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Adult CPR

Establish Unresponsiveness
Call 911
Airway- open airway (head tilt/chin lift)
Breathing -Check for breathing 3 to 5 seconds (look, listen, & feel)
If patient is not Breathing, Give 2 breaths (pinch the nose)
Circulation-Check Pulse at the Carotid artery for 5-10 sec.
If patient has no Pulse,
Place patient on a firm surface on his/her back
Place hands (one on top the other) on the lower ½ of the sternum (chest)
Give 15 compressions (in 10 -12 sec.)
Give 2 breaths
Continue 15 compressions with 2 breaths for 4 cycles
After 1 min, recheck pulse and breathing
If patient has regained pulse, discontinue compressions
If patient is still not breathing, ventilate 1 breath every 5 sec.

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Infant CPR

Establish Unresponsiveness
Call 911
Airway- open airway (head tilt/chin lift)
Breathing -Check for breathing 3 to 5 seconds (look, listen, & feel)
If patient is not Breathing, Give 2 breaths (pinch the nose)
Circulation-Check Pulse at the Brachial artery (arm) for 5-10 sec.
If infant has no Pulse,
Place infant on a firm surface on his/her back
Place 2 fingers 1 finger width below the nipple line
Give 5 quick compressions
Give 1 breath after every 5 compressions
Continue 5 compressions with 1 breaths
After 1 min, recheck pulse and breathing
If infant has regained pulse, discontinue compressions
If infant is still not breathing, ventilate 1 breath every 3 sec.

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Choking

Ask: Are you choking? If patient can talk or has poor air exchange
Call 911
Stand behind patient and put your arms around the stomach
Place your fist above the navel
Perform Abdominal thrusts until patient expels object or becomes unconscious
If patient is unconscious, place his/her back on a firm surface
Check mouth for object
Open Airway (head tilt/chin lift)
Attempt to ventilate
If air does not go in: Perform abdominal thrusts
Place hands (one on top the other) above navel
Perform 5 inward and upward thrusts
Check the mouth, perform finger sweep
Open Airway, Re-attempt to ventilate
If air still does not go in,
Continue 5 abdominal thrusts, finger sweep of mouth, attempt ventilations
If air does go in, open airway, check for breathing, & circulation
Perform CPR if necessary

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Bleeding Control

· Direct pressure over the wound using the hand or a pressure dressing
· Elevate the wound above the level of the heart
· Pressure points- use finger pressure to compress supplying artery against underlying
bone. Use the brachial artery for arms and the femoral artery for legs

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Shock

Inadequate blood flow to the tissues and organs of the body. It is brought on whenever there is severe injury to the body or a shock to the nervous system. All bodily processes are affected. Vital functions slow down.

In the early stages the body compensates for a decreased blood flow to the tissues by constricting blood vessels in the skin, soft tissues, and muscles. This causes the patient to have:

Cold, clammy, pale skin
Weakness and nausea
Rapid, labored breathing - causing restlessness and anxiety
Increased pulse rate and decreased blood pressure

As shock progresses, the patient will become apathetic and relatively unresponsive, and pupils will dilate, finally becoming unconscious.

TREATMENT for shock is as follows:

· Check ABC's (Airway, Breathing, Circulation)
· Control all obvious bleeding
· Keep patient lying down, legs slightly elevated
· Prevent loss of body heat
· Splint any broken bones
· Avoid excessive handling
· Check vital signs- pulse, breathing
· No liquids

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Heart Attack

Generally, heart attacks occur in 2 forms, angina pectoris and myocardial infarction (MI). The symptoms of both are the same: pain in the chest region radiating to the jaw and arms; pale, sweating skin; weak pulse; shortness of breath; nausea.

The differences are: Angina occurs when oxygen demand exceeds supply during physical or emotional stress. Pain subsides with rest, oxygen and nitroglycerine, and lasts only 3 to 8 minutes. MI (Myocardial Infarction) pain is not related to stress and is not relieved by rest or nitroglycerine. This pain lasts more than 10 minutes.

Treatment in both cases consists of:

· Check ABC's (airway, breathing, circulation)
· Call 911 immediately
· Calm and reassure the patient
· Place patient in semi-reclining position or in most comfortable position for them
· Ask questions about any previous heart problems and medications they may be taking

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Seizures

Protect the patient from injury during seizure. Then maintain Airway, Breathing, and Circulation. If the patient regains consciousness, reassure and calm him/her.

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Diabetes

Diabetes is a disease in which the body is unable to use sugar at a cellular level. Insulin is a drug used by diabetics to promote cellular use of sugar. When a diabetic uses his insulin but does not eat, Insulin Shock may occur. By not eating, this person has failed to replenish the sugar levels in his body, leaving the insulin nothing to work with. Since the brain needs a constant supply of sugar, shock and unconsciousness will occur if the sugar levels are not replenished.

Symptoms: Pale, moist skin; dizziness, headache; full, rapid pulse; thirst; slurring speech, seizures; coma. Sometimes mistaken for alcohol intoxication.

Treatment: Immediate improvement following oral administration of carbohydrates (sugar, candy, juice, soda pop).

If a diabetic fails to take insulin, his/her body cannot use sugar for cellular energy, and other, more harmful sources of energy are used. The result is acid waste products in the blood and excessive fluid loss causing Diabetic Coma.

Symptoms: Air hunger manifested by deep sighing respirations; dehydration manifested by dry, warm skin; a sweet or fruity breath odor; a rapid weak pulse; unresponsiveness

Treatment: Prompt transport to hospital for insulin

When in doubt, give sugar! It will not worsen a diabetic coma, but will help insulin shock.

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Hypothermia

Cause: Prolonged exposure to cold. Water conducts heat 250 times faster than air.

Symptoms: Low body temperature; shivering; apathy and sleepiness; slow heart rate and respirations, unconsciousness.

Treatment: ABC's; rewarming by drying the patient, wrapping in a blanket, and moving out of the wind. Hot fluids if tolerated. Use vehicle heater if conditions permit.

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Heat Exhaustion

Cause: Overexposure to heat

Symptoms: Weakness; cool and clammy skin; excessive sweating; nausea

Treatment: Bring to cool, airy place; lay victim down, feet elevated; liquids unless
vomiting.

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Heat Stroke

Cause: Failure of the sweating mechanism, allowing body temperature to rise to
dangerous levels

Symptoms: Hot, dry, red skin; full rapid pulse; throbbing headache; unconsciousness

Treatment: Immediate cooling by applying cold water and fanning; call an ambulance.

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Burns

Burns are classified by degree. First Degree is a reddening of the skin such as a mild sunburn. Second Degree is when the skin blisters, as in a deep sunburn or direct contact with hot objects.

Treatment for First and Second Degree burns is to immerse in cold water for 15 minutes then apply sterile dressing. Cold compresses reduce pain.

A Third Degree burn is when the skin is charred. Treatment is to cover burn with a sterile dressing and treat for shock.

·Do not apply ice
· Do not apply butter, oil or other substance to the wound.

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Eye Injury

Do not examine eyes with dirty hands. Foreign particles should be rinsed out using eye wash or clean water. Use a Q-tip for stubborn particles. If something is stuck in the eye, cover both eyes and let a doctor remove it.

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Impaled object

Treatment:

Do not remove object
Stop bleeding
Stabilize the object
Send patient to hospital

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Fractures & Splinting

A fracture is a break in the bone and is either closed or open.

Closed fracture: The bone is broken but there is no connecting wound from the break in the bone through the skin.

Open fracture: The bone is broken with connecting wound through the surface of the skin. The danger of infection exists. Symptoms include: swelling, pain, tenderness, deformity, protruding bone, grating sound. The treatment is to prevent further damage. Immobilize the fracture by applying gentle traction and splinting.

These steps should also relieve pain. Splints should always be long enough to extend beyond the joint just above and below the fracture bone. Check the pulse and feeling around the fracture site.