Medical emergencies don't occur every day. But when they do, being well informed can help you deal with these situations. Everyone should learn at least the basic first aid and CPR Cardiopulmonary resuscitation) techniques. You may need to use them at any time at home, at school or work or even while you're traveling. Knowing what to do can make the difference to a person's recovery, and you could even save their life.
The goal in learning first aid is to give care to someone suffering from an injury or medical emergency until trained medical help can arrive.
There are four basic steps to take in an emergency:
· Recognize that an emergency has occurred.
· Decide to act
· Call EMS (Emergency Medical Services)
· Give first aid until help arrives
When calling EMS personnel for help, inform the dispatcher; 1) what has happened 2) the address and 3) the phone number from where you are calling.
A Primary Survey
In any emergency , you must first perform a primary survey to determine if any conditions threaten a casualty’s life. Things to consider;
· is the casualty conscious?
· Are there signs of major bleeding / circulation problems?
· Is the casualty breathing?
· Is the person in shock?
CARDIOVASCULAR EMERGENCIES
Sudden Cardiac Arrest (SDA) occurs when the heart unexpectedly stops beating effectively. SCA is a major cause of death in Canada. In sudden cardiac arrest, the heart no longer pumps blood to the brain. Without the oxygen and nutrients supplied by the blood, brain cells begin to die within minutes, and death soon follows.
What are the odds?
The more people in a given workplace, at a public event, etc, the more likely the occurrence of sudden cardiac arrest.
It is estimated there is one cardiac arrest for every 100,000 life-years.
Life years = # of people per location by the average age.
Example 1: Over 2,000 employees with an average age of 40 years = 80,000 life years.
You can expect at least one incident of sudden cardiac arrest in the workplace per year.
Example 2: At a outside event with 5,000 spectators with an average age of 40 years, it works out to two likely incidents of SCA per year. (ie; (5,000 x 40) /100,000)
Those who are at a high risk of having a Cardiac Arrest include; 1) The elderly
2) People who have high levels of stress
3) People who smoke
4) Lack of physical exercise
5) Poor eating habits.
As you can see, only the first factor is out of everyone’s control. However, aging can be slowed down dramatically with changes to eating habits and introducing physical exercise.
Signs and Symptoms of a Heart Attack
* Persistent Chest Pain
* Difficulty breathing
* Neck, abdominal or back pain (women)
* Pale or bluish skin
* Pulse too fast, too slow, or irregular
* Sweating (stress)Nausea and vomiting
Cardiopulmonary resuscitation (CPR)
CPR can help maintain oxygenation and blood circulation. Without CPR, brain cells begin to die within 4 to 6 minutes. CPR provides a minimum of the normal blood flow to the brain and heart. The chance of survival is very slim (around 2%) unless defibrillation (AED) can be applied within 5 minutes.
Using a Automated External Defibrillator (AED) can increase the chance of survival from sudden cardiac arrest by 30 to 74% or more. The AED is a small, easy-to-use device that detects electrical activity of a person’s heart and checks the heart’s rhythm.
The window of opportunity for using an AED is small – defibrillation is best performed within 5 minutes of cardiac arrest. Chances of survival decreases 7-10 percent with every minute that passes after the arrest.
CPR GUIDELINES
For Adults: Chest Compressions are Continuous
Try to compress at 100 beats per minute and about two inches (five centimeters) deep until emergency help arrives.
For Children, Infants, Drownings and cases where cardiac arrest hasn't been witnessed, you must do both Chest Compressions and Ventilation.
Ventilation (Rescue Breaths)
Normal breath given over 1 second until chest rises
Chest Compression to Ventilation Ratio: 30:2
Chest Compression Landmarking:
Center of the chest (heel of hand between the nipples) for an Adult or child
Below the nipple line at chest center for an infant
AED - 1 shock then 5 cycles (2 minutes) of CPR.
For Children, Infants, Drownings and cases where cardiac arrest hasn't been witnessed, you must do both Chest Compressions and Ventilation.
Ventilation (Rescue Breaths)
Normal breath given over 1 second until chest rises
Chest Compression to Ventilation Ratio: 30:2
Chest Compression Landmarking:
Center of the chest (heel of hand between the nipples) for an Adult or child
Below the nipple line at chest center for an infant
AED - 1 shock then 5 cycles (2 minutes) of CPR.
Can I kill someone if I do CPR incorrectly?
No. The person in cardiac arrest is already clinically dead. CPR can only help.
What if I crack a rib when I do CPR?
Frequently ribs are broken with the pressure CPR places on the sternum. Up to 30% of cardiac arrest victims have broken ribs as a result of CPR. This happens more frequently with older casualties. But remember, it's better to have a cracked rib than be dead.
Will CPR always save a life?
No, in fact, most instances of CPR for cardiac arrest are unsuccessful (2% success rate , 70% with AED)
When should I stop CPR?
When help arrives to take over, or the victim starts to move.
STROKE
A stroke or CVA (cerebrovascular accident) is caused by a blood clot or bleeding from a ruptured artery in the brain. The risk factors for stroke are similar to those of heart disease.
Signs and symptoms of Stroke Sudden weakness or numbness of the face, arm, leg – usually on one side of the body.
Difficulty talking or understanding speech
Dizziness or confusion
Unconscious
Loss of bladder control
Steps to take in case of a Stroke
· Call EMS (911)
Before the ambulance arrives Here are things you can do next;
· Give CPR or mouth to mouth resuscitation if needed.
· Do not attempt to move them. Make the stroke victim as comfortable as possible. Loosen clothing.
· Do not give them anything to eat or drink. Stroke causes the inability to swallow and they could choke. · Do not take aspirin, because you do not know what kind of stroke it is. Though aspirin can reduce blood clot, it could make hemorrhage worse. If an aspirin has been taken that day, be sure to tell the ER. · Breathe Deeply. Taking slow, deep breaths can help to calm the stroke victim, while providing more oxygen to the brain. Keep them lying down and talk to them reassuringly.
· Keep the Head Cool, the body warm. If you have ice packs, you can apply them to the head briefly keep it cool. Wrap in a thin cloth or it will be too cold. Keeping the head cool cuts down on the inflammatory reaction during stroke and may help with the painful headache during stroke. Covering them with a coat or blanket to keep the body warm will prevent shock.
BLEEDING
Severe bleeding is a life-threatening emergency. Direct Pressure should be applied to decrease the bleeding. If you suspect internal bleeding there is little that a first aider can do - call EMS immediately. Do not dismiss a closed wound as “just a bruise”. If a person complains of severe pain or has trouble moving a body part seek medical attention immediately. Severe internal bleeding may cause the casualty to go into shock.
FIRST AID MYTHS
1) Sucking a Snake Bite Slicing into a newly bitten victim and removing the poison by sucking it out does NOT work. The venom doesn’t just sit in the wound waiting for you to remove it. Cutting into the wound will just create infections. Sucking it out with your mouth is even worse - the snake will just get a two-for-one special that way. Call EMS (911) first. Keep the bite below heart level. Wash the area with warm water and soap. Remove constricting clothing and wrap with an elastic pressure bandage.
2) Butter on Burns Butter and oil are great for basting, but unless you want to make a burn worse, leave them in the kitchen. Oils hold in the heat, exactly the opposite of what a burn victim needs. Cool the burned area with water unless a large part of the body is affected. Cover with moist sterile dressing to prevent infection.
3) Putting Something in a Seizure Patient's Mouth to Bite While somebody suffering a seizure may very well bite his or her tongue, it rarely becomes an airway emergency. Seizures look scary, but generally do very little harm. You're more apt to cause an airway blockage by stuffing an object in the seizure victim's mouth.
4) Breathing Into a Paper Bag for Hyperventilation There are a lot of reasons why we hyperventilate (breath fast). In no case is a paper bag indicated as proper treatment. This one is actually very dangerous. DO NOT USE A PAPER BAG FOR HYPERVENTILATION! Instead, tell the casualty to relax and breathe slowly. Reassurance is often enough to correct hyperventilation.
5) Leaning Back with a Nosebleed I know, I know, mom's going to be mad when you bleed on your soccer uniform, but leaning back will cause you to swallow blood. To control a nosebleed, lean forward and pinch the nostrils together until the bleeding stops.
CONCLUSION
I have only touched on some of the major First Aid and CPR Guidelines. In an emergency situation many people will either panic or freeze. By taking a first aid and CPR training course on a regular basis you can retain what you have learned. You can rest assured that you can help a friend, colleague or loved one in the case of an emergency situation.
References/Links:
http://www.redcross.org
http://www.sja.ca
http://www.strokefamily.org/strokeemergency.html
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