18 Jul CPD First Aid
James bond plugs himself in an AED look up
AED’s Zole R2
Q’s students ask
Shnergly fergly burgly disease = spontaneous penile shrinkage
Q Michael Jackson heart beating compression on bed yes he should have
Positional asphyxia spine in restraining someone story of guy who stole 10£ perfume and security guard sat on him and he died. You can get PA in car crash
Burns is all treatment cold water?
Lift hand up and hold for a few seconds now compare hands and see one is pale
Act a like you are having a heart attack
Supplying and providing medication however is someone is having a heart attack and you have 300mg aspirin in your pocket you can say would you like to take it and they take it that’s ok unless he refuses over 16 years of age if they are allergic and know they are then they will refuse or child under 16 (cos statistically they don’t have heart attacks or have Rayes syndrome and salicylic acid 50% chance child will die.
It’s the hand that gives it
Moving someone spinal injury but what if there is danger?
Moving an obese person
When showing practical turn off visual PowerPoint
What does an epi pen do exactly?
Why do you examine children feet first and adults head first? You do not
Is there a better side for RP? Ladies with lumps to the left
Find video life threatening allergic reaction? Think ABCDE
W position slows return of blood back to heart relaxes it and makes it work more effectively
Why baby’s breathe first why 5 because it is respiratory failure and the CO2 stimulates the hypoxic drive which makes us breath and they like it, top finger in line with nipple and other above and push deep as heart is deeper
Legal issues? Samaritan or duty of care
Resuscitator council guidelines google
Why do mouth to mouth
Pregnant choking and disabled
The Mammalian Diving Reflex (MDR) ice cold face preserves brain
Drowning why do kids last longer?
Basics matter most
Go into burning building you become casualty
Alert voice pain unresponsive avpo scale
Kneel on one knee squeeze shoulder with one hand and shake AVPO scale above collar bone pain protects you from attack because it protects you = aggressive e.g. hypo head injury on one knee gives you easy escape
Modify 10% technique using 100% common sense
Shout for help
Sweep or pincer out food
Put them on side away from you or toward you better
People die ‘cos people are scared of moving them
Not everybody who is paraplegic is dead but everybody who is dead is paraplegic
If you can’t control the environment control the casualty
Postural drainage to head tilt chin lift look listen feel for breathing max 10 secs
How many breaths normal = 12 to 20
Men breathe diaphrmatically women higher up
Tilt head back and swallow
Now tilt head back jaw forward and try swallow and you can’t
Make telephone call
Advanced cardiac life support
Apply pads like a seat belt across chest over shoulder
Chest compressions how to find centre of chest is in line with armpit of casualty heel of hand focuses force hand over other hand 100-120 per minute (2 per sec) 15 to 18 secs children at least 1/3 deep or 5-6cm don’t be afraid to push too hard.
# Ribs is when hand moves over to far think of trampoline fabric is sternum cartilage is like the rings that support mat. You can bounce happily in middle but if you bounce on metal bit it will break.
You can feel ribs crunching but stay where you are and go back into dip in centre of chest. Sore chest recover better than dead.
0.25% survival with BLS alone. We do it so we keep them viable
999/112 after checking if they are not breathing so better check if not breathing and unresponsive adult casualty. 8 minutes category A call.
1 minute BLS before going for help
30 compressions and 2 rescue breaths 1 second for each resuscitation council guidelines
41 people died in Hillsborough because they were left on their backs
If any doubt get on the chest
St Johns teach the difference for kids with a DVD
Primary survey completed casualty not breathing so we now use the
Norway 8 year olds taught CPD and AED is in every public building by law and they know the chain of survival.
150-200,000 deaths from heart attack in uk annually
50% of these happen before patient reaches hospital
Early access and BLS is essential (don’t use the words CPR better use BLS)
Anyone can use a defib the operator will give you key code to the nearest pad and follow instructions.
The hypoxic heart is a dead heart (no O2) a blue heart won’t start so BLS is essential
Heart is going lub dub lub dub
VF bottom chambers are wobbling and blood can’t get out as the heart muscle stretches so CPR is mechanically taking over of movement of blood through the chambers. The heart quivers so put pads on and heart goes wow what happened and it kicks back into sinus rhythm ASAP
Encourage learners to do a defib course with you
Fabric mowamber survived with BLS as he had 4 shocks from AED
Defibrillations is the only means to restart the heart
With each minute that defib delayed – survival rates decline
Discuss a and p of heart
People have had heart attacks but don’t know they had it
Top chambers bottom chambers relax in normal sinus rhythm
Exercise with students put hand up one by one and down then ask why you did it? Cos I asked u I am the SA node. I get a call and leave the room and you all do different tasks so when I come back you are in VF until I reorganise you
Show video of pig’s heart in VF
PEA pulseless electrical activity caused by blood loss and blood pouring in to cardiac space stopping it filling
Pads applied like a seatbelt crossing right shoulder and across chest and it zaps the heart going both ways so it does not matter which way round
Very hairy shave or put on anyway
Avoid air space between pads
May cause burns
Water emergency just dry the area
Nipple rings leave and avoid placing pad on
Metal surface avoid
Bag masks give 21% O2 if you do it yourself, it is only 16%
Compressions is not important pushing down but more bringing hands up as it gives the heart a chance to fill.
Choking blowing with CPR will go into right lung
You can use AED on children but careful with infants (unlikely they will have an arrest) but for a parent to see you tried everything is good as kids don’t survive therefore consider but it probably will not work.
Pregnancy yes as you keep mum alive to keep foetus alive
See video from lesson on AED training
As people come out of cardiac arrest they go into agonal gasping (person dying)
Video search bondi beach rescue