FIRST AID - zona.fmed.uniba.sk · Basic First Aid F.A. is a complex of basic medical and technical procedures, which are providing to the patient without special equipment. Activation

FIRST AID

Assoc. Prof. ROMAN ZAHOREC, MD, PhD.

Dpt. Of Anesthesia and ICU

St. Elizabeths Cancer Institute

DEFINITION of FIRST AID

◼ Acute disturbance of the health which may occur to everybody in every time and everywhere

◼ First aid should be provide by every man / citizen in every time and everywhere

◼ FIRST AID is a bundle of simple procedures which may help the patient to save his/her life or maintain health

CHAIN OF SURVIVAL

◼ FIRST AID on the place of event

◼ Call for emergency rescue system

◼ Technical and Emergency integrated Rescue system – call tel. No. 112 !

◼ Transport of injuried people to the hospital – Emergency Ambulancy

◼ Hospital care - Emergency dpt, ICU, Traumatology ward, Coronary ward...

Chain of survival - coordination

FIRST

AID

Technical

First Aid

Emergency

Rescue System

Transport

Hospital

care

ED. ICU

CHAIN OF SURVIVAL

INTEGRATED RESCUE SYSTEM:112

General Principles of First Aid

Non nocere to patient

and to rescuer

Activation of EMS:

emergency

rescue system

Action of F.A. quick

adequate

appropriate

Bariers -psychoemotional

Limits- hygien-epidemiological

Stop Stress –failure to help, anxiety,

First aid and cardiopulmonary resuscitation

CPR cardiopulmonary resuscitation

BLS basic life support – first aid

ACLS advanced cardiac life support

ABC arousal,activation of EMS - ERS,

Airway, - patency of airways, opening airwaysbreathing, - mouth to mouth breathing

circulation = chest compressions

Primary assessment

Secondary assessment

Signs, symptoms

Providing medical first aid

◼ FIRST AID should be provide by everymedical doctor

◼ Three categories of acute life/ healthdisturbances :

◼ 1. states of acute life threatening events– cardiac arrest, apnoe, coma

◼ 2. acute injuries/illness and seriousdisease attacks – circul. shock, MI, anafylaxis, polytrauma, burns, bleeding

General principles of First Aid

◼ FIRST AID is orientated to maintainvital functions, diminish injury, and all consequences of acute illness, and prevent of secondary complications.

◼ Quality of First Aid depends on theamount of theoretical knowledge ofbasic procedures and on the quality ofpractical action and skills whenproviding First Aid

Basic First Aid

◼ F.A. is a complex of basic medical and technical procedures, which are providing to the patient without special equipment.

◼ Activation of Emergency medical system – call teleph.no. 112, 155. 150.

◼ All procedures and care about patient

◼ Control of vital function and clinical status of injuried/seriously ill patient

Dispatch Life Support

◼ telefonic assistancy in life-threatening events – live-saving advices

◼ First professional rescuer on the place of accident / event.

◼ preferred resuscitation only with external cardiac massage

Rea, D. T.: Dispatcher-Assisted Cardiopulmonary Resuscitation and Survival in Cardiac Arrest, Circulation 2001

3 VITAL FUNCTIONs

◼ CONSIOUSNESS - vigility

◼ RESPIRATION - breathing

◼ CIRCULATION – puls, BP ◼ Orientation in time and place

◼ Breathing – flow of air in inspiration, and expiration, elevation of thorax

◼ Puls palpable on big arteries – arteria carotis com., art. femoralis, a. radialis.

BLS adults

◼ Diagnostics of breathing

(10 seconds)

◼ Without 2 initial breaths

◼ Start with compressions

◼ ratio ventilation /

compressions = 2:30

EDUCATION OF ADULTS

POPULATION IN CPR /FIRST AID

The Systematic Approach

◼ BLS primary SurveyAsses Action

Airway

- is the airway open?

Open airway

Breathing

- is the patient breathing?

Give 2 rescue breaths

Rate/volume

Circulation

- is pulse present?

High quality CPR

Defibrilation

-check for shockablerhythm

Shock as indicated

Follow with chest compressions

What is new ?

◼ no change in the recommendation for a compression-to-ventilation ratio of 30:2 forsingle rescuers of adults, children, and infants(excluding newly born infants)

◼ change in the BLS sequence of steps from A-B-C (Airway, Breathing, Chest compressions)

◼ to C-A-B (Chest compressions, Airways, Breathing) for adults, children, and infants(excluding the newly born)

The systematic approach

Asses Action

Circulation

- is pulse present?

High quality CPR

Airway

- is the airway open?

Open airway

Breathing

- is the patient breathing?

Give 2 rescue breaths

Rate/volume

Defibrilation

-check for shockable rhythm

Shock as indicated

Follow with chest compressions

The Systematic Approach

◼ ACLS Secondary Survey

Airway

Is the arway patent?

Is advanced airway indicated?

-maintian airway patency

- use advanced airway

Breathing

Are oxygenation and ventilation adequate?

Give supplemental O2

Saturation

Capnography

PEA

V fib

Asystole