Automated External Defibrillation Youth First Responder Course

1. Automated external defibrillation Youth First Responder Course Day two I Session four

2. FIRST RESPONDER COURSE Overview: • Discuss (in simple terms) how defibrillation works. • Explain and demonstrate the procedure for safe defibrillation; including pad placement and verbally and visually clearing prior to shocking. • Describe the sequence of actions and skills required to use an AED in conjunction with basic principles of resuscitation. • Explain problem solving techniques if a problem is encountered in a cardiac arrest situation.

3. Automated external defibrillation • What is defibrillation? • Normally electrical impulses travel through the heart along conduction pathways in an orderly manner • ‘Malfunctions’ of this circuit can result in chaotic electrical impulses (referred to as ‘fibrillation’) • This means the heart is unable to respond and contract • A larger than normal electrical impulse can stop this, and allow the normal electrical circuit of the heart to resume • The AED delivers this impulse FIRST RESPONDER COURSE

4. Automated external defibrillation • Not all patients in cardiac arrest can be shocked • Needs to be a specific rhythm • If the heart is electrically okay, or there is no electrical activity, shocking will have no effect • The role of the AED • Analyse the patients ECG • Determine if here is a shockable rhythm • Charge so you can deliver a shock FIRST RESPONDER COURSE

5. Automated external defibrillation • Irrespective of your type of AED, using it is as easy as 1,2,3 • Turn the defibrillator on and apply the pads • Analyse the rhythm • Deliver the shock FIRST RESPONDER COURSE

6. Automated external defibrillation • Irrespective of your type of AED, using it is as easy as 1,2,3 • Turn the defibrillator on and apply the pads • Analyse the rhythm • Deliver the shock FIRST RESPONDER COURSE

7. Automated external defibrillation • Irrespective of your type of AED, using it is as easy as 1,2,3 • Turn the defibrillator on and apply the pads • Analyse the rhythm • Deliver the shock FIRST RESPONDER COURSE

8. Automated external defibrillation • Irrespective of your type of AED, using it is as easy as 1,2,3 • Turn the defibrillator on and apply the pads • Analyse the rhythm • Deliver the shock FIRST RESPONDER COURSE

9. Automated external defibrillation PRACTICAL: Using an AED FIRST RESPONDER COURSE

10. Automated external defibrillation KEY MESSAGE: Attach and use the defibrillator as soon as possible. Defibrillation must not be delayed by performing other interventions FIRST RESPONDER COURSE

11. Automated external defibrillation • Troubleshooting • Like all tools, occasionally defibrillators can fail • This serious situation that can contribute to patient death • In this setting it is important to keep a level head • Troubleshooting key points • Task specific personnel to focus on resuscitation • Task specific personnel to focus on troubleshooting the defib • Follow the defibrillator failure checklist • We recommend keeping a copy of the defibrillator failure checklist with your defib FIRST RESPONDER COURSE

12. Questions? Youth First Responder Course Day two I Session four

13. Full resuscitation Youth First Responder Course Day two I Session five

14. FIRST RESPONDER COURSE Overview: • Evaluate the full cardiac arrest algorithm • Understand the idiosyncrasies of single, double and multiple rescuer resuscitation • Demonstrate full and effective resuscitation of a patient in cardiac arrest. Lifepak 12 Phillips MRx Lifepak 15 14

15. Full resuscitation Cardiac arrest algorithm with an AED: Perform continuous chest compressions *Note attaching the defib and analysing takes priority over airway management if these cannot be done concurrently Attach defib, *place OPA, setup bag mask Check safety of team and bystanders Obvious signs of life (moving, waking up)? Analyse rhythm shock advised? Yes No No 2 minutes Single shock Immediate compressions at 30:2 FIRST RESPONDER COURSE

16. Full resuscitation VIDEO: Single responder FIRST RESPONDER COURSE

17. Full resuscitation VIDEO: Double responder FIRST RESPONDER COURSE

18. Full resuscitation VIDEO: Multiple responder FIRST RESPONDER COURSE

19. Full resuscitation PRACTICAL: Full resuscitation FIRST RESPONDER COURSE

20. Full resuscitation Cardiac arrest algorithm with an AED: Perform continuous chest compressions *Note attaching the defib and analysing takes priority over airway management if these cannot be done concurrently Attach defib, *place OPA, setup bag mask Check safety of team and bystanders Obvious signs of life (moving, waking up)? Analyse rhythm shock advised? Yes No No 2 minutes Single shock Immediate compressions at 30:2 FIRST RESPONDER COURSE

21. Questions? Youth First Responder Course Day two I Session five

22. Shock and Trauma Youth First Responder Course Day TwoI Session seven

23. FIRST RESPONDER COURSE Overview: • Define trauma • Discuss common causes of trauma (mechanism of injury) • Discuss common injuries of trauma situations (index of suspicion) • Discuss the types of shock and severity of shock • Recognise the shocked patient • Discuss the management of the shocked patient

24. Shock and trauma • Trauma • An injury resulting from an external force being applied to the body FIRST RESPONDER COURSE

25. Shock and trauma • Mechanism of injury • How the injury occurred • What forces are applied during trauma • This allows you to have an index of suspicion FIRST RESPONDER COURSE

26. Shock and trauma EXERCISE 6 : Mechanism of injury Circle the joints you think would be affected as a result of this person landing on the ground. Which parts of the body do you think will be affected as a result of the imapct on these joints? What injuries might this person sustain? What differences in injury might occur if the patient was landing from a second story balcony? FIRST RESPONDER COURSE

27. Shock and trauma • Significant MOI • Intrusion more than 0.3m into a passenger compartment • Intrusion more than 0.5m into an engine compartment • Car versus pedestrian > 30 km/h • Death of other vehicle occupant • Explosion • Fall more than twice the patient’s height • Motor vehicle crash > 60 km/h • Object fallen on patient from >5 meters • Patient ejected from motor vehicle • Patient in vehicle rollover • Trapped for more than 30 minutes FIRST RESPONDER COURSE

28. Shock and trauma KEY MESSAGE: Mechanism of injury should not be considered when determining patient status FIRST RESPONDER COURSE

29. Shock and trauma • Shock • A problem that results in inadequate circulating blood flow, and thus supply of vital nutrients to the vital organs. • Shock can be caused by a number of problems. common misconception is that ‘shock’ is a severe ‘fright’ FIRST RESPONDER COURSE

30. Shock and trauma • Causes of shock • Anaphylactic • Cardiogenic • Hypoadrenal • Hypovolaemic • Obstructive • Septic • Spinal FIRST RESPONDER COURSE

31. Shock and trauma • Recognising shock • Hypotension (low blood pressure) • Absent or weak pulse • Tachycardia (fast heart rate) • Cool extremities • Agitation • Decreased LOC • Delayed capillary refill time FIRST RESPONDER COURSE

32. Shock and trauma KEY MESSAGE: If your patient has signs of shock you must call for a Paramedic or Intensive Care Paramedic. FIRST RESPONDER COURSE

33. Shock and trauma • What do I do if my patient is shocked? • Reassure the patient • Lie the patient flat with legs raised • Administer oxygen if the patient has an SpO2 equal to or less than 94% • Treat the cause (if possible) • Seek backup from a Paramedic or Intensive Care Paramedic • Transport without delay • Have a low threshold for contacting the Clinical Desk FIRST RESPONDER COURSE

34. Shock and trauma EXERCISE 7 : Recognising shock Refer to the exercise in your workbook. Do these patients have shock? Why/ why not? FIRST RESPONDER COURSE

35. Questions? Youth First Responder Course Day TwoI Session seven