What You’ll Learn

1. What You’ll Learn 1. Discuss steps to take when checking a victim. 2. Explain first aid procedures for choking. 3. Explain first aid procedures for CPR. • Describe first aid procedures for heart attack. 5. Explain first aid procedures for shock.

2. What You’ll Learn 6. Describe first aid procedures for wounds. 7. Explain first aid procedures for poisoning and stroke.

3. Key Terms • tetanus • nosebleed • victim assessment • universal distress signal • abdominal thrusts • shock • cardiopulmonary resuscitation (CPR) • cardiac arrest • laceration

4. Checking a Victim • Emergency first aid procedures are actions taken when a person is seriously injured or suddenly becomes ill. • A victim assessment is a check of the injured or medically ill person to determine if certain conditions are present.

5. Checking a Victim • Performing a victim assessment includes making sure that the victim has an open airway, the victim is breathing, and the victim’s heart is beating. • Performing a victim assessment also includes checking to see if the victim is severely bleeding or if the victim has other injuries.

6. What to Know About Checking a Victim • Call the emergency number.  • A victim who is able to speak to you is breathing and has a pulse. • If the victim does not respond, call the local emergency number and obtain medical care immediately.

7. What to Know About Checking a Victim

8. Choking • Choking is an emergency in which the airway is blocked. • A conscious victim will cough to try to dislodge the piece of food or object that is blocking his or her airway.

9. First Aid for Choking • If a victim can talk, the victim is getting enough air and should be encouraged to continue trying to cough up the object. • If the victim cannot get enough air to talk or cough, or the cough is very weak, the airway is completely blocked. • The universal distress signal is a warning that a person is having difficulty breathing and is shown by clutching at the throat with one or both hands.

10. First Aid for Choking • Abdominal thrusts are a series of thrusts to the abdomen that force air from the lungs to dislodge an object. • The method of giving abdominal thrusts is different for adults, children, and infants.

11. First Aid for Choking What to Do if You are Choking  1. If possible, call the local emergency number and obtain medical care immediately. If you cannot speak, do not hang up. The emergency dispatcher can trace your call and send an ambulance to your location. Be aware that an emergency dispatcher cannot trace a call made from a cellular phone. Use a regular telephone if at all possible. 2. Get the attention of someone around you. Use the universal distress signal if you are unable to speak.

12. First Aid for Choking What to Do if You are Choking 3. Give yourself abdominal thrusts if no one can help you. Make a fist with one hand, and grab the fist with your other hand. Give yourself five quick abdominal thrusts. Apply pressure inward and push up toward your diaphragm in one smooth movement. Repeat until the object is dislodged. 4. If a sturdy chair is available, push your body against the back of the chair, pushing between the waist and ribs. Hold onto the chair with your hands to push yourself back up. Repeat until the object is dislodged.

13. First Aid for Choking What to Do if an Adult or Child Older than One Year is Conscious and Choking • Call the emergency number.  • To obtain medical care immediately, call the local emergency number. • Do not do anything if the victim can speak or cough easily. • Encourage the victim to continue coughing to dislodge the object.

14. First Aid for Choking What to Do if an Adult or Child Older than One Year is Conscious and Choking 1. If the victim is conscious but cannot speak, breathe, or cough, stand behind the victim and wrap your arms around the victim’s waist. Make a fist with one hand. Place the thumb side of the fist into the victim’s abdomen above the navel and below the rib cage. Grab your fist with the other hand.

15. First Aid for Choking What to Do if an Adult or Child Older than One Year is Conscious and Choking 2. Give five quick abdominal thrusts. Apply pressure inward and push up toward the victim’s diaphragm in one smooth movement. Repeat the cycle of five abdominal thrusts until the object is dislodged. The victim may need rescue breaths after the object is dislodged. Stay with the victim and watch for breathing difficulties. Rescue breaths are delivered by breathing air into an unconscious victim who is not breathing, but has a pulse.

16. First Aid for Choking What to Do if an Adult or Child Older than One Year is Conscious and Choking 1. Call the local emergency number and obtain medical care immediately. 2. Roll the victim onto his or her back. Open the victim’s airway by lifting the victim’s chin while tilting the head back. Find the lower part of the victim’s breastbone and measure up the width of two fingers from that point. 3. Place the heel of your other hand directly over the heel of the first hand and interlock your fingers. Do not let your fingers touch the victim’s chest.

17. First Aid for Choking What to Do if an Adult or Child Older than One Year is Conscious and Choking 4. Position your shoulders over your hands and lock your elbows straight. Exert pressure straight down. Compress the chest 30 times at a rate of about 100 compressions per minute. 5. Look for an object in the victim’s mouth. If you see one, remove it. Place a face mask or a shield over the victim’s face. Place your mouth over the mask and give two slow breaths.

18. First Aid for Choking What to Do if an Adult or Child Older than One Year is Conscious and Choking 6. Repeat the cycle of 30 chest compressions, a check for an object in the victim’s mouth, and two breaths until the object is dislodged.

19. First Aid for Choking What to Do if an Infant is Choking 1. Call the local emergency number and obtain medical care immediately, whether the infant is conscious or unconscious. 2. If the victim is coughing or crying, do not interfere. Coughing can help clear an airway. If the infanthas stopped coughing and theobject has not come out, place the victim face up on your upper leg. Make certain the victim’s head is lower than the rest of the victim’s body. Press two or three fingers in the center of the breastbone. Give five quick chest thrusts.

20. First Aid for Choking What to Do if an Infant is Choking 3. If the infant cannot cough, cry, or breathe, place the victim face down on your forearm or upper leg. Support the victim’s head by placing your hand around the lower jaw and chest. Use the heel of your other hand and give five quick blows to the victim’s back between the shoulder blades.

21. First Aid for Choking What to Do if an Infant is Choking 4. Repeat chest thrusts and back blows until the object is dislodged. After each set of five chest thrusts and back blows, try to breathe into the mouth and nose of the infant. If air goes in, provide rescue breaths. If not, continue giving another set of back blows and thrusts. 5. If the infant is unconscious and choking, use the chest compressions/rescue breaths first aid technique described in “How to Give CPR to Infants.”

22. Rescue Breathing • Cardiopulmonary resuscitation, or CPR, is a first aid technique used to restore heartbeat and breathing. • CPR should be used only if you are trained to use it.

23. First aid procedures for CPR follow general guidelines of the American Heart Association and the American Red Cross. • For training and certification, contact the local chapter of the Red Cross.

24. What to Know About Giving Rescue Breaths • A victim will become unconscious if he or she is without oxygen for only a few minutes. • If the body is without oxygen, eventually the heart will stop beating and the victim will die. • With rescue breaths, an unconscious victim who is not breathing can receive air. • Rescue breaths give a victim the oxygen needed to stay alive.

25. What to Know About Giving Rescue Breaths • Adults and children 1. Apply the rim of the mask between the victim’s lower lip and chin, thus pulling back the lower lip to keep the mouth open under the mask. 2. Position the end marked “nose” over the victim’s nose. Seal the mask. 3. Open the victim’s airway and blow slowly. 4. Remove your mouth from the victim’s mouth to allow the victim to exhale. 5. If the victim vomits, remove themaskand clear the victim’s airway.Reapply the mask.

26. What to Know About Giving Rescue Breaths • Infants • Follow the same procedures, except reverse the mask so the end marked “nose” is under the infant’s chin.

27. How to Give Rescue Breaths to Adults and Older Children 1.Call the local emergency number and obtain medical care immediately. 2. Roll the victim on his or her back. Tilt the victim’s head back in the following way: Place one hand under the victim’s chin and lift up while pressing down on the victim’s forehead with your other hand. 3. Use a face mask or shield for protection. Follow the instructions provided with the mask. Apply the mask. Open the victim’s airway. Breathe slowly into the victim, giving two slow breaths.

28. How to Give Rescue Breaths to Adults and Older Children 4.Give each breath over 1 second long, one after the other. Each breath should make the chest rise. 5. If the victim’s chest does not rise after the first rescue breath, tilt the head and lift the chin again. Then give the second rescue breath. 6. After giving two rescue breaths, immediately begin chest compressions. Continue performing CPR until professional medical help arrives.

29. Tips for Giving Rescue Breaths • Call for help or send someone for help before starting to give rescue breaths. • Before beginning rescue breaths, do not loosen clothing or attempt to warm the victim. • Unless the victim is lying in a dangerous area, do not move the victim. • Be sure to get permission before caring for a conscious victim. • Use a barrier between you and the victim to reduce the risk of disease transmission.

30. How to Give Rescue Breaths to Infants and Young Children 1. Call the local emergency number and obtain medical care immediately for an unconscious infant or child known to be at risk for heart problems. 2. If you are alone, provide 2 minutes of care, including rescue breaths and chest compressions (about five cycles) before leaving the child to call the emergency number. 3. Roll the victim on his or her back.

31. How to Give Rescue Breaths to Infants and Young Children 4. Tilt the victim’s head back slightly. For an infant, the head should be tilted so the ears are lined up with the shoulders. 5. Follow the instructions provided with the mask. Apply the mask. 6. Pinch a child’s nose and cover the mouth if the mask permits. 7. For an infant, cover the mouth and nose with your mouth.

32. How to Give Rescue Breaths to Infants and Young Children 8. Give two slow breaths. Each breath should be slow and gentle, lasting about 1 second. 9. Watch to see if the victim’s chest slowly rises. 10. Remove your mouth to allow the victim to exhale between breaths.

33. Chest Compressions • After delivery of rescue breaths, immediately begin chest compressions. • The combination of compressions and rescue breaths will most likely give the best outcome for all victims of cardiac arrest. • The ratio of compression-to-rescue breath should be 30:2. The American Heart Association has provided the following recommendations for chest compressions:

34. How to Give Chest Compressions to Adults and Older Children • You should begin chest compressions immediately after you have given the unconscious victim two rescue breaths. • Find the lower part of the victim’s breastbone and measure up the width of two fingers from that point. • Place the heel of the other hand directly over the heel of the first hand. Interlock your fingers. Do not let them touch the victim’s chest.

35. Shock How to Give Chest Compressions to Adults and Older Children • Position your shoulders over your hands and lock your elbows straight. Exert pressure straight down. Compress the chest 30 times at a rate of about 100 compressions per minute. • Push hard and fast. Exert enough pressure to depress the breastbone 1 to 2 inches. • Use a face mask or a shield for protection. Follow the instructions provided with the mask.

36. How to Give Chest Compressions to Adults and Older Children • Allow the chest to re-expand completely. The time allowed for the chest to re-expand should equal the compression time. 8. After 30 compressions, stop and give two rescue breaths. Give each breath over 1 second. Each breath should make the chest rise.

37. How to Give Chest Compressions to Adults and Older Children • If the victim’s chest does not rise after the first rescue breath, tilt the head and lift the chin again. Then give the second rescue breath. Do not try more than two times to give a rescue breath that makes the chest rise, because it is important to resume chest compressions as soon as possible. • After giving two rescue breaths, immediately resume chest compressions.

38. How to Give Chest Compressions to Adults and Older Children 11. Continue giving sets of 30 chest compressions and two rescue breaths until the victim recovers or professional medical help arrives.

39. Cardiopulmonary Resuscitation How to Give CPR to Young Children • If you are alone with an unresponsive child, perform five cycles (about 2 minutes) of CPR before you call the local emergency number. Start chest compressions immediately after you have given the unconscious victim two rescue breaths. • Find the lower part of the victim’s breastbone and measure up the width of two fingers from that point.

40. How to Give CPR to Young Children • Place the heel of one hand on the center of the victim’s breastbone. Exert pressure straight down. • Exert enough pressure to depress the breastbone about 1/3 to ½ the depth of the chest. If the child is large and more force is needed, place the heel of your other hand directly over the heel of the first hand and interlock the fingers.

41. How to Give CPR to Young Children 5. Compress the chest 30 times at a rate of about 100 compressions per minute. Each compression forces blood from the heart to other parts of the body. 6. Allow the chest to re-expand completely after each compression. This allows the victim’s blood to completely refill the heart. The time you allow for the chest to re-expand should equal the compression time. .

42. How to Give CPR to Young Children • After 30 compressions, stop and give two rescue breaths. Give each breath over 1 second. Each breath should make the chest rise. • If the victim’s chest does not rise after the first rescue breath, tilt the head and lift the chin again. Then give the second rescue breath. Do not try more than two times to give a rescue breath that makes the chest rise, because it is important to resume chest compressions as soon as possible.

43. How to Give CPR to Young Children • After giving two rescue breaths, immediately resume chest compressions. • Continue giving sets of 30 chest compressions and two rescue breaths until the child recovers or professional medical help arrives.

44. How to Give CPR to Infants 1. If you are alone with an unresponsive infant, perform five cycles (about 2 minutes) of CPR before you call the local emergency number. Start chest compressions immediately after you have given the unconscious victim two rescue breaths. • Place two fingers on the victim’s breastbone just below the nipple line. Exert pressure straight down. • Compress the chest, 30 times at a rate of about 100 compressions per minute.

45. How to Give CPR to Infants 4. Exert enough pressure to depress the breastbone about 1/3 to ½ the depth of the chest. Each compression forces blood from the heart to other parts of the body. 5. Allow the chest to re-expand completely after each compression. The time you allow for the chest to re-expand should equal the compression time. 6. After 30 compressions, stop and give two rescue breaths. Give each breath over 1 second. Each breath should make the chest rise.

46. How to Give CPR to Infants • If the victim’s chest does not rise after the first rescue breath, tilt the head and lift the chin again. Then give the second rescue breath. Do not try more than two times to give a rescue breath that makes the chest rise, because it is important to resume chest compressions as soon as possible. • After giving two rescue breaths, immediately resume chest compressions. • Continue giving sets of 30 chest compressions and two rescue breaths until the infant recovers or professional medical help arrives.

47. A heart attack is the death of cardiac muscle caused by a lack of blood flow to the heart. • Cardiac arrest occurs when the heart stops beating and blood stops flowing through the body.

48. First Aid for Heart Attack 1.Have the victim stop activity and rest in a comfortable position. 2. Ask the victim about his or her condition. Does the victim have a history of heart disease? Is the victim taking any medications? 3. Call the local emergency number and obtain medical care immediately. 4. Comfort the victim until help arrives. Help the person take the prescribed heart medication.

49. First Aid for Heart Attack 5.Observe the victim for changes in condition. 6. If cardiac arrest occurs, the victim is not breathing and has no pulse, a person should perform CPR.

50. First Aid for Heart Attack Heart Attack Warning Signs The warning signs of a heart attack include: • persistent pain or pressure in the center of the chest that is not relieved by resting or changing position • pain that spreads from the center of the chest to the shoulder, arm, neck, jaw, or back •dizziness • sweating • fainting • difficulty breathing or shortness of breath • pale or bluish skin color • moist face • irregular pulse