Disaster Nursing and Basic Life Support

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BASIC LIFE SUPPORT



The Nature of Disasters



Goal

The goal of this chapter is to

introduce the First Aiders the

concepts behind the disasters,what they are, and how

disaster response is organized.



Objectives

At the completion of this session,the First Aiders will:

discuss the concepts of emergency and

disaster;

describe the difference between a natural

and man-made disaster;

Perform the simplified Adult BLS Algorithm



INTRODUCTION



“Disaster

preparedness, whether it's inanticipation of potential weather-related incidents or terrorist incidentsrequires a skill set that in my mindsomeone has to be trained for.”

~~Bennie Thompson





Emergency

Is a situation where a suddenincident or event has occurredand normally used, local

responses will suffice to care forthe situation without calling inoutside help.

-- WHO, 2005



Emergency

Natural

Man-made

Examples:

Car accident

Water main breaking



Disaster

Any event that leads to a responsebeyond which the affected communitycan deal with locally.

-- WHO, 2005



Disaster

Like emergency,

Natural

Man-made



Disasters

Are subset of emergencies and

tax responding agencies beyond

their capacities.Can be like a spreading ring of

concentric circles, influencing the

outer rings less and less.-- WHO, 2005



Local response

Provincial response

National response

Figure 1 - 1. As the level of response spreads out from the incident, thedegree of severity decreases going from local disaster to national

emergency.



Types of disasters

Natural

disasters

Man – madedisasters



Natural disasters

earthquakes, tsunamis,pandemic flu and tornadoes

Man – made disasters

bioterrorisms, hijacking, and war



Types of response

Assess

Contain

RespondRecover





FIRST AID is an immediate care

given to a person who has beeninjured or suddenly taken ill. It

includes self-help and home care

if medical assistance is not

available or delayed.



Objectives of First Aid:

a.

To alleviate sufferingb. To prevent added/further injury or

danger



Emergency action principles

Do a primary survey:

•

Check A –

airway•Check B – breathing

•Check C – circulation



Do a secondary survey:

•Interview the victim.•Check the vital signs

•determine radial or carotidpulse

•determine breathing

(respiration rate)•determine skinappearance



•Do a head-to-toe examination

looking for DCAP-BTLS

(Deformity, Contusion, Abrasion,Puncture, Burn, Tenderness,Laceration, Swelling)



•Golden Rules in Giving Emergency

Care:

•What to DO

•Do obtain consent when possible.

•Do think the worst. It’s best toadminister first aid for the gravest

possibility.

•Do remember to identify yourselfto the victim.



•Do provide comfort and emotional

support.•Do respect the victim’s modesty

and physical privacy.

•Do be as calm and as direct aspossible.

•Do care for the most seriousinjuries first.



•Do assist the victim with his/her

medication.

•Do keep onlookers away from the

injured person.•Do handle the victim to a

minimum.

•Do loosen tight clothing.



What Not to DO:

•Do not let the victim see his/herown injury.

•Do not leave the victim alone

except to get help.

•

Do not assume that thevictim’s

obvious injuries are the only ones.



•Do not make any unrealisticpromises.

•

Do not trust the judgment of theconfused victim and require themto make a decision.



Cardiopulmonary Resuscitation(CPR) is the combination of

compression and rescue

breathing. This must be confinedfor effective resuscitation of the

victim of cardiac arrest.



Criteria for Not Starting CPR:

All patients in cardiac arrestreceive resuscitation unless:

• The patient has a valid “Do Not

Attempt Resuscitation” (DNAR)order.

• The patient has signs of irreversibledeath: rigor mortis, decapitation

or dependent lividity.



•No physiological benefit can beexpected because the vital

functions have deteriorated

despite maximal therapy for suchconditions as progressive

septic or cardiogenic shock.



•Withholding attempts to

resuscitate in the delivery room isappropriate for newly borninfants with:

•Confirm gestation <23 weeks orbirth weight <400g.

•Anencephaly

•Confirmed trisomy 13 or 18.



Simplified Adult BLS Algorithm

• Unresponsive, No breathing or no normalbreathing [Gasping]

• Activate emergency response

– Get defibrillator

• Check rhythm/shock if indicated

• Repeat every 2 minutes

– Start CPR• Push hard, Push Fast




• Area safety – scene survey – Rescuer: 90%

– Victim: 10%

• BSI [Body Surface Isolation]• Introduction of self

• Tap and shout

– Sternal rub




– Responsive – Ok

– Unresponsive – BSI if with blood

• Airway

– Head tilt, Chin lift [Maximum]

– Don’t remove at forehead unless during CPR

• Breathing

• Circulation




• Breathing

– Chest rise [Best indicator]

– Feel the air

– 5 – 10 seconds [not more than 10 sec]

Not breathing:

2 initial blows6 min – clinical or biological death, brain damage




• Circulation

– 5 – 10 seconds [not more than 10 secs]

– CPR

• Center of the chest

• Male – nipple line

– Heel – sternum

– Dominant [handedness] – sternum

– Non dominant – above

– Hips – fulcrum

» Longer muscular energy




• Compression

– 30

• Breaths

– 2

• 5 cycles for 2 minutes




• 2010

– More than 100 beats/min

– Staying alive rhythm

CAB - compression, airway, breathing

5 cycles/ 2 minutes



When to STOP CPR:

• S – Spontaneous signs of circulationare restored.

• T – Turned over to medical services orproperly trained and authorizedpersonnel.

• O – Operator is already exhausted andcannot continue CPR.

• P – Physician assumes responsibility(declares, death, take over, etc.)



finDomo

ArigatoGozaimasu

Disaster Nursing and Basic Life Support

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