Abrasion

► Laceration

► Incision

► Puncture

► Avulsion

► Amputation
 Care for Serious External Bleeding (1 of 2)

• Wear gloves if
available.
• Expose wound.
• Cover with clean
cloth or gauze.
• Apply direct
pressure.
Heavy Bleeding
Bleeding Control

• Avoid contact with blood by

putting on disposable exam
gloves.
• To control bleeding:
► Place a gauze dressing over the
wound. If not available, use your
gloved hand.
► Apply direct pressure.
► If the dressing becomes blood-
soaked, add more dressings onto the
first one and press harder and wider
over the wound.
 Tourniquets

• If direct pressure fails to

control bleeding on an arm or a
leg, apply a manufactured
tourniquet 2 to 3 inches (5 to 7
cm) above the wound.
► Tighten the tourniquet until the
bleeding stops, then secure it in
place.
• Manufactured tourniquets appear
to be better than those that are
improvised.
Tourniquets Video
 Hemostatic Dressings

• Apply a hemostatic dressing

if:

Courtesy of Z-Medica.
► Direct pressure is not
effective in controlling
bleeding.
►A tourniquet is not available,
is ineffective, or cannot be
applied.
• Apply a hemostatic dressing
in combination with direct
pressure followed by a
pressure bandage.
 Wound Infection
• Signs of infection
— Swelling

— Reddening

— Warmth

— Throbbing

— Pus discharge
• Seek medical care for infected wounds.
• Get tetanus booster shot every 10 years
 Wounds That Require Medical Attention

• Arterial bleeding • Possibility of noticeable

• Uncontrolled bleeding
• Deep wounds
• Large or deeply embedded
objects
• Human or animal bite
scar
• Cut eyelid
• Serious internal bleeding
• Uncertain how to treat
• Requires a tetanus shot
 Internal Bleeding

• Skin is not broken and blood is not seen.

• Recognizing internal bleeding
► Bruising
► Painful, tender area
► Vomiting or coughing up blood
► Black or bright red stool
 Care for Minor Internal Bleeding

• Bruised arm or leg

► Apply ice for 20 minutes.
► Apply compression for 2 hours.
► Elevate if there is no fracture
 Care for Serious Internal Bleeding

• Call 8-1-1.
• Care for shock.
• If vomiting occurs, roll victim onto his or her side
What Causes Nose Bleeds ?
Nose Bleed - video
 Care for Nosebleeds

• Sit and lean the

victim slightly
forward.
• Pinch nose for
5–10 minutes.
• Seek medical
care if bleeding
cannot be
controlled.
 Nosebleeds: What to Do
• If bleeding has not stopped after 10 minutes:
► Have the person gently blow his or her nose to get rid of ineffective
blood clots.
► Pinch the nostrils together again for 10 minutes.
► Try other methods, such as applying an ice pack or spraying
decongestant spray in nostrils.
• If bleeding reoccurs, seek medical care.
Applying Direct Pressure
 Bleeding Control: Agree or Disagree?

1. Most cases of bleeding require more than direct pressure to

stop it.
2. While trying to stop bleeding, remove and replace blood-
soaked dressings.
3. If a bleeding arm wound is not controlled through direct
pressure, apply pressure to the brachial artery.
4. If direct pressure fails to control an arm or leg’s severe
bleeding, apply a tourniquet.
5. If direct pressure fails, raise the arm or leg.
6. Once bleeding has been stopped, pressure bandages can
maintain control if needed.
Shock
 Shock: Agree or Disagree?

1. All unresponsive people should have their breathing checked; if

not breathing, CPR should be started.

2. Give a person in shock something to drink.

3. Help a responsive person move around to help blood flow

throughout the body.

4. Place an unresponsive person on his or her side.

5. Loosen tight clothing and, if needed, cover the person with a

blanket to prevent chilling.

6. Lay the person down and elevate the legs and feet slightly, unless
you think this may cause pain or further injury.
 Shock

• Circulatory system failure

► Pump (heart) failure
► Fluid loss
► Pipe failure (blood vessels)
• Results from serious injury or
illness
 Recognizing Shock

• Cold, clammy skin

• Rapid shallow breathing
• Rapid, weak pulse
• Thirsty
• Changing level of consciousness
• Low blood pressure
• Yawning (air hunger)
• Slow capillary refill time
 Care for Shock

• Position victim
on his or her
back.
• Keep warm.
• Call 8-1-1.
Shock
 Anaphylaxis Shock: Agree or Disagree?

1. Use a physician-prescribed epinephrine kit on a person with a

severe allergic reaction to an insect sting.
2. Place an ice pack over an insect sting site.
3. Remove an embedded stinger by scraping or brushing it off.
4. Encourage a person who has been stung to move around to
stay alert and awake.
5. Apply heat to the area to draw the venom out of the skin.
6. People having trouble breathing should sit up to help make
breathing easier
 Anaphylaxis

• Type of shock
• Powerful reaction to substances that
enter the body
• Causes
► Medications
► Foods
► Insect stings
► Plants
 Recognizing Anaphylaxis

• Breathing difficulty
• Skin reaction
• Swelling of tongue, mouth, or throat
• Sneezing, coughing
• Tightness in chest
• Blueness around lips and mouth
• Dizziness
• Nausea and vomiting
 Care for Anaphylaxis

• Call 8-1-1.
• If victim has his
or her own
EpiPen auto-
injector, help
with its use.
Allergic Reactions and Anaphylactic Shock
 Using an EpiPen Auto Injector

• Remove safety
cap.
• Hold leg still.
• Push firmly and
hold for 10
seconds.
 Seizures: Scenario 1

You see some of your coworkers holding down another

employee on the floor. They are trying to force a couple of
pencils between her teeth. The person is unresponsive and
is having severe muscle jerks. Her medical identification
bracelet shows that she has epilepsy.
 Seizures: Agree or Disagree?

1. Have bystanders form a circle around a person having a

seizure.
2. Move nearby objects away from the person.
3. Hold the person down to prevent injury.
4. Place a sturdy stick between the teeth to prevent biting
the tongue.
5. If a seizure lasts more than five minutes, call 8-1-1.
6. After a seizure, place the person on his or her side to
maintain an open airway.
 Seizures: What to Do

Call 8-1-1 for any of the following:

► Seizure lasting longer than 5 minutes
► Series of seizures following one another
► The person has breathing difficulties after the seizure
► The person has diabetes or is pregnant
► Seizure happened in water
► This is the person’s first known seizure
► The seizure is injury-related
► Slow recovery
 Seizures: What to Do

After the seizure:

► Keep the airway open by placing the person on his or her side and
head on a rolled towel.
► Monitor breathing and if it stops, give CPR.
► Allow the person to sleep.
► Stay with the person until he or she is alert.
Seizures
Burns
 Thermal Burns: Agree or Disagree?

1. Apply butter or petroleum jelly on a burn.

2. Apply ice or ice water on a burn.
3. Run cold water over first- and small second-degree
burns.
4. Cover first-degree burns with a sterile dressing.
5. Break blisters from a burn to shorten the healing time.
 Types of Burns

• Thermal (heat) burns

• Chemical burns
• Electrical burns
 Depth of Burns

• Depth (degree)
► First-degree (superficial)
► Second-degree (partial thickness)
► Third-degree (full thickness)
First-Degree Burns (Superficial)

• Redness
• Mild swelling
• Tenderness
• Pain
© Amy Walters/ShutterStock, Inc.
Second-Degree Burns (Partial Thickness)

• Blisters
• Swelling
• Weeping fluids
• Intense pain

© E. M. Singletary, M.D. Used with permission.

Third-Degree Burns (Full Thickness)

• Dead nerve
endings
• Leathery, waxy
skin
• Pearly gray or
charred skin
 Extent of Burns

• Rule of the hand

► Victim’s hand equals 1%
of body surface area.

• Which parts of body

are burned?
• Other injuries or
medical conditions?
• Is patient elderly or
very young?
 Care for First-Degree Burns

• Cool burn until pain free.

• Apply moisturizer such as aloe vera gel.
• Administer OTC pain reliever as needed (eg, ibuprofen).
 Care for Small Second-Degree Burns

• Cool burn until pain free.

• Apply antibiotic ointment.
• Cover burn with dry, nonstick, sterile dressing.
• Administer OTC pain reliever as needed (eg, ibuprofen).
• Seek medical care.
Care for Large Second-Degree and Third-Degree Burns

• Remove jewelry and clothing not stuck to burn.

• Cover burn with dry, nonstick, sterile dressing.
• Care for shock.
• Call 8-1-1.
 Chemical Burns

• Results from caustic or

corrosive substance
► Acids, alkalis, and organic
compounds
• Chemicals continue to burn
as long as they are in
contact with the skin;
remove quickly.
 Chemical Burns: Agree or Disagree?

1. When washing chemicals off the body, flush

continuously with water for at least five minutes.
2. When washing chemicals off the body, use high
pressure water.
3. Try to neutralize a chemical so it does not cause more
damage.
4. Brush dry powder chemicals from the skin before
flushing.
5. Taking off clothing covering the affected area can be
done while flushing the body with water.
Care for Chemical Burns

• Brush/flush skin to
remove chemical.
• Remove
contaminated
clothing.
• Cover burn with
dressing.
• Seek medical care.
Electrical Burns

• Thermal burn
(flame)
• Arc burn (flash)
• True electrical
injury (contact)
Care for Electrical Burns

• Make the scene safe.

► Unplug, disconnect, and turn off electricity.
• Check responsiveness and breathing.
• Provide CPR if needed.
• Care for shock.
• Call 8-1-1.
ECSI BURNS
Head and Spinal Injuries
 Head Injuries

• Scalp wounds
• Skull fracture
• Brain injuries
 Scalp Wounds

• Care for scalp wounds

► Control bleeding.
► Keep head and shoulders
slightly elevated if spinal injury is
not suspected.
► Seek medical care.
 Brain Injuries

• Recognizing brain injury

► Vacant stare
► Slow to answer questions
► Unaware of time and place
► Slurred speech
► Stumbling
► Loss of responsiveness
► Headache, dizziness, and nausea
 Care for Brain Injuries

• Check responsiveness and breathing.

• Stabilize head and neck.
• Control bleeding with sterile dressing.
► Apply pressure around edges of the wound if there is skull fracture.
• Call 8-1-1.
Spinal Injuries

• Common causes
► Motor vehicle crashes
► Direct blows
► Falls from heights
► Physical assaults
► Sports injuries
 Recognizing Spinal Injuries
• Inability to move limbs
• Numbness, tingling, weakness, burning sensation in arms and
legs
• Deformity of neck
• Neck or back pain
Care for Spinal Injuries

• Stabilize head and

neck.
• Check
responsiveness and
breathing, and
provide care if
needed.
► If vomiting occurs,
carefully roll the victim
onto his or her side.

• Call 8-1-1.
Bone, Joint, and
Muscle Injuries
 Bone Injuries

A. Closed fracture
B. Open fracture
Recognizing Bone Injuries

• Use DOTS
► Deformity

► Open wounds
► Tenderness

► Swelling
Care for Bone Injuries

• Stabilize injured part to prevent movement.

► Hold injured part.
► Splint if EMS is going to be delayed or you are
transporting victim.
• Cover any exposed bones without applying pressure.
• Apply ice to prevent swelling.
• Call 8-1-1 for any open or large bone fractures.
Splinting

• Stabilizes a bone or joint injury

• Reduces pain
• Prevents further damage to muscles,
nerves, and blood vessels
 Types of Splints

• Rigid splint • Soft splint

• Self-splint (anatomic
splint)
Rigid Splint
Soft Splint Arm Video
 General Splinting Guidelines
• Cover open wounds before applying splint.
• Splint only if it will not cause further pain.
• Splint the injured part in the position found.
• Splint should extend beyond joints above and below
any extremity injury.
 Joint Injuries

• Sprain
► Torn ligaments
• Dislocation
► Bone ends in a joint are no
longer together
 Recognizing Joint
Injuries
• Pain, swelling, inability to use

• Similar to fractures
• Main sign of dislocation is deformity.
 Care for Joint Injuries

• For dislocations, splint and provide care as you

would for fracture.
• For sprains, use RICE procedure.
• Seek medical care.
► Call 8-1-1 for difficult-to-transport injuries.
RICE Procedure

• R = Rest
• I = Ice
• C = Compression
• E = Elevation
RICE Procedure Video
 Recognizing Muscle Injuries

• Muscle strain (pull)

► Sharp pain, tenderness, weakness, stiffness
• Muscle contusion (bruise)
► Pain, tenderness, swelling, bruising
• Muscle cramp (spasm)
► Spasms, pain, restriction, or loss of movement
 Care for Muscle Injuries

• For muscle strains and contusions

► Rest.
► Apply ice.
• For muscle cramps
► Stretch muscle.
► Apply pressure.
Arm Sling
 When Bandages or Other Resources Are Unavailable

• Place the hand inside a buttoned jacket.

• Use a belt, necktie, etc. around the neck and injured arm.
 When Bandages or Other Resources Are Unavailable

• Pin the sleeve of the

shirt or jacket to the
clothing.
• Turn up lower edge of
person’s jacket or shirt
over injured arm.
Medical Emergencies
 Adult and Child CPR: Scenario 2

As the designated first aid provider at your office, you

receive a phone call urgently telling you about an
employee who was found collapsed on the workroom floor.
You run down the hallway to the workroom and find two
employees looking at the person but doing nothing. They
seem relieved to see you and move off to the side for you
to get next to the person.
 Chest Pain

• Causes
► Heart attack
► Respiratory infection
► Overexertion resulting in muscle pain
Cardiovascular Emergencies
Heart Attack Explained
 Heart Attack

• Blood supply to part of the heart muscle is

reduced or stopped.
• Recognizing a heart attack
► Chest pressure, squeezing, or pain that lasts
longer than a few minutes or goes away and
comes back
► Pain spreading to shoulders, neck, jaw, or arms
► Dizziness, sweating, nausea
► Shortness of breath
 Care for a Heart Attack
• Call 8-1-1.
• Help victim into
comfortable position.
• Assist with
prescribed
medications.
► Nitroglycerin

• Provide aspirin.
► Regular or chewable
 First Aid: Aspirin

• Give aspirin for adults with

nontraumatic chest pain
unless allergic or previously
advised not to by a health
care provider
 Risk Factors of Cardiovascular Disease

• Cannot be changed • Can be changed

► Smoking
► Heredity
► High blood
► Gender
pressure
► Age
► High cholesterol
► Diabetes

► Obesity

► Inactivity

► Stress
CPR
Compression Only CPR
 Lay Responder: Chest Compressions (1 of 2)

• The order is CAB:

► Compressions
► Airway
► Breathing
 Lay Responder: Chest Compressions (2 of 2)

• Compression depths:
► Adult: At least 2 inches deep
► Child: About 2 inches deep (or one-third
the AP diameter of the chest)
► Infant: About 1.5 inches deep (or one-
third the AP diameter of the chest)

• 100–120 compressions per

minute
• Allow full chest recoil
• Do not lean on the chest
 Lay Responder: Compression-Only CPR

• Lay responder adult

CPR/AED programs only
• Not for infants
► Infants need breaths

• Compressions only
► Hard
► Fast
► Continuous
 Lay Responder: AED Use

• No changes to Guidelines
• Adults
► Use adult electrode pads

• Children
► Use pediatric electrode pads if
available
► Use adult electrode pads if no
pediatric electrode pads are
available
 Lay Responder: Pediatric CPR

• Applicable to lay responders

and BLS providers
• 2020 Guideline updates:
► One breath every 2–3 seconds
• Traditional CPR with (20–30 breaths per minute)
ventilations still
recommended for pediatric ► Can use 1 or 2 hands for
patients compressions in children

► Compression-only CPR is
► For infants, two-thumbs
primarily for adults encircling hands is the preferred
compression technique
► Kids need ventilations!
 Lay Responder: Infant CPR

• Applicable to lay responders and

BLS providers
• Preferred method
► Two-thumbs encircling hands
technique for single- and two-rescuer
CPR
► The majority of the studies suggest the TT
method as the more useful for infants and
neonatal resuscitation than the TF.

• Alternate method
► Two-finger compressions
 Infant CPR

• Continue CPR until one of the following occurs:

• The infant begins breathing

• EMS arrives and takes over

• You become physically exhausted and unable to continue

 First Aid: Obstructed Airway

• Back blows for adults and

children:
► Provide five back blows and then
five abdominal thrusts (or chest
thrusts if large or pregnant)
► Continue until obstruction is
dislodged or victim becomes
unresponsive
Adult and Child Choking

• Ask, “Are you choking?”

Shout for help.
• Wrap your arms around the
person’s waist and locate
the navel with a finger.
Choking Explained
Adult and Child Choking

• Make a fist with the other

hand and place the thumb
side of the hand just above
the navel and below the
breast bone.
• Grasp the fist with the other
hand and thrust the fist into
the abdomen.
 Adult and Child Choking

• If the person becomes unresponsive or a person is found

unresponsive, provide CPR with the addition of a step:
► Give 30 chest compressions.
► Give 2 breaths. If the first breath does not cause the chest to rise,
retilt the head and attempt a second breath.
► Continue sets of 30 chest compressions and 2 breaths.
Infant Choking

• Give up to 5 separate and

distinct back blows.
• Give up to 5 separate and
distinct chest thrusts.
 Infant Choking

• Continue alternating the 5 back blows and 5 chest

thrusts without interruption until one of the following
occurs:
► The infant stops responding or can breathe, cough, or cry.
► EMS or a person who is trained takes over.
Abdominal Thrusts
Pregnant Person Choking
AED DEMO
 The End

Any Questions