Airway-Breathing-Compressions-Defibrillation

Hint

S.A.M.P.L.E.

Signs are what can be observed and may include bleeding, bruising, swelling, skin colour, sweating. Symptoms are what the casualty can feel and may include nausea, dizziness, headache, confusion.

Allergies – allergic reactions can range from mild-moderate or severe. If there is a known allergy this could be why the casualty is unwell.

Medications – Names, doses, timing and last dose taken. Casualty’s may take a regular medication that may assist in their first aid management, for example ventolin puffer for asthma.

Past medical history – Previous illness or injury, some conditions like asthma or heart conditions can reoccur, likewise soft tissue injuries such as sprains and strains may happen more than once.

Last time they ate or drank – This is relevant for dehydration, blood sugar levels and cases of anaphylaxis. Important to handover to medical personnel if the casualty requires surgery.

Events leading to the incident– Understanding the events leading to the injury or illness. For example understanding how a casualty has fallen could help you to locate further injuries.

Check the casualty’s condition and send or go for help, or call 000 for an ambulance if required.

If you are on your own, leave the casualty and go for help if you cannot call 000.

Observe and reassess the casualty regularly for breathing and the feeling of warmth in their hands for circulation.

Hint

Pregnant Casualty

A woman in advanced stage of pregnancy (20+weeks) requiring CPR should be positioned on her back with shoulders flat on the ground. Place padding under her right buttock to tilt the pelvis to the left. This takes the baby off the main blood supply back to the heart (the Inferior Vena Cava). If padding is not available to achieve a definite tilt, a second person should gently tilt the hips to the left side while CPR is being performed.

Hint

When giving breaths during CPR you notice there is no rise and fall of the casualty’s chest, you should check

• That air is not leaking from the casualty’s nose: This may happen if there is a blockage in the airway.
• That their tongue is not blocking their throat. As the tongue is a muscle and weights between 60-70 grams it will fall backwards and obstruct the upper respiratory system.
• If there is not an adequate head tilt. If the head is not titled backwards for for adults of larger children the soft tissue of the throat (trachea) may narrow and prevent rescue breaths reaching the lungs.

Hint

Open the mouth gently without moving the head or the neck at this early stage in case there have been any injuries to the spinal cord.
When a casualty becomes unconscious their muscles including the tongue and the soft tissue of their throat relax. Particularly if a casualty is lying on their back, this relaxed tongue falls back and blocks the airway preventing air from reaching the lungs.  Open the mouth and pull the tongue and soft tissues away from the back of the throat.

Hint

What is a body position that may cause asphyxiation?

As muscles relax when a persons falls into an unconcise state the position that the causality is managed is vital to ensure that the airway will remain open.  If the causality was sitting upright ( motor vehicle incident or fainted in a chair) the head will fall forward resulting in a blockage of the upper respiratory system.  If a person that is unconcise has fallen their front the weight of the body forcing on to the ribcage will reduce movement of the lungs – this is referred to as positional asphyxiation.

Hint

After an unconscious casualty’s airway has been assessed as clear, use the look, listen and feel technique to check for normal breathing. This step should not be rushed as you might miss the signs, take at least 15-20 seconds, and if breathing is NORMAL you should see between 4-5 rises and falls of the chest in that time.

Put your cheek near the casualty’s mouth and nose. Look down and along the chest and:

• Look – for the rise and fall of the chest.
• Listen – for any sound, any breathing.
• Feel – for the movement of air from the nose and mouth against your cheek, and place your hand on the casualty’s chest to feel for the rise and fall.

Hint

Once you commence CPR you should only stop when:

• You are relieved by an experienced operator.
• Normal breathing or responsiveness returns.
• It is impossible to continue e.g. exhaustion.

Hint

The Australian Resuscitation Council recommend that if the CPR operator is not prepared to give breaths, due to a risk of contracting a communicable disease or unable to gives breaths because of physical damage to the casualty’s face not allowing access to give breaths the should continue and provide compressions only.  To ensure that the causality can draw air in to their lungs the head must be positioned backwards allowing for passive breathing.

Hint

Adult, Children and Infants
1 Kneeling beside the casualty with one knee level with the chest and the other knee level with the head.

2 Locate the lower half of the sternum in the centre of the chest.

3 Place the heel of one hand on the lower half of the sternum (breastbone) and place the heel of the other hand on top of the first hand, interlock fingers of both hands and raise fingers to ensure that pressure is not applied over casualty’s ribs, upper abdomen or bottom part of the sternum.

4 Position yourself vertically above the casualty’s chest.

5 With straight arms, press down on the sternum (breastbone) to depress approximately one third of the depth of the chest. Compressions should be given at a rate of almost 2 per second. You should achieve 5/6 cycles of 30 compressions and 2 breaths in 2 minutes.

6 Repeat to complete 30 compressions at a rate of approximately 100/120 per minute.

Hint

When performing CPR the depth of each compression should be:

The Australian Resuscitation Council ( A.R.C) recommend when giving chest compressions the CPR operator should achieve depth of at least 1/3rd of the casualty’s chest.

Estimated depths in centremeters.

• Adult 8 years of age and upwards: 5-6cm.  This will require 2 hands
• Children 1 – 8 years: 4-5 cm. 1 hand may be effective, if not increase pressure by using 2 hands.
• Infants zero to 1 year of age: 2-3 cm. In this case, the use of 2 fingers for a newborn may be enough, if not progress to the use of 1 hand.

Hint

When performing CPR on an infant, child or adult the correct ratio of compressions to breaths is:

The A.R.C guidelines recommend following the ratio of 30 compressions followed by 2 breaths when it is safe to do so.