Advance First Aid and CPR

Content
Introduction
Pre Test
First Aid Definition
Life Saving Measures
BLS & CPR
Breathing
Control Bleeding
Fracture Management
Foreign Body Air way Obstruction
Snake Bite
Content
Kitchen Fire
Review
Question – Answer Session
Post Test Session
Feedback
Worldwide Existence

Velosi Group was founded in Malaysia in 1982

Expanded in UK and Pakistan in 2007 & 2008

respectively

Operate globally through our 29 associated offices

Velosi Services Coverage

Power Sector Oil & Gas Sector Chemical Sector Fertilizer

Industry

Cement Sector Sugar Sector FMCG Sector Textile sector

Life Saving Measures
Objectives

To know the life saving measures

To apply the life saving measures

Summary
Introduction & Significance
The most important function to save life
Introduction to Oxygen
Access of Oxygen to the brain
The order of live saving measures
Demonstration of live saving measures
Points to remember
Questions
Introduction & Signficance

What is meant by Life Saving Measures and

what is their significance?
For Best Cadet Only

What is the single most important function in human body

to maintain life?

Hmmm……lets think about it

For Best Cadets Only

Answer

Well…..It is to carry Oxygen from air to brain

• Tell me how will it reach your brain?

Just Use your brain

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A.. Airways
B… Breathing
C.. Circulation
D.. Disability
How to classify Life Saving
Measures
DR…..ABCD
• D.. Danger
• R.. Response
• A.. Airways
• B.. Breathing
• C.. Circulation
• D.. Disability (neurologically)
Application

• D.. Danger
Application

• R.. Response
Application

• A.. Airway
Application

• B.. Breathing
Application

• C.. Circulation
Application

• D.. Disability
 &
Basic life Support
Cardiopulmonary
Resuscitation
Heart Attack Risk Factors
Factors that cannot be changed
• Family history
• Sex
• Ethnic Background
• Age
• Smoking
• High Blood Pressure
• High Cholesterol
• Physical Activity
Clinical Death

Occurs when a patient is in respiratory arrest (not breathing) or in

cardiac
arrest (heart not beating). The patient has a period of 4 to 6 minutes to
be
resuscitated without brain damage.

Clinical death can be reversed.

Biological Death

• The moment the brain cells begin to die.

• Biological death cannot Be reversed.

Cardiac Arrest
Causes of Cardiac Arrest

• Heart Attack
• Drowning
• Poisoning
• Suffocation
• Electrocution
• Major Injuries
Cardiac Arrest

Casualty
• Unresponsive
• Not Breathing
• No Pulse

Treatment
• CPR
Preparing for CPR

• Establish Unresponsive

• Activate the EMS System

• Check DRCAB
Adult CPR

It is critical to remember that dialing 1122 may be the most important

step you can take to save a life. If someone besides you is present,
they should dial 1122 immediately. If you're alone with the victim, try to
call for help prior to starting CPR on an adult and after a minute
on a child. Before we learn what to do in an emergency, we must first
emphasize what not to do:
• DO NOT leave the victim alone
• DO NOT try make the victim drink water.
• DO NOT prompt the victim into a sitting position.
Phone Call

• In Pakistan
Rescue 1122

• From a mobile
• Landline
Emergency Service 1122
Always Give the Following Information
• Name & telephone number
• Give exact location with accurate directions
• Type of incident
• Seriousness of incident
• Number of patients
• Condition of patients
• Any hazards
• Don’t hang-up until you are told to do so
• Don’t keep your phone engaged
Circulation

C is for CIRCULATION. In order to determine if the victim's heart is

beating, place two fingertips on his carotid artery and apply slight
pressure for several seconds. If there is no pulse then the victim's heart
is not beating, and you will have to perform chest compressions.
Airway

Head Tilt
Chin Lift
Jaw Thrust
Breathing
B is for BREATHING. With the victim's airway clear of any obstructions,
gently support his chin so as to keep it lifted up and the head tilted
back. Pinch his nose with your fingertips to prevent air from escaping
once you begin to ventilate and place your mouth over the victim's,
creating a tight seal As you assist the person in breathing, keep an eye
on his chest. Try not to over-inflate the victim's lungs as this may force
air into the stomach, causing him to vomit. If this happens, turn the
person's head to the side and sweep any obstructions out of the mouth
before proceeding.
• Give two breaths
• Let victim exhale
Give 2 Rescue Breathing
Summary of Adult CPR
• In case of an emergency you may be the victim's only chance of survival.
Until an ambulance arrives and professional assistance is available, you
can increase that chance by 40% simply by remembering and effectively
administering Cardio Pulmonary Resuscitation. 1. Check for
responsiveness by shouting and shaking the victim, ensuring scene safety.
Do not shake or move the victim if you suspect he may have sustained
spinal injury.
• Call 1122
• Remember C-A-B
• Circulation: if there is no pulse, perform 30 chest compressions at the rate of at
least 100/minute - 2 hands, 2 inches
• Airway: tilt the head back and lift the neck to clear the airway
• Breathing: pinch the victim's nose and give 2 breaths, watching for the chest to rise
with each breath.
Steps of CPR
Check the Victim for Response
If No Response Call 1122
Look, Listen and Feel ( B & C)
Place heel of one hand in center of Victim’s
Chest
Place your other hand over the
first
Interlock the Fingers of your
Hands
Press down on the Sternum
Open Airway, Head Tilt, Chin lift
Take Normal Breath & Pinch the
Nose
Give two Breaths
Cardiac Arrest
Perform 5 Cycles of CPR and then change position if Second Rescuer is
present
You can check Pulse after two minutes or 5 cycles of CPR
Continuing @ 30:2 until help or AED arrives
Signs of Successful CPR

• Have someone feel for a pulse during compressions. A pulse should be

palpable with every compression.
• The chest should rise and fall with each ventilation
• The pupils may begin to react normally.
• Patient’s skin color may improve
• Patient may attempt to move and try to swallow
• Heartbeat may return.
AHA 2011 Recommendations
Adult Unresponsive?
• Call for help & AED
• Not breathing or only gasping
• Start compressions in the center of the chest between the nipples, at
a rate of 100/min and a depth of at least 2 inches, allowing for chest
recoil
• 30:2 Ratio of compressions to breaths
• After 30 compressions, open the airway with a head tilt-chin lift and
deliver 2 breaths
• When rescuers are untrained or not proficient, compressions only can
be performed
• PUSH HARD & FAST
 Breathing
Pulmonary Anatomy & Mechanics
Breathing Assessment
Remember DR..ABCD?
1. LLF (Both for Airway & Breathing)
Note for:
• Absent Breathing
• Laboured/Noisy Breathing
• Chest wounds/Deformatiy/Abnormal Movement
Breathing Assessment
Breathing Assessment
2. Connect Pulse Oximeter
Normally
• Pulse= 60 – 100/min
• % oxygen saturation > 95%

3. Look for Cyanosis

Ventilatory Support & Oxygen
Indications:
• Absent/Labored Breathing
• Oxygen Saturation < 95%
Method for Ventilatory Support
Firstly always do Suction and Clearing
Mannual:
• Mouth to Mouth Breathing
• Mouth to Nose Breathing

Mechanical:
• AMBU Bag (face mask, ETT)
• Ventilators/Respirators
Bag and Mask Ventilation
Bag & Mask Ventilation
Oxygen Inhalation
Every trauma victim should get 100% oxygen to inhale in Golden Hour

Methods:
• Through Mask
• Through Nasal/ Tracheal Cannula
• Through Connector to AMBU Bag
Rapid Killers Related to Chest

• Tension Pneumothorax
• Open Pneumothorax
• Flail Chest Segment
• Cardiac Temponade
• Massive Haemothorax
Control Bleeding
Control Bleeding
Uncontrolled bleeding initially causes weakness. If bleeding is not controlled, the
victim will go into shock within a short period of time, and finally will die. An adult has
about five liters of blood. Losing one liter can result in death.
There are three types of bleeding & the type can usually be identified by how fast the
blood flows
• Arterial Bleeding: Arteries transport blood under high pressure. Bleeding from an
artery is spurting bleeding.
• Venous Bleeding: Veins transport blood under low pressure. Bleeding from a vein
is flowing bleeding.
• Capillary Bleeding: Capillaries also carry blood under low pressure. Bleeding from
capillaries is oozing bleeding.
Methods for Controlling Bleeding
There are three main methods for controlling bleeding
• Direct Pressure:
Place direct pressure over the wound by putting a clean dressing
over
the wound and pressing firmly.
Maintain pressure on the dressing over the wound by wrapping the
wound firmly with a pressure bandage.
Methods for Controlling Bleeding
• Elevation:
Elevate the wound above the level of the heart.

• Pressure Points
Put pressure on the nearest pressure point to slow the flow of blood
to
the wound. Use the:
1. Brachial point for bleeding in the arm.
2. Femoral point for bleeding in the leg
Procedure
Direct pressure combined with elevation will address most bleeding.
Demonstrate the procedure for controlling bleeding through direct
pressure:
Step 1: Place direct pressure over the wound by putting a clean
dressing over the wound and pressing firmly.
Step 2: Maintain pressure on the dressing over the wound by wrapping
firmly with a Pressure bandage.
• Direct pressure and elevation can take 5 to 7 minutes to stop the bleeding
completely. The use of a dressing and pressure bandage allows the rescuer to move
on to the next victim.
• A pressure bandage should be tied with a bow, so that it can be loosened—rather
than cut—to examine the wound, and then retied. This procedure helps to conserve
supplies and saves time.
• Bleeding can also be controlled through elevation: Elevating the wound above the
level of the heart. Elevation is used in combination with direct pressure.
• There are also pressure points that can be used to stem the flow of bleeding.

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Pressure Points
The pressure points most often used are the:
• Brachial point in the arm.
• Femoral point in the leg.
• Get victims to help themselves, whenever possible.
Fracture Management
Fractures
A fracture is a complete break, a chip, or a crack in a bone. There are
several types of fractures:
• Closed Fracture: A closed fracture is a broken bone with no
disruption in the continuity of the skin. First aid treatment for closed
fractures may require only splinting.
• Open Fracture: An open fracture is an injury where a broken bone is
open through the skin. This requires careful attention prior to
splinting. DO NOT re align bones and splint as found as possible.
Open fractures are more dangerous because of the risk of severe
bleeding and infection. Therefore, they are a higher priority and need to
be checked more frequently.
When treating an open fracture:
• Do not draw the exposed bone ends back into the tissue
• Do not irrigate the wound.
You Should:
• Cover the wound with a sterile dressing and reinforce dressing if needed.
• Splint the fracture snugly. Never too tight and not too loose
• Place a moist 4" x 4" dressing over the bone end to keep it from drying
out.

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Displaced Fracture
Displaced fractures may be described by the degree of displacement of
the bone fragments. If the limb is angled, then there is a displaced
fracture.
• Non-displaced fractures are difficult to identify, with the main signs
being pain and swelling.
• Treat a suspected fracture as a fracture until professional treatment is
available.
Foreign Body Air Way Obstruction
Choking
Steps from Conscious to unconscious (adult)
a. Confirm airway obstruction by asking “are you choking”
b. Encourage to cough
c. Observe for signs of complete obstruction:
i. Pale to Bluish discoloration of the face
ii. Unusual sounds; shrill
iii. Unable to cough
d. Perform Heimlich maneuver until patient becomes unconscious
e. Once unconscious call for help (if alone) and proceed to CPR
Treating Life-Threatening
Conditions
During emergencies and disasters, professional responders are subdivided on their
tasks. Fire departments will combat large area fires.
Paramedics and Emergency personnel will take care of the severely injured people
thus leaving the community to act on its own for the first 24 and 72 hours.
Being a member of your community response part of your mission is to do the
greatest good for the greatest number of people. For that reason, if breathing is not
restored on the first try using the Head-Tilt/Chin-Lift method, Community Responders
should try again using the same method. If breathing cannot be restored on the
second try, you must move on to the next victim. If breathing has been restored, the
airway still must be maintained.
One option is to use a volunteer or walking wounded to hold the head in place. The
airway also can be maintained by placing soft objects under the victim’s shoulders to
elevate the shoulders slightly and keeping the airway open.
Snake Bite
Animal & Insect Bites
• Animal and insect bites are often categorized as “puncture wound”.
Though most are not life threatening it should be treated immediately.
• Animal bites and stings are dangerous if the animal has Rabies or
Venom. Also because it is a puncture wound it is prone to infection.
• Examples are bites and sting from Snake, dog, cat, spider, scorpion
and bee
• As Community responders we don’t need to identify if the bite or sting
is lethal or not, what we need to do is do the proper wound care and
immediately bring the patient to a Hospital for care.
Snake Bite
What to do
• Do not try to catch the animal.
• Take note what kind of animal and characteristics.
• Do not try to “suck”- extract out the venom with your mouth from the
wound.
• Follow the steps in cleaning and bandaging and Apply cool
compress/wet cloth to affected part
• Apply a firm bandage 2-4 inches above bite to:
a. Prevent venom from spreading
b. Take care of any bleeding
Snake Bite
• Don’t let the patient move too much which will increase circulation.
Keep the bite below the level of the heart.
• Immediately bring to hospital for treatment
• If able to call the hospital, inform them of your patients arrival for
immediate preparation of needed anti-venom.
Burn
Burn
A burn is when you have tissue damage, usually after contact with
heat.
There are three types of Burn:
• First-Degree Burn: First-degree burns (superficial burns) are mild
compared to other burns. They cause pain and reddening of the
epidermis (outer layer of the skin).
• Second-Degree Burn: Second-degree burns (partial thickness burns)
affect the epidermis and the dermis (lower layer of skin). They cause
pain, redness, swelling, and blistering.
• Third-Degree Burn: Third-degree burns (full thickness burns) go
through the dermis and affect deeper tissues. They result in white or
blackened, charred skin that may be numb.
Kitchen Fire
Fire
The active principle of burning characterized by the heat and light of
combustion.
Is a rapid, self-sustaining oxidation process accompanied by the
evolution of heat and light of varying intensity.
The flame is the visible portion of the fire and consists of glowing hot
gases.
Classes of Fire
Fire Extinguisher
A fire extinguisher is an active fire protection device used to extinguish
or control small fires, often in emergency situations.
It is not intended for use on an out-of-control fire, such as one which
has reached the ceiling, endangers the user (i.e. no escape route,
smoke, explosion hazard, etc.), or otherwise requires the expertise of a
fire department.
Typically, a fire extinguisher consists of a hand-held cylindrical pressure
vessel containing an agent which can be discharged to extinguish a fire.
Parts of Fire Extinguisher
• Handle and Operation lever
• Safety Pin
• Hose
• Nozzle
• Hose Clip
• Pressure Gauge
• Cylinder
• Inspection Tag
• Label
How to Use Fire Extinguisher
Pull the pin
Aim the nozzle
Squeeze the lever
Sweep
Question-Answer Session

91
Post-Test Session

92
Feedback

93