Perform CPR HLTCPR211A

1. Perform CPRHLTCPR211A Be prepared for an emergency. Learn first aid, you could save a life.

2. Welcome • Basic Housekeeping • Schedule • Break • Location of toilets • Location of emergency exits • Mobile phones

3. Course Content • Legal considerations • Chain of Survival • Basic Life Support • The unconscious casualty • Airway management

4. Assessment 100% Practical • Assess the patient • Perform CPR on a manikin • Apply an AED

5. Aims of first aid • Ensure that the scene is safe • Preserve the life • Protect the unconscious • Prevent progression of the injury • Provide comfort/promote recovery • Phone for an ambulance.

6. Legal Considerations • Duty to Act • Negligence • Consent • Recording

7. Primary Survey Danger Response Send for help Airway Breathing Compressions Defibrillation

8. Basic Life Support D Danger Ensure the scene is safe Unsafe Check for and remove hazards/risks S Send for help - call 000 Check for a response R No Yes A UnconsciousOpen and clear airway, look listen and feel for breathing Conscious : Manage injuries/illness Monitor , rest and reassure B Not breathing normally Commence chest compressions Breathing normally Manage patient in the recover position C 30 chest compressions followed by 2 breaths Continue until responsiveness or normal breathing returns If unwilling /unable to perform rescue breaths continue chest compressions D Defibrillate: Attach AED- follow voice prompts Continue CPR

9. Danger • Once an emergency has occurred you need to ensure the safety of all of those at the scene by checking for hazards • The groups that you need to consider are shown in order of priority below: • Yourself • Bystanders • The casualty Don’t become an innocent victim

10. Response • Check the casualty for a response • Call out to the patient “what is your name?” • Gently tap on the patient on the shoulder and ask “can you hear me?” If no response patient is unconscious , manage the airway

11. Send for Help - Call 000 • Phone Fast /Emergency service controller • Name/contact details • Exact location • Type of incident • Status of the patient • Hazards • Do not hang up • Stay with the patient until help arrives

12. Airway • Ensure the airway is open and clear • If the airway is obstructed, remove any visible foreign bodies

13. Airway Management AIRWAY OPEN AIRWAY OBSTRUCTED AIRWAY CLOSED

14. Breathing • Keep the airway open and check for normal breathing • Look, Listen and Feel for no more than 10 seconds for normal breathing • Look – to see if the chest rises • Listen – for the sound of normal breathing • Feel – for air against your cheek

15. Breathing If Breathing Normally: • Roll into the recovery position • Pregnant women onto their left side • Observe and reassess the casualty for continued breathing regularly • Maintain an open airway with head tilt and jaw support • No head tilt for infants If Breathing Absent • Send someone for the AED (if available) • Commence CPR

16. Recovery position • The unconscious patient who is breathing normally must be placed in • the recovery position. This lifesaving position helps to maintain an open and clear airway • Encourage the jaw and tongue to relax and fall forward • Promote free drainage so that fluids such as vomit and saliva will not obstruct the airway • Patients may be either turned towards or away from the First Aider • Ensure the neck and head is gently tilted back with the face slightly downward and supported by the patients own hand • With an unconscious patient care of the airway takes precedence over any injury • Care of the spinal patient • Spinal patients must be moved with caution. The neck and head must be supported and the body in correct alignment. Use of the log roll technique is recommended. • Advanced stages of pregnancy • Place the patient on her left side to avoid distress to the foetus.

17. Breathing Sounds of gurgling, sighing or coughing may be present – this is regarded as not breathing normal and is an indication of a patient in cardiac arrest, immediately commence chest compressions

18. Sudden Cardiac Arrest • Sudden Cardiac Arrest occurs when the heart stops suddenly beating due to an electrical malfunction of the heart muscle. This disrupts the normal heart rhythm, resulting in the loss of consciousness, loss of pulse and loss of life in minutes.

19. Sudden Cardiac Arrest • The heart may begin to vibrate or quiver in an irregular manner, this is called fibrillation. The heart is unable to pump oxygen rich blood through the heart. When this blood is not supplied to the brain you lose consciousness • The only way to start a fibrillating heart and restore normal rhythm is to defibrillation

20. Chain of Survival • Early recognition and early access • Early CPR • Early defibrillation • Early advanced medical care

21. CPR • CPR is only performed on a person who is in Cardiac Arrest • Sudden cardiac arrest is not a heart attack • Primary need to get heart beating again ASAP or • Mimic action of heart beating to send blood out to the tissues (perform Chest compressions)

22. CPR Cardiopulmonary resuscitation (CPR) is a combination of chest compressions and rescue breathing

23. Chest Compressions • Give 30 compressions • Compress 1/3 chest depth • Give 2 breaths continue with 30 compressions (5 cycles every 2 minutes)

24. Summary • 30 chest compressions • 2 breaths • Rate 100 compressions per minute • Each cycle is 30 compressions : 2 breaths • Compress ⅓ of the chest depth • Hand position – centre of the chest • Adult – 2 hands • Child – 2 hands • Infant – 2 fingers

25. Summary Only stop CPR if: • the scene becomes unsafe • qualified help arrives and takes over • signs of life return • you become physically unable to continue CPR • an authorised person pronounces life extinct

26. Summary • Unconscious • No normal breathing • Patient is in CARDIAC ARREST-PERFORM CPR Any attempt at resuscitation is better than none

27. Summary Chest compressions only If the First Aider is unable/unwilling to perform rescue breaths chestcompressions only is advised as residual oxygen supplies in the body will be circulated in the body. • Compressions should be continued at a rate of 100 per minute Multiple First Aiders • In the presence of multiple First Aiders, Call the ambulance first. • Obtain any necessary emergency equipment such as defibrillator. • Regular rotation is recommended to reduce fatigue; Every 2 minutes.

28. Defibrillation • Defibrillation is the definitive treatment for Cardiac • Arrest • An AED (Automated External Defibrillator) delivers a controlled electric shock to the patient’s heart • The AED is an automated electronic device used to restore a normal heartbeat. • Asystole the absence of • any heart beat. • CPR holds off asystole

29. Defibrillation Ventricular Fibrillation: Heart irritability where the heart cells are not ‘firing off’ in an organised manner. Blood circulation is impaired and can result in death Ventricular tachycardia: Heart irritability where the heart cells are stimulated prematurely resulting in a fast abnormal heart beat. The heart is unable to refill and the patient will become unconscious with no heart beat. Asystole is characterised by the absence of any cardiac activity VF or VT can be reversed provided there is rapid intervention with CPR and defibrillation. If treatment is delayed the chance of survival is reduced by less than 10% for each minute the heart is stopped. CPR artificially keeps the heart beating and circulates O2 blood, the heart must be defibrillated to return the electrical conduction system back to normal so the heart can beat spontaneously.

30. Defibrillation • Ensure CPR is continued • Turn on AED • Follow the AED instructions • Shave chest hair and dry moisture with towel if required • Check for any implanted medical devices • Place pads on chest and ensure firm contact • Ensure no one is touching casualty when shock is delivered

31. Defibrillation • An AED should only be applied when a patient is unconscious and not breathing • Each minute that defibrillation is delayed reduces the patient’s chances of survival by about 10 % • The sooner the shock is administered, the greater the likelihood of the patient’s survival It is virtually impossible to save a patient with cardiac arrest without a defibrillator

32. Practical Assessment with AED

33. Choking • Choking occurs the upper airway is obstructed by swollen tissue or a foreign body, or when food or other material enters the trachea instead of the oesophagus.

34. Choking • Must often occurs while eating and involves the inhalation of food down the trachea during a meal. Coughing is the body’s reflex action to dislodge a foreign object

35. Partial Obstruction Signs and Symptoms • difficulty in breathing • wheezing • snoring sound • persistent cough • cyanosis (blue skin colour) • in children and infants • flaring of the nostrils • in-drawing of the tissues above the sternum and in between the ribs Management • Encourage patient to cough to expel foreign material • Do not give any back blows because this could cause the patient to inhale the object and my result in a severe airway obstruction

36. Complete Obstruction Signs and Symptoms • unable to breathe, speak or cough • agitated and distressed • may grip the throat • bluish skin colour • rapid loss of consciousness

37. Complete Obstruction Management • Attempt five sharp back blows between the shoulder blades • If unsuccessful attempt five chest thrusts • Continue alternating, call 000 and be prepared to commence CPR.

38. Choking Flow chart

39. Shock • Shock is a sudden or slow /steady loss of blood volume and/or pressure due to illness, pain or trauma. • It is the bodies defensive response to protect the vital organs – heart, lung, kidneys and brain • Shock is caused by many factors the most significant is pain.

40. Shock Initial shock • Pale cold clammy skin. • Weak, Rapid pulse. • Rapid breathing. As shock progresses • Faintness or dizziness • Nausea • Anxiety • Restlessness. • Thirst. • Drowsiness, confusion. • Cyanosis in extremities. Finally • collapse and unconsciousness, due to progressive ‘shutdown’ of body’s vital functions

41. Major Functions of Blood • Transports oxygen, nutrients and wastes • Protects against disease • Maintains constant body temperature

42. Capillary • gentle ooze form wound Signs of External Bleeding Arterial Venous • rapid and profuse • flows from wound at a steady rate • bright red in colour • as it is under pressure usually spurts • dark red in colour

43. Control Bleeding • Direct pressure • Elevation • Rest QAS 56

44. Internal Bleeding Management • Call 000 and closely monitor airway, breathing and circulation regularly. • Rest and reassure patient • Raise legs if injuries permit. • Do NOT give any food or drink. First aiders cannot control internal bleeding but early recognition and calling 000 can save lives

45. Practical session - bandaging

46. Asthma • People with asthma have very sensitive airways, and when they are exposed to certain triggers, their airways narrow making it difficult for them to breathe. • The inside lining of the airways becomes red and swollen • Extra mucus is often produced • The muscles around the airways constrict

47. Asthma • Shortness of breath especially when speaking • Wheeze may or may not be present • Dry, irritating, persistent cough • Rapid breathing • Tightness in the chest • Cyanosis around the lips and ear lobes • Tiredness, exhaustion • Collapse

48. Asthma Management • Get patient to have 1 puff of reliever medication • Patient then takes 4 breaths • Repeat until patient has had 4 puffs • Wait 4 minutes • If no improvement give another 4 puffs • If no improvement call 000 • Continue with 4 puffs x 4breaths x 4 minutes until ambulance arrives

49. Anaphylaxis • The most severe and sudden form of allergic reaction • Occurs when there is exposure to an allergen to which a person is sensitive to

50. Anaphylaxis • Is potentially life threatening and should be treated as a medical emergency • Anaphylaxis results when a generalised allergic reaction affects the respiratory(breathing) and/or cardiovascular (heart and blood pressure) system. Blood vessels dilate and blood pressure falls, airway is constricted resulting in breathing difficulty.