First AidFirst AidResponsible personsResponsible persons

Assoc. Prof. MUDr. Jiří Málek, CSc. - Assoc. Prof. MUDr. Jiří Málek, CSc. - malekj@fnkv.czmalekj@fnkv.cz

Prim. MUDr. Jan Šturma, CSc. Prim. MUDr. Jan Šturma, CSc. sturma@fnkv.czsturma@fnkv.cz

Mrs. Ing. Zdena Bednářová, secretary – Mrs. Ing. Zdena Bednářová, secretary – karsec@fnkv.czkarsec@fnkv.cz

Department of Anesthesiology and intensive careDepartment of Anesthesiology and intensive care

Building H, 3rd floor, tel.: 267162461, 726772461Building H, 3rd floor, tel.: 267162461, 726772461

First AidFirst Aid

Lesson 1Lesson 1 History and organisation of the First AidHistory and organisation of the First Aid Activation of Emergency Medical Activation of Emergency Medical

SystémSystém Disaster MedicineDisaster Medicine Disturbances of breathingDisturbances of breathing Chest painChest pain

First AidFirst Aid

DefinitionDefinition

First aid is the immediate and First aid is the immediate and temporary proper aid provided to a temporary proper aid provided to a

sick or injured person or animal until sick or injured person or animal until medical treatment can be provided.medical treatment can be provided.

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Main Aim:Main Aim:

1.1. To preserve lifeTo preserve life

2.2. Avoid or prevent complications and Avoid or prevent complications and condition worseningcondition worsening

3.3. Promote fast recoveryPromote fast recovery

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Integrated Rescue SystemIntegrated Rescue System

Components:Components: Technical (Fire department)Technical (Fire department) Organizational (Police)Organizational (Police) Medical (Medical rescue service)Medical (Medical rescue service)

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What First Aid consist of ?What First Aid consist of ?

First Aid in general consist of simple, First Aid in general consist of simple, life-saving medical techniques that a life-saving medical techniques that a non-doctor or lay person can be non-doctor or lay person can be trained to perform with minimal trained to perform with minimal equipmentequipment

First AidFirst Aid

ProvidersProviders

LaymenLaymen

Educated laymenEducated laymen

Rescue workerRescue worker

General practitioners (GP)General practitioners (GP)

Specially educated physiciansSpecially educated physicians

HistoryHistory

The Knights Hospitaller- The Knights Hospitaller- first order specialized in first order specialized in battlefield care for battlefield care for wounded soldiers wounded soldiers (founded 11th cen.)(founded 11th cen.)

1st Military Hospital in 1st Military Hospital in Europe (Malta 1547)Europe (Malta 1547)

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St. John Ambulance was formed in St. John Ambulance was formed in 1877 to teach first aid (a term 1877 to teach first aid (a term devised by the order) in large railway devised by the order) in large railway centres and mining districtscentres and mining districts

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Henry DunantHenry Dunant

1828 – 19101828 – 1910

Battle of Solferino Battle of Solferino (1859)(1859)

1901 – Nobel Peace 1901 – Nobel Peace PrizePrize

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Battle of Solferino (24th June 1859)Battle of Solferino (24th June 1859)

40 000 soldiers on both sides died or 40 000 soldiers on both sides died or were left wounded on the fieldwere left wounded on the field

total lack of medical attendance and total lack of medical attendance and basic carebasic care

1862 – A Memory of Solferino1862 – A Memory of Solferino

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9th February 18639th February 1863Committee of the Five Committee of the Five Gustave Moynier – lawyer, Louis Gustave Moynier – lawyer, Louis Appia – physician, Theodore Maunoir Appia – physician, Theodore Maunoir – physician, Guillame-Henri Dufour – – physician, Guillame-Henri Dufour – Swiss Army general, Henry DunantSwiss Army general, Henry Dunantinvestigatory commission of the investigatory commission of the Geneva Society for Public WelfareGeneva Society for Public Welfare

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February 14th 1863 – rename the February 14th 1863 – rename the committee to thecommittee to the

International Committee for relief to International Committee for relief to the Woundedthe Wounded

October 1863 – conference of 36 October 1863 – conference of 36 individuals from 16 countriesindividuals from 16 countries

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Final resolution:Final resolution:The foundation of national relief societies for The foundation of national relief societies for

wounded soldierswounded soldiersNeutrality and protection for wounded soldiersNeutrality and protection for wounded soldiersThe utilization of volunteer forces for relief The utilization of volunteer forces for relief

assistance on the battlefieldassistance on the battlefieldThe introductin of a common distinctive The introductin of a common distinctive

protection symbol for medical personnel in protection symbol for medical personnel in the field, namely a white armlet bearing a the field, namely a white armlet bearing a red crossred cross

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Original Original document of the document of the first Geneva first Geneva ConventionConvention

(1864)(1864)

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1876 -International Committee for relief 1876 -International Committee for relief to the wounded renamed toto the wounded renamed to

International Committee of the Red International Committee of the Red CrossCross

(official designation up to date)(official designation up to date)

1891 – American Red Cross1891 – American Red Cross

1919 – Czechoslovac Red Cross1919 – Czechoslovac Red CrossFirst chairwoman: Alice Masarykova, daughter of first Czechslovac First chairwoman: Alice Masarykova, daughter of first Czechslovac

presidentpresident

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Florence NightingaleFlorence Nightingale

1820 – 19101820 – 1910

1854 – Scutar – helped 1854 – Scutar – helped british wounded british wounded soldierssoldiers

1859 – Notes on 1859 – Notes on HospitalHospital

1860 – Notes on Nursing1860 – Notes on Nursing

Florance Nightingale - Florance Nightingale - ScutarScutar

Fitst AidFitst Aid

Nikolay IvanovichNikolay Ivanovich

PirogovPirogov

Founder of field Founder of field surgerysurgery

Founder of mobile Founder of mobile ambulances and ambulances and hospitalshospitals

(MASH – Mobile Army (MASH – Mobile Army Surgical Hospital)Surgical Hospital)

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Ernest Hemingway Ernest Hemingway

(1899-1961)(1899-1961)

in uniform as a Red in uniform as a Red Cross ambulance driver Cross ambulance driver

(WWI Italy)(WWI Italy)

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Chain of SurvivalChain of Survival

Early AccessEarly Access

Early CPREarly CPR

Early defibrillationEarly defibrillation

Early advanced careEarly advanced care

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TransportTransport

Ground x AirGround x AirPrimary Primary – place of accident – place of – place of accident – place of

definitive treatmentdefinitive treatmentSecondarySecondary – place of emergency – place of emergency

treatment – place of definitive treatment – place of definitive treatmenttreatment- - Randez vous systemRandez vous system

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Responsibility of the First Aider:Responsibility of the First Aider:- Assess the situation without endangering Assess the situation without endangering

your own life or life of any other personyour own life or life of any other person- Identify the disease od condition from Identify the disease od condition from

which the casualty is suffering (diagnosis)which the casualty is suffering (diagnosis)- Give immediate, appropriate and Give immediate, appropriate and

adequate treatment, bearing in mind that adequate treatment, bearing in mind that a casualty may have more than one injury a casualty may have more than one injury and some casualities will require more and some casualities will require more urgent attention than othersurgent attention than others

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Responsibility of the First Aider:Responsibility of the First Aider:- Arrange, without delay, for disposal a Arrange, without delay, for disposal a

casualty to a doctor hospital or home, casualty to a doctor hospital or home, according to the seriousness of the according to the seriousness of the casualty condition casualty condition - Your resposibility ends when the casualty is Your resposibility ends when the casualty is

handed over to the care of doctor, a nurse or handed over to the care of doctor, a nurse or other appropriate person. You should not leave other appropriate person. You should not leave the incident until you have made your report to the incident until you have made your report to whoever takes charge and have ascertained whoever takes charge and have ascertained whether you could be of any futher helpwhether you could be of any futher help

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Activation of EMSActivation of EMS

112112 - - general emergency callgeneral emergency call

155155 - - Emergency medical serviceEmergency medical service

150150 - - FireFire

158158 - - PolicePolice

FNKV – Emergency Help FNKV – Emergency Help systemsystem

HH (hasiči) - Fire (hasiči) - Fire 150150

EE (Energy – electricity, heating, gas) (Energy – electricity, heating, gas) 25412541

LL (lékař – Medical help) (lékař – Medical help) 53535353

PP (policie – Police) (policie – Police) 158158

!! (Emergency technician and manager (Emergency technician and manager service) service) 606702899606702899

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Vital functionsVital functions

Functions of organism, which serves Functions of organism, which serves to its operation, maintenace and the to its operation, maintenace and the reaction to external enviroment reaction to external enviroment (sense, vegetative, reproductive, (sense, vegetative, reproductive, motoric etc.motoric etc.

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Basic vital function – their failure can Basic vital function – their failure can cause death of organismcause death of organism

BreathingBreathing

Blood circulationBlood circulation

ConsciousnessConsciousness

HomeostasisHomeostasis

? Thermoregulation ?? Thermoregulation ?

The most severe emergency situationsThe most severe emergency situations

Lack of breathing and/or heartbeatLack of breathing and/or heartbeat Severe bleedingSevere bleeding A state of unconsciousnessA state of unconsciousness

Action at an EmergencyAction at an Emergency

Preserve lifePreserve life Prevent deterioration in the casualtyPrevent deterioration in the casualty

´s condition´s condition Promote recoveryPromote recovery

Action at an emergencyAction at an emergency

Rapid but calm approachRapid but calm approach Quick assesmentQuick assesment Correct diagnosis (history, symptoms, Correct diagnosis (history, symptoms,

signs)signs) Immediate and appropriate treatmentImmediate and appropriate treatment Proper disposal of casualty to deffinite Proper disposal of casualty to deffinite

treatmenttreatment

Action at an emergencyAction at an emergency

Road accidentsRoad accidents

Control the trafficControl the traffic Watch out for fire risk (petrol Watch out for fire risk (petrol

spillage, switch of the ignitionspillage, switch of the ignition

Action at an emergencyAction at an emergency

Gas and poisonous fumesGas and poisonous fumes

Cut of the sourceCut of the source Ensure adequate ventilationEnsure adequate ventilation

Action at an emergencyAction at an emergency

Fire and collapsing buildingsFire and collapsing buildings

Move the casualty to safety Move the casualty to safety immediately if you can do so without immediately if you can do so without endangering your own lifeendangering your own life

Multiple casualties Multiple casualties (disaster)(disaster)

Where there is more than one casualty, you Where there is more than one casualty, you must decide by rapid assessment which must decide by rapid assessment which

one needs priority of treatment !!one needs priority of treatment !! REMEMBERREMEMBER

Noisiest casualty is rarely the most severely Noisiest casualty is rarely the most severely injured !!injured !!

Serious accidents rarely produce only a Serious accidents rarely produce only a single injury !!single injury !!

POLYTRAUMATISMPOLYTRAUMATISM

Chest painChest pain

Angina pectorisAngina pectoris Pain is often spreading down the left Pain is often spreading down the left

shoulderto arm and fingersshoulderto arm and fingers Skin may be ashen and lips may be Skin may be ashen and lips may be

blueblue Patient should be short of breathPatient should be short of breath General weaknessGeneral weakness

Chest painChest pain

Acute myocardial infarction (heart attack)Acute myocardial infarction (heart attack) Sudden crushingSudden crushing Intensive retrosternal pain wihch does not Intensive retrosternal pain wihch does not

subside with restsubside with rest Ashen skin and blue lipsAshen skin and blue lips Profuse sweatingProfuse sweating Fast weak irregular pulseFast weak irregular pulse Dyspnoe (breathlesness)Dyspnoe (breathlesness) Finally unconsciousness, heart and breath Finally unconsciousness, heart and breath

stopstop

Breathing disturbancesBreathing disturbances

Obstructed airways (choking)Obstructed airways (choking) Aspiration (fluid in air passages)Aspiration (fluid in air passages) Compression of trachea (windpipe) (hanging Compression of trachea (windpipe) (hanging

or strangulation)or strangulation) Compression of chest (bury under earth or Compression of chest (bury under earth or

sand)sand) Injury to the lungsInjury to the lungs Injury to the chest wallInjury to the chest wall Fits preventing adequate breathingFits preventing adequate breathing

Breathing disturbancesBreathing disturbances

Condition affecting the brain, spinal Condition affecting the brain, spinal cord or peripheral nervescord or peripheral nerves

Electrical injuryElectrical injury PoisoningPoisoning Paralysis by brain stroke, brain Paralysis by brain stroke, brain

trauma or injury to the spinal cordtrauma or injury to the spinal cord

Breathing disturbancesBreathing disturbances

Air containing insufficient oxygenAir containing insufficient oxygen Fire – gas or smoke fille buildings, Fire – gas or smoke fille buildings,

shafts and tunnelsshafts and tunnels

Change in atmospheric pressureChange in atmospheric pressure High altitudesHigh altitudes Depressurized aircraftsDepressurized aircrafts Deep sea divingDeep sea diving

Breathing disturbancesBreathing disturbances

Conditioning preventing the use of Conditioning preventing the use of oxygen in the bodyoxygen in the body

Carbon monoxide poisoningCarbon monoxide poisoning Cyanide poisoningCyanide poisoning

Breathing disturbancesBreathing disturbancesSymptomsSymptoms

Difficulty in breathing (dyspnea)Difficulty in breathing (dyspnea) Breathinh may become noisy (snoring, Breathinh may become noisy (snoring,

gurgling)gurgling) Possible frothing in the mouthPossible frothing in the mouth Cyanosis (blue colour of skin)Cyanosis (blue colour of skin) ConfusionConfusion Lovering of level of responsivenessLovering of level of responsiveness Possible unconsciousnessPossible unconsciousness Breathing arrest (stop)Breathing arrest (stop)