CPR & Defibrillation
National Units of CompetencyHLTCPR201B – Perform CPR
22101VIC Course in Automated External Defibrillation
Paradise First Aid Pty Ltd – Registered Training Organisation 32268
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Course Induction & Housekeeping
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= Picture of real/makeup injury on next slide
Emergency Exits Mobile Phones Breaks Refreshments Smoking Toilets Certification Assessment Policies & Procedures Enjoy!
Legal Considerations First-aiders could be expected to;1: Act in accordance with their level of training and do so to the best of their ability2: Stabilise the casualty until advanced assistance is available 3: Maintain a consistent level of training
Scope of Practice
First Aid Code of Practice 2004 (Qld)
Duty of Care / Obligation
Consent
Recording
Negligence
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What is First Aid?
Immediate and temporary treatment of a person of sudden illness or injury while
awaiting the arrival of medical aid
Basic lifesaving skills
Doing the best you can with the resources you have
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What is First Aid?
Culturally aware, sensitive and respectful
Reassuring
Confidentiality
Skills & Limitations
Australian Resuscitation Council
Debriefing © Copyright Paradise First Aid Pty Ltd
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Perform a Scene Survey
Emergency Action Plan
DRS ABCD D – Danger
R – Response
S – Send
A - Airway
B - Breathing
C – CPR
D – Defibrillation © Copyright Paradise First Aid Pty Ltd
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Help
Defibrillator
Danger & Safety Hazard – A source or situation with the potential for harm in terms of human injury or ill-health, damage to property, the environment, or a combination of these.
Risk – The potential of the hazard being realised
Environmental / Physical DangersFire, fumes, fuel, electricity, gas, trip & slip hazards, visibility, sharp objects, chemicals, bystanders/relatives,
Communicable DiseasesDiseases or infections transmitted by bodily fluid or touch
Manual Handling Always follow safe manual handling practices when dealing with first aid situations. Use help to lift if available
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Response
Is the casualty conscious or unconscious?“Talk & Touch”
COWSC – Can you hear me?O – Open your eyesW – What’s your name?S – Squeeze hands / shoulders
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000 – Emergency number for all emergency services in Australia
112 – International standard emergency number
106 – Text emergency number (deaf)
ICE – In Case of Emergency (mobile phone)
Send for Help
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Airway
Remember ‘pistol grip’ Check the mouth before performing head tilt / chin lift Clear the mouth of foreign material if required
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Breathing
“Look, Listen & Feel”for NORMAL BREATHING
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Recovery Position
All casualties who are unconscious andbreathing normally must go into the recoveryposition regardless of their injuries.
Important PointsHead must have full head tiltFace should be angled towards the floor
Spinal Injuries – Use the spinal log roll if possible © Copyright Paradise First Aid Pty Ltd
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Important note – Pregnant women must be rolled on to their left side
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Cardiac Arrest
Recognition of Cardiac ArrestUnresponsiveNot Breathing Normally
Always ensure that the ambulance has been called. Then start CPR!
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What is CPR?
Cardiopulmonary Resuscitationits purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage. Defibrillation and advanced life support are usually needed to restart the heart.
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CPR
Ratio30 Compressions - 2 Breaths
Depth1/3 the depth of chest
Rate 100 min
Same for Adults, Children & Infants© Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0
REMEMBERHARD & FAST!
CPR
If during CPR… the casualty starts to breath normally
- put the casualty into the recovery position- monitor airway and breathing
the casualty vomits or regurgitates
- put the casualty on their side and clear the mouth- reassess breathing- continue CPR if needed
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CPR
If you are unable or unwilling to give rescue breaths, do chest compressions only.
“Any attempt at resuscitation is better than no attempt”
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Hands Only CPR Video
When to Stop CPR
Another first aider takes over Professional help arrives The casualty starts to breath normally The situation becomes too dangerous to continue You become too exhausted to continue A medical Doctor tells you to stop
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CPR Practical
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Children & Babies
Children 1 – 8yrs Infants 0 – 1yrsRatio30 Compressions - 2 Breaths
Depth1/3 the depth of chest
Rate 100 min
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Early Access(call for help)
Early CPR Early Defibrillation
Early ALS
Chain of Survival
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Resuscitation Video
Choking
Mild Airway Obstruction Treatment
Reassure the casualty
Encourage the casualty to lean forward
Encourage the casualty to keep coughing
Call 000/112 if object is not clearing
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Choking
Severe Airway Obstruction Treatment
Call 000/112 quickly, but attend to the casualty first if alone
Give up to 5 firm back blows between the shoulder blades
If unsuccessful – give up to 5 chest thrusts
If casualty becomes unconscious, start CPR© Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0
Choking – Children & Babies
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Defibrillation
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Paradise First Aid Pty Ltd 27/05/2010 V1.0
The Heart
Located in the centre of the chest behind the sternum.
A muscle (myocardium) comprised of four hollow chambers which fill with blood and empty as the hearts contacts and relaxes.
Must have a continuous oxygen supply via the coronary arteries to function effectively
Has an electrical action and a mechanical action which work together in a normal healthy heart to circulate blood around the body.
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The Electrical Action of the Heart
Most muscles in the body require an electrical stimulus from a nerve to make then work
The heart is a specialised form of muscle tissue that can generate its own electrical impulse without stimulation from a nerve
These impulses travel a well defined pathway through the heart muscle called the conduction pathway
The heart muscle responds to the electrical impulses with a mechanical action called a contraction
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The Mechanical Action of the Heart
The heart muscle receives an impulse from the electrical system
The muscle contacts in a synchronised and coordinated motion causing the blood in the four chambers to be pumped around the body and to the lungs
After each contraction the heart muscle relaxes which allows the chambers to refill with blood ready for the next contraction
This contraction of the heart muscle can be felt as a pulse
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Normal Heart Function
The electrical impulse is generated by the SA nodeIs conducted normally through the conduction pathwayCauses normal contraction of the heart muscleNormal circulation of blood throughout the body
Normal Sinus Rhythm (NSR)
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Sudden Cardiac Arrest (SCA)
Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. When this
happens, blood stops flowing to the brain and other vital organs.
Can happen to people that appear well and healthy, at any age.
The patient will be unresponsive and not breathing normally
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Ventricular Fibrillation ‘VF’
Electrical activity within the heart is chaotic and not following the conduction pathway
The heart muscle has a useless quivering action and is unable to pump blood around the body
This is the most common cause of cardiac arrest and the one most likely to respond to treatment by a defibrillator
Often a result of a heart attack (Myocardial Infarction)
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Ventricular Tachycardia ‘VT’
A very fast heart rate above 130 beats per minute
Can be so fast that the heart cannot refill with blood between contractions causing the heart muscle to be starved of oxygen
If this rhythm is not treated it will deteriorate into Ventricular Fibrillation (VF)
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Shockable Rhythms
Ventricular Fibrillation
Ventricular Tachycardia
These rhythms can be treated by shocking the patient with a defibrillator
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Pulseless ElectricalActivity ‘PEA’
Pulseless Electrical Activity is caused when the electrical activity is working correctly, but the mechanical activity is not.
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Asystole
When all electrical and mechanical activity within the heart has ceased
Often described as “flat line”
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Non Shockable Rhythms These rhythms cannot be treated by shocking
the patient with a defibrillator
Chance of survival from these rhythms is low
Pulseless Electrical Activity
Asystole
Paradise First Aid Pty Ltd 27/05/2010 V1.0
Causes of Cardiac Arrest
Heart AttackAirway ObstructionMassive Blood LossPoisoningElectrical ShockDrug OverdoseDrowningStroke
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Treatment of Cardiac Arrest
DangerResponseSend for HelpAirwayBreathingCPRDefibrillation
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Preparation of CasualtyFor Defibrillation
• Fully expose casualties chest. Remove clothing by ripping or cutting.Do not waste time “undressing” the casualty.
• Remove all metal objects from the casualties chest.
• If the casualties chest is wet or sweaty, dry with a towel.
• Remove any medication patches.
• Remove casualty from metal surfaces.
• If the casualty is excessively hairy, shave the chest using a disposable razor. (at the location of pad placement)
Ensure that CPR continues at all times when preparing the casualty.
Paradise First Aid Pty Ltd 27/05/2010 V1.0
Safety Precautions
• Ensure no person is in contact with the casualty while machine is analysing or when delivering the shock.
• Be aware of the explosive properties of oxygen and other substances.
• Do not place pads over medication patches or implanted pacemakers.
• Ensure that pads are firmly attached to the casualties chest.
• Only use batteries, pads and cables supplied for the model of AED.
Paradise First Aid Pty Ltd 27/05/2010 V1.0
Pad Placement > 25kg(8yrs +)
Right Pad • To the right of the sternum• Between the collarbone and right nipple
Left Pad • Outside the left nipple • Several inches below left armpit
If the pads are applied the wrong was around the AED will still work. Do not remove them once applied, as they may not re stick.
Paradise First Aid Pty Ltd 27/05/2010 V1.0
Pad Placement < 25kg(0 – 8 yrs)
Front Pad• Centre of the chest• Between the Childs nipples
Back Pad • Centre of the back• Between the shoulder blades
If the pads are applied the wrong was around the AED will still work. Do not remove them once applied, as they may not re stick.
If no child pads are available adult pads may be used as per the diagram on the pads. Ensure the pads are not touching each other. If the pads are two large use the front back position.
Paradise First Aid Pty Ltd 27/05/2010 V1.0
D R S A B C
CALL 000 / 112LOCATE DEFIBRILLATOR
ANALYSE
SHOCK ADVISED NO SHOCK ADVISED
DELIVER 1 SHOCKCPR FOR 2 MINUTES
IF NO NORMAL BREATHINGCPR FOR 2 MINUTES
SWITCH DEFIBRILLATOR ONATTACH PADS – FOLLOW VOICE PROMPTS
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Maintenance
• Refer to manufacturers instructions
•The unit may be cleaned with a damp cloth. Do not submerge in water.
• Pads are single use only. Dispose of once used.
• Always keep a spare set of pads and spare battery with the AED
• Daily checks should be made to ensure the AED is operational. Including checking battery status indicator