Before Giving Care

Recognizing an emergency exists

By recognizing an emergency and taking immediate action to help, you give a suddenly ill or injured person the best chance for survival.
Emergencies can be recognized because of unusual sights (blood, smoke or fire, broken items, people milling around), appearances and behaviors (A person who is noticeably uncomfortable, clutching their chest or throat, unconscious, appears to be confused or drowsy for unknown reasons, has trouble breathing), odors (unusual odor of a person’s breath, gasoline, natural gas, smoke, unrecognizable smell) or noises (screaming, sudden silence from infants or children, an explosion, items falling, glass breaking, tires screeching, metal crashing, changes in machinery sounds-pitch or tone).

Overcoming barriers to act

There are many reasons why bystanders do not get involved in an emergency situation.
It is normal to feel hesitant or unsure about what to do.

Reasons people do not act

The presence of other people may lead one to assume that someone else will get involved.
Uncertainty about the person’s condition.
Type of injury or illness.
Fear of catching a disease.
Fear of doing something wrong.
Fear of being sued.
Being unsure of when to call 911.

What are some ways to overcome barriers to act.

Getting trained in first aid, CPR, or AED.
Training to develop the confidence to act, which enables you to take charge until more advanced help arrives.
Avoiding contact with blood or body fluids by using protective barriers and following standard precautions.
Being familiar with Good Samaritan laws and obtaining consent.

Good Samaritan Laws and Obtaining Consent

All states have enacted Good Samaritan laws to protect people who voluntarily give emergency care, without accepting anything in return.
These laws, which differ from state to state, may protect you from legal liability as long as you- act in good faith, are not negligent, and act within the scope of training.
You must obtain permission (consent) to help an ill/injured person.
If a person refuses care, at least call 911 or the local emergency number.
A person who is unconscious, confused or seriously ill may not be able to grant consent. In such cases, consent is implied. Implied consent means that a person would agree to the care if he or she could.
If the person is a minor, get consent from a parent/guardian, if present; otherwise consent is implied. Notify a parent/guardian as soon as possible.
Implied consent for a child in a life-threatening situation means that the parent/guardian would agree for care to be given.
To obtain consent: state your name; tell the person you are trained in first aid; ask the person if you can help; explain what you think is wrong; explain what you plan to do.

Preventing Disease Transmission

Avoid contact with- blood and body fluids.
Use protective equipment such as disposable gloves and CPR breathing barriers.
Wash your hands immediately after care with soap and warm water.

Emergency Action Steps

Always follow the emergency action steps: Check-Call-Care in any emergency.
CHECK the scene for safety then CHECK the person for life-threatening conditions.
CALL 911 or the local emergency number.
CARE for the ill or injured person.
If you are alone, you must decide to Call First or Care First.
Call First situations are likely to be cardiac emergencies for a sudden cardiac arrest or if you witness the sudden collapse of a child.
Call First (call 911 or the local emergency number) before giving care for- an unconscious adult or adolescent age 12 or older, a witnessed sudden collapse of a child or infant, an unconscious infant or child known to be at a high risk for heart problems.
Care First situations are likely to be related to breathing emergencies.
Care First (give 2 minutes of care, then call 911 or local emergency number) for – an unwitnessed collapse of an unconscious person younger than age of 12, any victim of a drowning.
Usually, when you give first aid, you will not have to face hazards that require moving the person immediately.
Moving a person can lead to further injury. You should move a person only when you can do so safely and when there is an immediate danger.

Checking an Ill or Injured Person

Potentially Life Threatening Injuries

Unconsciousness, Not breathing or having trouble breathing, Choking, Persistent chest pain, No signs of life (normal breathing or movement), Severe bleeding, Severe burns, Shock, Seizures (that recur, last more than 5 minutes, result from injury or involve someone pregnant, diabetic or a person who fails to regain consciousness after a seizure).

Checking a Conscious Adult

For purposes of first aid care, an adult is defined as someone who is about 12 years of age or older.
After checking the scene, you should check the adult first for life-threatening conditions;
Some conditions may become life threatening if not recognized and cared for early.
Obtain consent to give care.
A head-to-toe examination should be done to check a conscious adult.
Care for the person based on conditions found.
Take steps to minimize shock.

Recognizing and Caring for Shock

Shock is likely to develop after any serious injury or illness severe bleeding, serious internal injury, significant fluid loss or other conditions.
A person showing signals of shock needs immediate medical attention.
Body systems and organs begin to fail.
The goals of first aid are to get help quickly and give care to minimize shock while caring for the illness or injury.
Signals of Shock: restlessness or irritability; altered level of consciousness; nausea or vomiting; rapid breathing and pulse; pale or ashen, cool, moist skin; excessive thirst.
Care for shock: make sure to have 911 called; continue to monitor the person’s ABC’s; control any external bleeding; keep the person from getting chilled or overheated; elevate legs about 12 inches if a head, neck, or back injury or if broken bones in the hips or legs are not suspected; comfort and reassure the person until EMS personnel arrive and take over.
Do not give the person anything to eat or drink.

Checking an unconscious adult

After checking the scene, you should check the person for life-threatening conditions.
One way to remember what to check for is using the acronym “ABCs”.
A stands for airway
B stands for breathing
C stands for circulation

Rescue Breathing

You give 1 breath every 5 seconds
Tilt head and lift chin, then pinch the nose shut.
Take a breath and make a complete seal over the person’s mouth.
Blow in to make the chest clearly rise.
Each breath should last about 1 second.

Breathing Emergencies and Conscious Choking-Adult

A breathing emergency occurs when a person is having trouble breathing (respiratory distress) or cannot breathe at all (respiratory arrest).
There are different conditions that may cause a breathing emergency including injury, illness, or disease.
Breathing emergencies cause by asthma can be prevented by the person following his/her physician’s guidance and taking prescribed medications.
Breathing emergencies related to allergic reactions can be prevented by recognizing the first signals of an allergic reaction and getting help immediately.

Conscious Coking- Adult

Choking is a breathing emergency that can lead to death.
Common causes of choking include- trying to swallow large pieces of poorly chewed food; drinking alcohol before or during meals; wearing dentures; eating while talking excitedly or laughing, or eating too fast; walking, playing or running with food or objects in the mouth.
A person’s airway can be partially or completely obstructed.
A person with a partial airway obstruction can still move air to and from the lungs, so he/she can cough in an attempt to dislodge the object.
A person with a complete airway obstruction is unable to cough, speak, or breath.
A person who is choking may clutch at his/her throat. This gesture is known as the universal sign of choking.
The primary way to clear an airway obstruction for a conscious adult or child is to use back blows and abdominal thrusts.
Obtain permission to give care; Position yourself slightly behind the person. Place one arm diagonally across the person’s chest and lean the person forward.; Firmly strike the person between the shoulder blades with the heel of your hand.; Place the thumb side of the fist against the middle of the abdomen just above the naval. Grasp the fist with the other hand.; Give a combination of 5 back blows and 5 abdominal thrusts.; Continue this until the object is forced out, the person can breathe, speak or cough forcefully or the person becomes unconscious.

The Cardiac Chain of Survival and Cardiac Emergencies

Heart disease is one of the leading causes of death in both men and women.
Taking steps to prevent heart disease or to reduce your risk of heart disease is one of the most important things you can do for your health.
Symptoms of a Heart Attack- Persistent chest pain or pressure that lasts longer than 3-5 minutes or goes away and comes back; Chest pain spreading to the shoulders, neck, jaw, or arms; Shortness of breath or trouble breathing; Nausea or vomiting; Dizziness, lightheadedness or fainting; Pale, ashen (grayish) or bluish skin; Sweating.
A person having a heart attack may deny that he/she has any signals.
Both men and women experience the most common heart attack signal, which is chest pain or discomfort. Women are somewhat more likely to experience some of the other warning signals, particularly shortness of breath, nausea/vomiting and back or jaw pain.
Women also tend to delay telling others about their signals to avoid bothering or worrying others.

The Cardiac Chain of Survival

Caridopulmonary resuscitation (CPR) alone is not enough to help someone survive a cardiac arrest (a condition in which the heart stops functioning altogether). Advanced medical care is needed as soon as possible. This is why it is so important to call 911 or the local emergency number immediately. Although rare, older children and teenagers can experience cardiac arrest. Unlike adults, children seldom initially suffer cardiac emergency. Instead, they suffer a respiratory emergency that develops into a cardiac emergency.
The greatest chance of survival from cardiac arrest occurs when the following sequence of events happen as rapidly as possible: 1. Early recognition and early access; 2. Early CPR; 3. Early defibrillation; 4. Early advanced medical care.
Defibrillation is an electric shock that interrupts the heart’s chaotic electrical activity, most often ventricular fibrillation (V-fib), during sudden cardiac arrest. The shock may help the heart restore its ability to function as a pump.
An AED is a device that analyzes the heart’s electrical rhythm and, if necessary, prompts a responder to deliver a shock using the AED to a person experiencing sudden cardiac arrest.
Certain AEDs with pediatric AED pads are capable of delivering lower levels of energy to a child between the ages of 1 and 8 or less than 55 pounds.
AEDs are now found in many places across the US, in workplaces and places where large numbers of people gather, such as airports, shopping malls and stadiums.
You may be faced with a situation that requires you to use an AED.

CPR and Unconscious Choking- Adult

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If a person is in cardiac arrest, he/she is unconscious, not breathing and shows no other signs of life.
Cardiopulmonary resuscitation (CPR) can help circulate blood that contains oxygen to vital organs by a combination or chest compressions and rescue breaths.
If you attempt rescue breaths but are unable to make the chest clearly rise, you must act quickly to get air into the person. Care for an unconscious choking adult is very similar to the skill of adult CPR, with the exception that you look for a foreign object between compressions and breaths. Chest compressions are used to help force air from the person’s lungs to dislodge the object.
CPR consists of 30 compressions (at a depth of about 2 inches) and 2 rescue breaths.
Caring for an Unconscious Choking person: Tilt head back and give 2 rescue breaths; If air doesn’t go in, retilt and give breaths again; If chest doesn’t rise, give 30 chest compressions; look for object; remove if you see one; try 2 rescue breaths. If breaths don’t go in, repeat.