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8/4/2019 Disaster Nursing and Basic Life Support
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BASIC LIFE SUPPORT
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The Nature of Disasters
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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.
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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
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INTRODUCTION
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“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
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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
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Emergency
Natural
Man-made
Examples:
Car accident
Water main breaking
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Disaster
Any event that leads to a responsebeyond which the affected communitycan deal with locally.
-- WHO, 2005
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Disaster
Like emergency,
Natural
Man-made
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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
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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.
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Types of disasters
Natural
disasters
Man – madedisasters
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Natural disasters
earthquakes, tsunamis,pandemic flu and tornadoes
Man – made disasters
bioterrorisms, hijacking, and war
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Types of response
Assess
Contain
RespondRecover
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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.
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Objectives of First Aid:
a.
To alleviate sufferingb. To prevent added/further injury or
danger
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Emergency action principles
Do a primary survey:
•
Check A –
airway•Check B – breathing
•Check C – circulation
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Do a secondary survey:
•Interview the victim.•Check the vital signs
•determine radial or carotidpulse
•determine breathing
(respiration rate)•determine skinappearance
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•Do a head-to-toe examination
looking for DCAP-BTLS
(Deformity, Contusion, Abrasion,Puncture, Burn, Tenderness,Laceration, Swelling)
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•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.
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•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.
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•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.
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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.
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•Do not make any unrealisticpromises.
•
Do not trust the judgment of theconfused victim and require themto make a decision.
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Cardiopulmonary Resuscitation(CPR) is the combination of
compression and rescue
breathing. This must be confinedfor effective resuscitation of the
victim of cardiac arrest.
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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.
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•No physiological benefit can beexpected because the vital
functions have deteriorated
despite maximal therapy for suchconditions as progressive
septic or cardiogenic shock.
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•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.
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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
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Simplified Adult BLS Algorithm
• Area safety – scene survey – Rescuer: 90%
– Victim: 10%
• BSI [Body Surface Isolation]• Introduction of self
• Tap and shout
– Sternal rub
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Simplified Adult BLS Algorithm
– Responsive – Ok
– Unresponsive – BSI if with blood
• Airway
– Head tilt, Chin lift [Maximum]
– Don’t remove at forehead unless during CPR
• Breathing
• Circulation
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Simplified Adult BLS Algorithm
• 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
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Simplified Adult BLS Algorithm
• 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
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Simplified Adult BLS Algorithm
• Compression
– 30
• Breaths
– 2
• 5 cycles for 2 minutes
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Simplified Adult BLS Algorithm
• 2010
– More than 100 beats/min
– Staying alive rhythm
CAB - compression, airway, breathing
5 cycles/ 2 minutes
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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.)
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ArigatoGozaimasu