CPR/AED/First Aid CPR/AED/First Aid TrainingTraining

bybyRob Sundquist, MS ATC LATRob Sundquist, MS ATC LAT

Director of Sports Medicine/Head Athletic TrainerDirector of Sports Medicine/Head Athletic TrainerCreekview High SchoolCreekview High School

Chain of SurvivalChain of Survival The chain of survival are four steps The chain of survival are four steps

to help increase the chances of an to help increase the chances of an injured person of surviving a cardiac injured person of surviving a cardiac arrest.arrest.

Chain of Survival – step oneChain of Survival – step one

After determining that there is an injury needing After determining that there is an injury needing advanced care; if unconscious tap and shout.advanced care; if unconscious tap and shout.

Call 911Call 911– Questions you will need to answer:Questions you will need to answer:– Nature of the emergency? Nature of the emergency? – Where are you?Where are you?– How many are hurt? How many are hurt? – Ages of who is/are hurtAges of who is/are hurt– Who are you?Who are you?– Has treatment started?Has treatment started?– Only hang up when instructed to do so by operator.Only hang up when instructed to do so by operator.

Chain of Survival – step twoChain of Survival – step two Begin CPRBegin CPR

– Most adult cardiac arrests (CA) victims heart is Most adult cardiac arrests (CA) victims heart is in ventricular fibrillation (VF) - Abnormal chaotic in ventricular fibrillation (VF) - Abnormal chaotic heart rhythm that prevents the heart from heart rhythm that prevents the heart from pumping blood. pumping blood.

– CPR will not usually stop VF but plays an CPR will not usually stop VF but plays an important part in pushing oxygenated blood to important part in pushing oxygenated blood to the brain and heart and prolonging VF so that the brain and heart and prolonging VF so that an AED will be useful.an AED will be useful.

– CPR can double or triple the victims survival CPR can double or triple the victims survival raterate

– For every passing minute without CPR; rate of For every passing minute without CPR; rate of surviving drops 7-10%.surviving drops 7-10%.

– With CPR there is only a 3-4% drop each minuteWith CPR there is only a 3-4% drop each minute

Chain of Survival – step Chain of Survival – step threethree

Use an AEDUse an AED– The use of the AED will stun the The use of the AED will stun the

fibrillating heart, if the heart is still fibrillating heart, if the heart is still viable the normal pacemakers in the viable the normal pacemakers in the heart will begin firing and start a heart will begin firing and start a normal rhythm.normal rhythm.

– If used within 5 min; chances of If used within 5 min; chances of survival is 49-75%.survival is 49-75%.

– Using an AED is simple.Using an AED is simple.

Chain of Survival – step fourChain of Survival – step four Advanced Care – EMSAdvanced Care – EMS

– Response time is 7-8 minutes – CPR is Response time is 7-8 minutes – CPR is extremely important.extremely important.

How to recognize How to recognize major emergenciesmajor emergencies

Heart AttackHeart AttackMyocardial infarctionMyocardial infarction

Coronary heart disease is the leading cause of death Coronary heart disease is the leading cause of death in our nation.in our nation.

During MI - part of heart muscle is starting to die.During MI - part of heart muscle is starting to die. Caused by a blockage of an artery (coronary) due Caused by a blockage of an artery (coronary) due

to buildup of cholesterol deposits or a blood clot.to buildup of cholesterol deposits or a blood clot. Victims are usually awake and can talk but feels Victims are usually awake and can talk but feels

severe painsevere pain Most critical time is within the first Most critical time is within the first

30 minutes after Sx begin.30 minutes after Sx begin.

Heart AttackHeart Attack Most common symptomsMost common symptoms

– Pain or pressure in the center of the chest – which last more than 3-5 minutes.Pain or pressure in the center of the chest – which last more than 3-5 minutes.

– Pain might feel pressure, fullness, squeezing, or heavinessPain might feel pressure, fullness, squeezing, or heaviness

– Pain might spread to shoulder, neck, lower jaw and down arm (usually the Pain might spread to shoulder, neck, lower jaw and down arm (usually the right).right).

– Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then Pain lasts 3-5 minutes. Sometimes will stutter, stop momentarily but then begin again.begin again.

Other Sx – lightheadedness, fainting, sweating without fever, nausea, Other Sx – lightheadedness, fainting, sweating without fever, nausea, shortness of breathshortness of breath

– Most victims will downplay symptoms, you must take action!!!Most victims will downplay symptoms, you must take action!!!

– Call 911, get the nearest AED, and have the person rest in a position that is Call 911, get the nearest AED, and have the person rest in a position that is comfortable where they can breathe easily.comfortable where they can breathe easily.

Put them in an area that you can get them to the floor easily and paramedics can get Put them in an area that you can get them to the floor easily and paramedics can get inin..

Cardiac ArrestCardiac Arrest When the heart stops beating. Usually When the heart stops beating. Usually

caused by VF, which begins where the caused by VF, which begins where the heart muscle is injured.heart muscle is injured.

Without blood flow and no pulse the Without blood flow and no pulse the person becomes unconscious and stops person becomes unconscious and stops breathing and collapses.breathing and collapses.

VF and cardiac arrest may be the only VF and cardiac arrest may be the only symptom of a heart attack.symptom of a heart attack.

AED is only thing that will stop a VF AED is only thing that will stop a VF

StrokeStroke

Its is a rapid onset of neurological Its is a rapid onset of neurological problems like weakness, paralysis in one problems like weakness, paralysis in one or more limbs, difficulty speaking, visual or more limbs, difficulty speaking, visual problems, intense dizziness, facial problems, intense dizziness, facial weakness, altered consciousness, and weakness, altered consciousness, and severe headache.severe headache.

Two causesTwo causes– blood vessel to brain is blocked by a blood clotblood vessel to brain is blocked by a blood clot– blood vessel to brain breaksblood vessel to brain breaks

#3 cause of death and #1 cause of #3 cause of death and #1 cause of serious disability among Americans serious disability among Americans

StrokeStroke Most signs overlooked; Most signs overlooked;

three major signs to three major signs to observeobserve

– facial droopfacial droop– arm weakness – most arm weakness – most

obvious when victim obvious when victim attempts to extend attempts to extend arms with eyes closed arms with eyes closed – one or both may not – one or both may not move very wellmove very well

– speech difficulties – speech difficulties – slurring of words and slurring of words and sentencessentences

– Call 911 immediately if Call 911 immediately if see signs of strokesee signs of stroke

Provide CPR if needed Provide CPR if needed

Foreign body obstructionForeign body obstruction Usually caused by food, but can be caused by Usually caused by food, but can be caused by

many objectsmany objects Major signsMajor signs

– Universal choking signalUniversal choking signal– poor ineffective coughspoor ineffective coughs– inability to speakinability to speak– high pitched sounds while inhalinghigh pitched sounds while inhaling– increased difficulty breathingincreased difficulty breathing– Blue lips or skin (cyanosis)Blue lips or skin (cyanosis)– Loss of consciousness and responsivenessLoss of consciousness and responsiveness

Heimlich maneuver in conscious victimHeimlich maneuver in conscious victim CPR in unconscious victim CPR in unconscious victim

CPR - adultCPR - adult

Step oneStep one Make sure area is safeMake sure area is safe Check unresponsiveness – tap and Check unresponsiveness – tap and

shout – “Are you alright”shout – “Are you alright”– If no response – call 911 or send If no response – call 911 or send

someone directly to callsomeone directly to call Grab AED if one present or send Grab AED if one present or send

someone to get one.someone to get one.

Step two Step two If possible place If possible place

victim supine and victim supine and on a hard on a hard surface.surface.

– If victim is prone – If victim is prone – roll overroll over

– Try protecting the Try protecting the neck as much as neck as much as possible if you possible if you suspect neck suspect neck injuryinjury

Begin CAB’sBegin CAB’s– C = CirculationC = Circulation

If not breathing or see abnormal breathing begin chest If not breathing or see abnormal breathing begin chest compressionscompressions

– Agnal breathingAgnal breathing – gasps that occur at the beginning of CA – not – gasps that occur at the beginning of CA – not efficient – act as they are not breathingefficient – act as they are not breathing

– No checking for pulse or signs of circulation just go No checking for pulse or signs of circulation just go straight to CPRstraight to CPR

– Place one palm on the chest between the nipple linePlace one palm on the chest between the nipple line– Interlock your other hand on top of the hand on the chestInterlock your other hand on top of the hand on the chest– Bring your shoulder over the topBring your shoulder over the top– Make sure you have a wide base (knees spread just outside Make sure you have a wide base (knees spread just outside

your shoulders)your shoulders)– Press down 1 ½ -2 inches at a rate of 100 compressions per Press down 1 ½ -2 inches at a rate of 100 compressions per

minute – hard and fastminute – hard and fast– Make sure chest recoils completely Make sure chest recoils completely – Complete 30 compressions and then give two breaths.Complete 30 compressions and then give two breaths.– Do not stop unless and AED is available, victim moves, or you Do not stop unless and AED is available, victim moves, or you

substituted out (if two rescuers are available – switch every five substituted out (if two rescuers are available – switch every five cycles of 30:2 – approx two minutes) – reduces fatiguecycles of 30:2 – approx two minutes) – reduces fatigue

– A = AirwayA = Airway Head tilt and Chin liftHead tilt and Chin lift

– B = BreathingB = Breathing If you do not detect normal breathing – give If you do not detect normal breathing – give

two breaths lasting 1 second each (may use two breaths lasting 1 second each (may use barrier)barrier)

Watch chest rise, allow exhalation before next Watch chest rise, allow exhalation before next breath.breath.

If breaths do not go in – reposition head and If breaths do not go in – reposition head and try again.try again.

PracticePractice

PracticePractice– Practice compressions 30 times twice – Practice compressions 30 times twice –

alternate with partner – no breathsalternate with partner – no breaths– 60 sec test – just compressions – try to 60 sec test – just compressions – try to

get 95-105 compressions – allows to learn get 95-105 compressions – allows to learn rhythm. Perform 1-2 times or as neededrhythm. Perform 1-2 times or as needed

– Two minute test – performing 30:2 Two minute test – performing 30:2 (includes breath) - should complete five (includes breath) - should complete five cycles in that time. cycles in that time.

During the beginning stages of CA – chest During the beginning stages of CA – chest compressions are more important than breaths. compressions are more important than breaths. Oxygen level will stay high for the first few minutes Oxygen level will stay high for the first few minutes but blood is not moving to due to the heart not but blood is not moving to due to the heart not pumping. pumping. – Breathing becomes as important as the length of CPR Breathing becomes as important as the length of CPR

continuescontinues

Very important to limit interruptions of chest Very important to limit interruptions of chest compressions.compressions.

Be mindful not to give to many breaths, too much Be mindful not to give to many breaths, too much breath or too forceful – may cause gastric filling and breath or too forceful – may cause gastric filling and the resultant complications, and/or cause diminished the resultant complications, and/or cause diminished blood flow and reduce survival.blood flow and reduce survival.

Vomiting/other breathingVomiting/other breathing If someone does throw up – do not panic.If someone does throw up – do not panic.

– Roll victim towards you. Use your body to hold Roll victim towards you. Use your body to hold them.them.

– Clean out the mouth – roll back and continue.Clean out the mouth – roll back and continue. Mouth to noseMouth to nose

– Use when it is impossible to use the mouth due to Use when it is impossible to use the mouth due to injury.injury.

Face shields and masks – may be used - Face shields and masks – may be used - – Very little chance of transfer of bodily fluids if Very little chance of transfer of bodily fluids if

perform mouth to mouth without mask. perform mouth to mouth without mask. – Using shield or mask can slow down the CPR processUsing shield or mask can slow down the CPR process– ““Chest compression only” CPR is more beneficial Chest compression only” CPR is more beneficial

than no CPR at all.than no CPR at all.

Recovery positionRecovery position If victim begins breathing and having If victim begins breathing and having

a pulse then turn victim to their side a pulse then turn victim to their side with lower arm in front.with lower arm in front.

No position is perfect- just make sure No position is perfect- just make sure they are stable, near a true lateral they are stable, near a true lateral position, and there is no pressure on position, and there is no pressure on the chest to impair breathingthe chest to impair breathing

Potential neck injuryPotential neck injury If two or more respondersIf two or more responders

– One stabilizes the neck – they will be in charge if One stabilizes the neck – they will be in charge if victim needs to be movedvictim needs to be moved

– Place hands on the sides of the head and neck, using Place hands on the sides of the head and neck, using your hands to cup around the neck. your hands to cup around the neck.

– Place pressure on head with forearms near the earsPlace pressure on head with forearms near the ears– Elbows should be on the ground, wrists in ulnar Elbows should be on the ground, wrists in ulnar

deviation so that they come in contact with the head. deviation so that they come in contact with the head. This will limit the amount of movement that will occur if you This will limit the amount of movement that will occur if you

have to move your body, for example moving so that CPR have to move your body, for example moving so that CPR can be administered or when EMS puts on a neck brace.can be administered or when EMS puts on a neck brace.

– If movement is necessary then move body as one.If movement is necessary then move body as one.

CPR – Child and infantCPR – Child and infant

Child CPR (ages 1-8)Child CPR (ages 1-8) Similarities with Adult CPRSimilarities with Adult CPR

– Location on chest for compressions is the same – nipple lineLocation on chest for compressions is the same – nipple line– Ratio of compressions to breaths the same – 30:2Ratio of compressions to breaths the same – 30:2

Differences with Adult CPR Differences with Adult CPR – In the chain of survival you will perform CPR In the chain of survival you will perform CPR firstfirst for two for two

minutes performing five cycles of 30:2 – then call 911 (if you minutes performing five cycles of 30:2 – then call 911 (if you are alone)are alone) Reason is that most child and infant cardiac arrests are due Reason is that most child and infant cardiac arrests are due

from asphyxiation, so they will benefit more from the CPR.from asphyxiation, so they will benefit more from the CPR.

– The depth you use for compression is 1/3 to ½ depth of the The depth you use for compression is 1/3 to ½ depth of the chest. Use one or two hands – which ever is more chest. Use one or two hands – which ever is more comfortable. comfortable.

Infant CPRInfant CPR Similarities with adult CPRSimilarities with adult CPR

– 30:2 ratio of compressions to breaths30:2 ratio of compressions to breaths

Similarities with ChildSimilarities with Child– Perform CPR first in the Chain of Survival, for the same reasons.Perform CPR first in the Chain of Survival, for the same reasons.

If small enough you may carry to phone with you after completing If small enough you may carry to phone with you after completing the five cycles – use speaker phonethe five cycles – use speaker phone

– Depth of compressions.Depth of compressions.

Differences with CPRDifferences with CPR– You will perform chest compressions one finger below nipple lineYou will perform chest compressions one finger below nipple line– You will place your mouth over mouth and nose of infantYou will place your mouth over mouth and nose of infant– You will only puff air inYou will only puff air in– If unsure if it is a child or not, if it can fit on your arm, then treat If unsure if it is a child or not, if it can fit on your arm, then treat

as an infantas an infant PracticePractice

Foreign Body Airway Foreign Body Airway Obstruction (FBAO)Obstruction (FBAO)

Heimlich ManeuverHeimlich Maneuver

ChokingChoking Universal sign of choking – hand Universal sign of choking – hand

around throataround throat Ask questionsAsk questions

– Are you choking? Can you speak? May I Are you choking? Can you speak? May I help you? – Very important.help you? – Very important.

If they say no leave them alone until they If they say no leave them alone until they pass out – then it is assumed they want help.pass out – then it is assumed they want help.

If a person can speak or can cough - If a person can speak or can cough - do not help do not help

Abdominal thrustsAbdominal thrusts Place yourself behind victim scissor you legsPlace yourself behind victim scissor you legs

Front leg between victims legsFront leg between victims legs Slightly bend kneesSlightly bend knees

Place hands on navelPlace hands on navel place hands on chest if woman is pregnant or victim is place hands on chest if woman is pregnant or victim is

severely overweightseverely overweight Pull in and upPull in and up

continue until object is out or they pass outcontinue until object is out or they pass out Use chest thrusts if you are unable to circumvent the Use chest thrusts if you are unable to circumvent the

abdomen abdomen If pass out lower them carefully to the floor begin CPRIf pass out lower them carefully to the floor begin CPR

Only difference with CPR is you check mouth for object Only difference with CPR is you check mouth for object before breaths.before breaths.

Finger sweep only if you see objectFinger sweep only if you see object. . PracticePractice

Infant FBAOInfant FBAO Infant – Infant –

– Conscious – place infant on forearm with Conscious – place infant on forearm with babies mouth between fingers – back blows babies mouth between fingers – back blows to upper backto upper back

– Unconscious – Unconscious – after back blows - five compressions –after back blows - five compressions – look for objectlook for object give breathgive breath repeat cycle – back blows, compressions, look and repeat cycle – back blows, compressions, look and

breathsbreaths Finger sweep if see object Finger sweep if see object PracticePractice

Automated External Automated External Defibrillator Defibrillator

AEDAED

What is an AED?What is an AED? Automated external defibrillator – is an computerized Automated external defibrillator – is an computerized

defibrillatordefibrillator it can analyze heart rhythmit can analyze heart rhythm recognize shockable rhythmrecognize shockable rhythm advise the operator whether the rhythm should be shockedadvise the operator whether the rhythm should be shocked very easy to use very easy to use

AED’s computer chips analyze the rate, size and wave AED’s computer chips analyze the rate, size and wave shape of human cardiac rhythm.shape of human cardiac rhythm.

will not shock a properly functioning heartwill not shock a properly functioning heart will not shock a heart that has stopped – VF is not present will not shock a heart that has stopped – VF is not present

Universal steps of AED useUniversal steps of AED use Place AED parallel to patients left earPlace AED parallel to patients left ear Power on the AED firstPower on the AED first

Some automatically turn on when openedSome automatically turn on when opened Attach the AED to the patients chest with electrode padsAttach the AED to the patients chest with electrode pads

Remove clothing – to bear chestRemove clothing – to bear chest Be kind to femalesBe kind to females

Dry patient or shave chest in area of electrode placement if neededDry patient or shave chest in area of electrode placement if needed Place one pad above right nipple and one to the side and below the left Place one pad above right nipple and one to the side and below the left

nipple. nipple. (CPR is continued up to the point of placing the pads (CPR is continued up to the point of placing the pads on)on)

Analyze rhythm Analyze rhythm Make sure everyone is clear (must say “stand clear of the victim”). No Make sure everyone is clear (must say “stand clear of the victim”). No

contactcontact Push analyzePush analyze Charge AED if shock is required (some machine charge automatically)Charge AED if shock is required (some machine charge automatically)

Shock if indicated – (after checking everyone is clear Shock if indicated – (after checking everyone is clear again)again)

Begin CPR for five cycles then analyze againBegin CPR for five cycles then analyze again If shock is advisable again you clear everyone and shockIf shock is advisable again you clear everyone and shock If shock is not advisable – continue with CPRIf shock is not advisable – continue with CPR If victim has pulse and is breathing put into recovery If victim has pulse and is breathing put into recovery

position. position. DO NOT take off pads or turn off AED until prompted by EMSDO NOT take off pads or turn off AED until prompted by EMS

Special ConsiderationsSpecial Considerations WaterWater

Must remove victim from water or wet surfaceMust remove victim from water or wet surface Dry before attaching padsDry before attaching pads

Metal surfacesMetal surfaces Is victim lying on metal surface? – if so move victimIs victim lying on metal surface? – if so move victim The metal surface may cause the shock form the AED to hit you.The metal surface may cause the shock form the AED to hit you.

ChildrenChildren Children 8 and older use as soon as possibleChildren 8 and older use as soon as possible Children 1-8 – CPR for two minutes before using AEDChildren 1-8 – CPR for two minutes before using AED

Transdermal medicationsTransdermal medications Remove patch and wipe clean before attaching AED padsRemove patch and wipe clean before attaching AED pads

Implanted pacemakers and defibrillatorsImplanted pacemakers and defibrillators Do not place an AED electrode directly over implanted device.Do not place an AED electrode directly over implanted device. Move at least one inch to the side of deviceMove at least one inch to the side of device

PracticePractice

First AidFirst Aid

Medical emergenciesMedical emergencies Breathing difficultiesBreathing difficulties

Asthma problems are increasingAsthma problems are increasing Most have medicinesMost have medicines May need assist victim is administrating May need assist victim is administrating If symptoms continue to get worse call 911If symptoms continue to get worse call 911

AnaphylaxisisAnaphylaxisis Severe reaction to allergenSevere reaction to allergen Victim may have epinephrine injector Victim may have epinephrine injector May need to administerMay need to administer Call 911 if medicine is not administered Call 911 if medicine is not administered

Seizures Seizures General rules – 1) Prevent injury 2) ensure open airway 3) General rules – 1) Prevent injury 2) ensure open airway 3)

maintain open airway after seizure is completed – place in maintain open airway after seizure is completed – place in recovery positionrecovery position

Never try to restrain victim, place anything in the mouth.Never try to restrain victim, place anything in the mouth.

Injury emergenciesInjury emergencies BleedingBleeding

Direct pressure best wayDirect pressure best way If bleeding continues add more gauze or cloth; If bleeding continues add more gauze or cloth;

do not remove gauze or clothdo not remove gauze or cloth Use elastic bandage to apply pressure to Use elastic bandage to apply pressure to

gauze and hold it in place.gauze and hold it in place.

The use of tourniquets should be avoided The use of tourniquets should be avoided unless in extreme mattersunless in extreme matters

The efficacy of elevation and pressure points is The efficacy of elevation and pressure points is inconclusive; if used, use only in conjunction inconclusive; if used, use only in conjunction with direct pressure and when there is no with direct pressure and when there is no apparent fracture or other underlying injury. apparent fracture or other underlying injury.

Wounds and abrasionsWounds and abrasions Irrigate wounds until free of any foreign Irrigate wounds until free of any foreign

matter.matter. Small wounds and abrasions should be Small wounds and abrasions should be

cleaned thoroughly then have triple cleaned thoroughly then have triple antibiotic ointment placed on it and antibiotic ointment placed on it and covered.covered.

Larger wounds need to also be cleaned Larger wounds need to also be cleaned then covered and taken to doctor for then covered and taken to doctor for possible stitches possible stitches

BurnsBurns Thermal burnsThermal burns

Cool burn with cold water until pain ceasesCool burn with cold water until pain ceases Do not cool for more than 10 min. Can lead to further damageDo not cool for more than 10 min. Can lead to further damage Burn blisters cover with loose gauze, but keep intact – Burn blisters cover with loose gauze, but keep intact –

breaking them can lead to infectionbreaking them can lead to infection

Electrical burnsElectrical burns Make sure electrical current is shut off before trying to help Make sure electrical current is shut off before trying to help

victim.victim. CPR and defibrillation may be needed as well as burn CPR and defibrillation may be needed as well as burn

treatmenttreatment All electrocution injuries should be checked out by a physicianAll electrocution injuries should be checked out by a physician

Spine stabilizationSpine stabilization Suspect possible spinal injury if…Suspect possible spinal injury if…

Car accidentCar accident Injured from fall greater than their heightInjured from fall greater than their height Complains of neck pain, tingling, or extremity Complains of neck pain, tingling, or extremity

weaknessweakness Is not fully alertIs not fully alert Appears to be intoxicatedAppears to be intoxicated Appears frail or is >65 yrs oldAppears frail or is >65 yrs old Has sustained a head injuryHas sustained a head injury

- Manually stabilize the neck until help arrives.- Manually stabilize the neck until help arrives.

Musculoskeletal trauma – sprains, strains, Musculoskeletal trauma – sprains, strains, contusions, fracturescontusions, fractures For sprains, strains, contusions – apply ice for 20.For sprains, strains, contusions – apply ice for 20.

Sprains elevate and place compression bandageSprains elevate and place compression bandage R.I.C.E. – rest, ice, compression, elevationR.I.C.E. – rest, ice, compression, elevation If victim has aversion to cold – place wet cloth between ice If victim has aversion to cold – place wet cloth between ice

and skinand skin Young kids and elderly especially susceptibleYoung kids and elderly especially susceptible

Contusion you want to stretch the injury as well as Contusion you want to stretch the injury as well as iceice

If you are unsure of the injury suspect fracture – do If you are unsure of the injury suspect fracture – do not move or straighten injury. Place ice on area and not move or straighten injury. Place ice on area and splint in position, send to ER.splint in position, send to ER.

If suspect dislocation – splint as is and send to ER. If suspect dislocation – splint as is and send to ER.

Dental injuriesDental injuries Avulsed toothAvulsed tooth

Hold onto by the crown not the root (part Hold onto by the crown not the root (part embedded into gumembedded into gum

Rinse off with water (do not scrub)Rinse off with water (do not scrub) Either place back into socket or place in Either place back into socket or place in

glass of milk and see a dentist immediatelyglass of milk and see a dentist immediately Clean bleeding wound with saline Clean bleeding wound with saline

solution or tap watersolution or tap water Use cotton to apply pressure to stop Use cotton to apply pressure to stop

bleedingbleeding

Environmental injuries Environmental injuries SnakebiteSnakebite

Do not suck wound, it will only exasperate the problemDo not suck wound, it will only exasperate the problem In case of Coral snake – wrap a bandage around the extremity of the In case of Coral snake – wrap a bandage around the extremity of the

bite – it will help slow the poison – then get to medical facility bite – it will help slow the poison – then get to medical facility immediately.immediately.

Coral snake bites and sucksCoral snake bites and sucks Other snake bites, wash area with soap and water, try not to move Other snake bites, wash area with soap and water, try not to move

extremity very much and get to medical facility.extremity very much and get to medical facility.

Cold injuriesCold injuries HypothermiaHypothermia

Immediately begin re-warming – remove wet clothes and wrap body surface Immediately begin re-warming – remove wet clothes and wrap body surface with anything at hand; get to medical facility immediatelywith anything at hand; get to medical facility immediately

If far from medical facility you begin active warming – placing near heat If far from medical facility you begin active warming – placing near heat source, placing in warm (not hot) water.source, placing in warm (not hot) water.

FrostbiteFrostbite Remove wet clothing, usually occurs on extremities, do not re-warm if there Remove wet clothing, usually occurs on extremities, do not re-warm if there

is any chance it could freeze again or you are close to a medical facility. is any chance it could freeze again or you are close to a medical facility. Use luke-warm water if you are far from medical facilityUse luke-warm water if you are far from medical facility

Heat InjuriesHeat Injuries Heat cramps – muscle cramping, usually due to extreme loss Heat cramps – muscle cramping, usually due to extreme loss

of fluidsof fluids Get to cooler areaGet to cooler area Replace fluidsReplace fluids Ice and stretch areaIce and stretch area

Heat exhaustionHeat exhaustion Dizziness, could have flushed skin or cool and clammy, Dizziness, could have flushed skin or cool and clammy,

disoriented, nausea, headachedisoriented, nausea, headache Get victim to cool area immediatelyGet victim to cool area immediately Place ice on side of neck (carotid artery), arm pits, and groin areaPlace ice on side of neck (carotid artery), arm pits, and groin area Replace fluidsReplace fluids Watch for shock; could lead into heat strokeWatch for shock; could lead into heat stroke

Heat Stroke – medical emergency – call 911 immediately Heat Stroke – medical emergency – call 911 immediately Extreme disorientation, possible unconsciousness, very little Extreme disorientation, possible unconsciousness, very little

sweating, internal temperature of >105.sweating, internal temperature of >105. Cool down by any meansCool down by any means

DrowningDrowning Get victim out of water as soon as possibleGet victim out of water as soon as possible Begin CPR immediatelyBegin CPR immediately If you are alone – finish five cycles of CPR If you are alone – finish five cycles of CPR

before calling 911before calling 911

PoisonsPoisons Poison control center – 1-800-222-1222Poison control center – 1-800-222-1222 Chemical BurnsChemical Burns

Brush off any powder and remove all Brush off any powder and remove all contaminated clothingcontaminated clothing

Alki or acid exposure – rinse with copious Alki or acid exposure – rinse with copious amounts of water.amounts of water.

Ingested poisonsIngested poisons Do not ingest any medication; milk, activated Do not ingest any medication; milk, activated

charcoal, syrup of ipecac unless instructed by charcoal, syrup of ipecac unless instructed by poison controlpoison control

ShockShock Develops when there is not enough blood flowing to the cells of Develops when there is not enough blood flowing to the cells of

the bodythe body Causes in adults; Causes in adults;

loss of bloodloss of blood heart attack, heart attack, allergic reactionallergic reaction

SymptomsSymptoms feel cold and shiver, feel cold and shiver, feel weak, faint, or dizzy, feel weak, faint, or dizzy, restless, restless, vomit, vomit, feel thirstyfeel thirsty

TreatmentTreatment Call 911Call 911 Put victim on their backPut victim on their back If not leg injury or pain raise legs 12 inchesIf not leg injury or pain raise legs 12 inches Cover victim with blanketCover victim with blanket If bleeding is visible – use direct pressureIf bleeding is visible – use direct pressure