SƠ cứu TRÊN TÀU(FIRST AID PRESENTATION)

CARDIO-PULMONARY RESUSCITATION CPR  Lifesaving technique useful in many emergencies, including heart attack or near drowning  An emergency procedure which is performed in an effor

Maria Luisa Malaca- Sanchez, M.D.

FIRST AID

To prepare the seafarer in providing

medical first aid in emergency cases

To provide the seafarer with the knowledge and skill in First Aid to be able to take

immediate action in case of accidents or

illness likely to occur on board a ship

FIRST AID

 Immediate and temporary treatment of a victim

of sudden illness or injury while awaiting the arrival of medical aid

 Proper early measures may be instrumental in saving life and ensuring a better and more rapid recovery

 The avoidance of unnecessary movement and over excitation of the victim often prevents

further injury

AIMS OF FIRST AID

 Preserve life

 Prevent further injury

 Promote recovery

First aid training also involves the

prevention of initial injury and responder safety, and the treatment phases

Certain self-limiting illnesses or minor injuries may not require further medical care past the first aid intervention

First Aid Kits

A vessel must carry a first aid kit in

accordance with national regulations

 GENERAL INSTRUCTIONS must be printed in legible type and must be

waterproof

ESSENTIALS OF FIRST AID

CARDIOPULMONARY RESUSCITATION ( CPR)

CARDIO-PULMONARY

RESUSCITATION ( CPR )

 Lifesaving technique useful in many

emergencies, including heart attack or near

drowning

 An emergency procedure which is performed

in an effort to manually preserve intact brain function until further measures are taken to

restore spontaneous blood circulation and

breathing in a person in cardiac arrest.

 It is indicated in those who are

unresponsive with no breathing or

abnormal breathing

It may be performed both in and outside of

a hospital

CPR alone is unlikely to restart the heart; its main purpose is to restore partial flow

of oxygenated blood to the brain and heart

The objective is to delay tissue death and

to extend the brief window of opportunity for a successful resuscitation without

permanent brain damage

ASSESS THE SITUATION

BEFORE STANDARD CPR

 Is the person conscious or unconscious?

 If the person appears unconscious, tap or shake his or her shoulder and ask loudly,

“Are you ok?”

 If no response, call emergency hotline or have someone else do it but if you’re alone perform 2 minutes of CPR before calling for help

REMEMBER ABC’ s of STANDARD CPR

 Clear the airway

1. Lie on a firm surface

2. Kneel next to the person’s neck and

shoulders

3. Head tilt- chin lift Palm on the victim’s

forehead , other hand lift the chin forward

4. Check for normal breathing:

< 10 sec: chest motion, breath sounds (feel

on cheek and ear)

 Breathe for the person

Rescue breathing can be mouth to mouth or

mouth to nose ( if the mouth is injured or

can’t be opened)

1 With the airway open, pinch the nostrils shut for mouth to mouth

2 Prepare to give to 2 rescue breaths 1 st

breath—1 sec– chest rise– give 2 nd breath

If no chest rise—repeat head tilt- chin lift then give 2nd breath

3 Begin chest compressions

 Restore blood circulation

1 Heel of one hand over the center of the

person’s chest the other hand on top of the

1 st hand Keep elbows straight

2 Use your upper body weight as you

compress the chest 1 ½ - 2 in Push hard and fast—2 compressions / sec

3 After 30 compressions, tilt head back and

lift chin up to open the airway Give 2

rescue breaths ( one cycle)

4 If still no response after 5 cycles ( about 2

min) use Automated External Defibrillator (AED) if you are trained

If no AED– continue CPR until there are signs of movement or until emergency medical personnel take over

2010 CPR GUIDELINES

In 2010, the American Heart

Association and International Liaison Committee on Resuscitation updated the

CPR guidelines

 The importance of high quality CPR

(sufficient rate and depth without

excessively ventilating) was emphasized

 An exception to this recommendation is for

those who are believed to be in a respiratory arrest (drowning, etc.) and children.

AMERICAN HEART ASSOCIATION

In adults with out-of-hospital cardiac

arrest, compression-only CPR by the lay

public has a higher success rate than

standard CPR.

COMPRESSION ONLY CPR

( 2010 CPR Guidelines)

Hands-only or cardio-cerebral resuscitation

Technique that involves chest

compressions without artificial respiration

 It is hoped that the use of compression

only delivery will increase the chances of the lay public delivering CPR

COMPRESSION ONLY CPR

( 2010 CPR Guidelines)

 It is recommended as the method of choice for the untrained rescuer or those who are not proficient as it is easier to perform and instructions are easier to give over the

phone

 The method of delivering chest

compressions remains the same, as does the rate (at least 100 per minute)

STANDARD CPR

For those with non cardiac arrest and

people less than 20 years of age standard

CPR is superior to compression only CPR

2015 AMERICAN HEART ASSOCIATION GUIDELINES UPDATE FOR CPR

The crucial links in the out-of-hospital

adult Chain of Survival are unchanged

from 2010, with continued emphasis on the simplified universal Adult Basic Life

Support (BLS) Algorithm

2015 AMERICAN HEART ASSOCIATION GUIDELINES UPDATE FOR CPR

The Adult BLS Algorithm has been

modified to reflect the fact that rescuers

can activate an emergency response (i.e,

through use of a mobile telephone) without leaving the victim’s side

• It is recommended that communities with people at risk for cardiac

2015 AMERICAN HEART ASSOCIATION GUIDELINES UPDATE FOR CPR

Recommendations have been strengthened

to encourage immediate recognition of

unresponsiveness, activation of the

emergency response system, and initiation

of CPR if the lay rescuer finds an

unresponsive victim is not breathing or not breathing normally (gasping)

2015 AMERICAN HEART ASSOCIATION GUIDELINES UPDATE FOR CPR

The recommended sequence for a single

rescuer has been confirmed: the single

rescuer is to initiate chest compressions

before giving rescue breaths (C-A-B rather than A-B-C) to reduce delay to first

compression The single rescuer should

begin CPR with 30 chest compressions

followed by 2 breaths

2015 AMERICAN HEART ASSOCIATION GUIDELINES UPDATE FOR CPR

There is continued emphasis on the

characteristics of high-quality CPR:

compressing the chest at an adequate rate and depth, allowing complete chest recoil after each compression, minimizing

interruptions in compressions, and

avoiding excessive ventilation

The recommended chest compression rate

is 100 to 120/min (updated from at least 100/min)

The clarified recommendation for chest compression depth for adults is at least 2 inches (5 cm) but not greater than 2.4

inches (6 cm)

2015 AMERICAN HEART ASSOCIATION GUIDELINES UPDATE FOR CPR

These changes are designed to simplify lay rescuer training and to emphasize the need for early chest compressions for victims of sudden cardiac arrest

AUTOMATED EXTERNAL DEFIBRILLATOR ( AED)

AUTOMATED EXTERNAL

DEFIBRILLATOR ( AED)

 Portable electronic device that

automatically diagnoses the potentially life threatening cardiac arrhythmias in a

patient

 Able to treat them by application of

electrical therapy which stops the

arrythmia, allowing the heart to re-

establish an effective rhythm

AUTOMATED EXTERNAL DEFIBRILLATOR ( AED)

 Vast majority of AED units have spoken prompts and some may also have visual displays to instruct the user

AUTOMATED EXTERNAL

DEFIBRILLATOR ( AED)

 The rhythms the device will treat is usually limited to: > Ventricular fibrillation > Pulseless Ventricular tachycardia

 AED’s are not designed to shock asystole

or FLAT LINE patterns

Designed to be simple to use for the layman

 Uncorrected , these cardiac conditions rapidly lead to irreversible brain damage and death

 After approximately 3-5 minutes, irreversible brain/ tissue damage may begin to occur.

 For every minute that a person in cardiac arrest goes without being successfully treated ( by

defibrillation), the chance of survival decreases

by 10 percent

AUTOMATED EXTERNAL

DEFIBRILLATOR ( AED)

AED’s are designed to be used by

laypersons who ideally should have

received AED training

Metals and piercings on the torso must be removed before using AED on someone to avoid interference

 Placement of public access AED should take into account where large groups of people

gather, regardless of age and or activity

 AED’s are also increasingly common on

commercial airlines, cruise ships and other transportation facilities

In order to make them highly visible, public access AED’s are often brightly colored,

and are mounted in protective cases near

the entrance of a building

A trend that is developing is the purchase of AED’s to be used in the home, particularly

by those with existing heart conditions

AUTOMATED EXTERNAL DEFIBRILLATOR ( AED)

AUTOMATED EXTERNAL DEFIBRILLATOR ( AED)

AUTOMATED EXTERNAL DEFIBRILLATOR ( AED)

AUTOMATED EXTERNAL

DEFIBRILLATOR ( AED)

Most manufactures recommend checking the AED before every period of duty or on

a regular basis for fixed units

Some units need to be switched on in order

to perform self check, others have a self

check system built in with a visible

indicator

AUTOMATED EXTERNAL

DEFIBRILLATOR ( AED)

 Fully automatic units are likely to have

few buttons, often activating as soon as the case is opened, and possibly just one

button to shock or in some cases this will

be performed automatically, just attach the pads and follow voice prompts

AUTOMATED EXTERNAL DEFIBRILLATOR ( AED)

 Semi- automatic units will tell the user that

a shock is needed, but the user must tell the machine to do so, usually by pressing a

button

 Most units are designed for use by non-

medical operators

 Their ease of use give rise to public

access defibrillation ( PAD), which experts agree has the potential to be the single

greatest advance in the treatment of out

-of- hospital cardiac arrest since the

invention of CPR

Proper placement of pads on the chest

BANDAGING

 A piece of material used to support a

medical device such as a dressing or splint

or on it’s own to provide support to the

body

TYPES OF BANDAGE

1 GAUZE– most

common, simple woven

strip which can come

TYPES OF BANDAGE

 From among the different types of

bandages available, the triangular

bandage is widely use considering that these type of bandages can easily be

secured out of any clothing material May it be at home, or in the office or practically anywhere.

TYPES OF BANDAGE

 The different types of bandages are of course very useful

 However, this could not be available all the

time considering that an accident or

emergency may happen anytime even on the most unexpected places.

 This is therefore the reason why the triangular bandages are the most popular among them

TYPES OF BANDAGE

There is no problem in so far as sizes

considering that the triangular bandage can easily be folded into different sizes in order

to apply to different areas of the body

 May the patient be an adult a child or an infant, triangular bandages can always be applied

Bandaging techniques

No hard and fast rules:

1 Use clean material

2 Bleeding is controlled

3 Dressing is opened carefully

4 Dressing adequately covers the wound

5 Wounds are bandaged snugly, but not too tightly

Bandaging techniques

6 No loose ends

7 Bandage securely tied

8 In bandaging the extremities, leave tips

of fingers and toes

9 Place the body part to be bandaged in the position in which it is to be left

10 Unless otherwise specified, all knots should be tied

Bandaging techniques

 Bandaging is an art form

 The only way to become proficient is to

PRACTICE

SPLINT

 A rigid or semi flexible device for the

immobilization of displaced or fractured

parts of the body for safer transportation

 Most commonly employed for fractures of bones, allows patient to be moved without displacing the injured part

 May be a means of fixation to immobilize the bones until healing is complete

 Any material that offers the degree of resistance required may be use as a

temporary splint, ex cloth, gauze, plaster, wood or metal

 Plastic or fiberglass molded to fit

 Air splints