• About CPR
  • Legal & Ethical
  • Recognising an Emergency
  • Phone the Ambulance
  • Responding to an Emergency
  • Cardiac Arrest
  • Casualty Assessment
  • Cardio Pulmonary Resusciation

About first aid

First aid is the initial care provided to someone who has suddenly fallen ill, or who has been injured, until more advanced care is provided or the person recovers. Immediate and effective first aid may reduce the severity of the injury or illness and promote recovery. Knowledge of first aid is important for everyday life at home, work, or in the community. Not every incident requiring first aid will be life threatening, however the more people with basic first aid knowledge, the better the chances are of saving a life!

Australian Resuscitation Council (ARC)

The Australian Resuscitation Council is a voluntary coordinating body that creates uniformity and standardisation for resuscitation techniques and for the provision of first aid. They develop guidelines for the provision of CPR and first aid. The guidelines can be viewed on their website: resus.org.au All information in this manual in relation to the provision of CPR and first aid is based on ARC guidelines.
FAQ
Closex

First Aid Kits

Not only must we have the skills to evaluate and treat the casualties in a workplace environment, we also need a fully stocked first aid kit to be able to render assistance when required. First aid kits should be checked regularly to ensure that there are sufficient supplies in the kit when it is required. Under state and territory legislation, first aid kits are required in all workplaces. First aid kits should be stored in a location clearly marked with a first aid sign. First aid kits will vary depending on the number of workers and even what industry you may be working in. The larger the workplace, the larger the kit will need to be.

Q

What does the Australian Resuscitation Council (ARC) do?

Develops guidelines for the provision of CPR and first aid

Develops procedures for workplace health and safety

It is a drowning registration organisation

Delivers CPR to those in need

First aid management

First aid must take into account:

  • For the workplace: workplace policies and procedures; safe work practices; industry/site specific regulations, codes of practice; WHS requirements; State and territory legislative requirements;
  • The setting in which first aid is provided, including: location and nature of the incident; associated situational risks e.g. electrical and biological hazards, weather, motor vehicle accidents; location of emergency services personnel.
  • Australian Resuscitation Council (ARC) guidelines.
  • Guidelines from Australian national peak clinical bodies.
  • First aid requirements for services under the Education and Care Services National Law as required.
  • The age, culture, ability or disability, health and mental status of the casualty.
  • Legal, social and community responsibilities of the first aider including: stress management techniques and available support; duty of care; respectful behaviour towards a casualty; consent; privacy and confidentiality; debriefing; currency of skill and knowledge.
  • Considerations when providing first aid including: safety; the use and availability of first aid equipment and resources; airway obstruction due to body position; appropriate duration and cessation of CPR; appropriate use of a defibrillator; standard precautions and infection control; the differences between adults and children.

Workplace practices, policies and procedures

State and territory legislation relevant to your workplace, and industry or site specific regulations must be taken into consideration when developing policies and procedures for first aid. Included in any document for the provision of first aid must also be emergency plans, safe work practices for risks and hazards and infection control, and how to provide first aid in accordance with guidelines from ARC and clinical peak bodies. A workplace first aider must be able to locate, and have an understanding of, the organisations policies and procedures for safety requirements and for the provision of first aid. First aid requirements will vary from one workplace to the next, depending on the nature of the work, the type of hazards, the workplace size and location, as well as the number of people at the workplace. These factors are taken into account when deciding what first aid arrangements need to be provided. The ‘First Aid Code of Practice’ provides information on using a risk management approach to tailor first aid that suits the circumstances of your workplace.

First aid Code of Practice

Codes of Practice are practical guides to achieving the standards of health, safety and welfare required under the Work Health and Safety (WHS) Act and the relevant WHS Regulations in a jurisdiction. An approved Code of Practice applies to anyone who has a duty of care in the circumstances described in the code. Note - A Code of Practice deals with particular issues and does not cover all hazards or risks that may arise. Therefore, health and safety duties also require duty holders to consider all risks associated with work, not only those for which Codes of Practice cover. The ‘FIRST AID IN THE WORKPLACE’ Code of Practice has been developed by Safe Work Australia and approved under the WHS ACT as a model Code of Practice for providing first aid safely in the workplace. For further information go to: safeworkaustralia.gov.au

The First Aid Code of Practice provides guidance for:

  • using risk management to tailor first aid to suit the circumstances e.g.: identifying hazards that could result in work-related injury or illness; assessing the type, severity and likelihood of injuries and illness; providing the appropriate first aid equipment, facilities and training; reviewing first aid requirements on a regular basis or as circumstances change.
  • the number of first aiders required in the workplace;
  • the training that first aiders must receive and who provides it;
  • the contents of first aid kits and its location;
  • other first aid equipment such as automatic defibrillators (AED), eye wash and shower equipment, first aid facilities and rooms;
  • procedures including: record keeping for first aid; first aid requirements when managing an emergency.

Duty of care

If a first aider decides to provide assistance to a person in need, they must provide a standard of care appropriate to their training (or lack of training) and never go beyond their own skills and limitations. Act in ‘good faith’ and without recklessness and with reasonable care and skill. First aid must be provided in accordance with established first aid principles. The casualty must be made as comfortable as possible using available resources and equipment. First aid equipment must be operated according to manufacturer’s instructions. The first aider should stay with the casualty unless it is necessary to call for medical assistance, a rescuer of equal or higher ability takes over, or continuing to give aid becomes unsafe. If you are trained in first aid, it is imperative that you maintain currency of skills and knowledge. Routinely attend refresher courses and be aware of changes to legislation, policy and procedures and ARC guidelines in relation to first aid. First aid in the workplace - In a workplace emergency, all workplace first aiders and staff have a duty of care. One must use common sense which dictates that, while they should not act beyond their capabilities, they are expected to do as much as they can to take appropriate action.
  • Provide treatment - recognise symptoms; administer first aid in accordance with procedures and protocols;
  • Report - complete a report as soon as possible after the incident according to relevant procedures and legislation;
  • Self-evaluate and debrief - to address individual needs and improve response to future incidents.

Privacy and confidentiality

Personal information about the health of a casualty must be kept confidential and should only be accessed by authorised people. Information includes details of medical conditions, treatment provided and the results of tests. Disclosure of personal information, without that person's written consent, is unethical and in some cases may be illegal.

Consent

The consent of an injured or ill person must be obtained before any assistance is rendered, regardless of age, ability, health or mental status. If the casualty is a minor, consent must come from a parent or guardian. Legal action and damages may be taken against you if you act without obtaining consent. The requirement for consent may be waived in certain circumstances, or implied, for example, if a casualty is unconscious. Competent adults are legally entitled to refuse any treatment, even if it is life-sustaining. Substitute decision-makers, such as parents or guardians of minors or legal guardians can likewise refuse treatment but only if in the ‘best interests’ of their charge.

Ethical issues

Ethical issues are dependent on law, cultural beliefs and principles and on moral grounds. Simple ethics include always displaying respectful behaviour towards the casualty, maintaining respect for their beliefs, privacy and dignity and paying careful attention to consent and confidentiality.

Cultural awareness

The role of the first aider depends on gaining the trust of casualties. Maintaining trust requires attentiveness and finding culturally appropriate ways of communicating that are courteous and clear. A strong sense of cultural awareness is required for all first aiders. Cultural awareness is required for treating casualties from diverse backgrounds. You need to be able to respect the values of different cultural groups and treat them with sensitivity. It may sometimes be necessary to communicate through verbal and non-verbal communication and you need to have the ability to identify issues that may cause conflict or misunderstanding.

Evaluation of own performance

Whilst providing the initial care for a casualty, you must be aware of your own skills and limitations. Your basic treatment can save lives, however, evaluating your own performance can provide you with an opportunity for self-improvement. It may be beneficial to speak with the paramedics who attended the incident. It is extremely important to recognise the possible psychological impacts on yourself, other rescuers, and children (if you work with children), especially when involved in critical incidents.

Debriefing

Each person reacts differently to traumatic events and in some instances, a situation may evoke strong emotions, which may affect the health, well-being and work performance of some individuals. What might be minor to one person may be quite significant and traumatic to another. In short, there is no right or wrong way to feel. What a person experiences is valid for that person. In some cases symptoms can develop into a chronic illness, requiring extensive and long term treatment. ANY traumatic event can leave devastating emotional residue. Symptoms can appear immediately or later, days, months or even years after the original event. In a workplace, debriefing should be done with a supervisor so that the incident can be discussed, evaluated and recorded for future improvement and referral. Also to ensure the first aider is not suffering emotionally after attending the incident. Where multiple people are involved, a group discussion, meeting or debriefing will be required.

Signs and symptoms of stress

Feeling stressed following a first aid response is a perfectly normal occurrence. You must understand the need for stress management techniques and find out what support is available following attendance at an emergency situation. Some of the signs and symptoms of stress include:
  • Physical- fatigue, headache, insomnia, muscle aches, stiff neck, heart palpitations, chest pains, abdominal cramps, cold extremities flushing/sweating, frequent colds;
  • Mental- decreased concentration/memory, indecisiveness, mind racing/going blank, loss of sense of humour;
  • Emotional- anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short temper;
  • Behavioural - pacing, fidgeting, nervous habits, crying, yelling, swearing, blaming, throwing things, eating, smoking, drinking. Feeling anti-social towards others.

FAQ
Closex

Good Samaritan Law

A ‘Good Samaritan’ is defined in legislation as a person acting without expecting financial or other reward for providing assistance. First aiders need not fear litigation if they come to the aid of a fellow human in need as long as they do not act recklessly and try to avoid further harm. Most Australian states and territories have some form of Good Samaritan protection. In general these offer protection if care is made in good faith.

Notifiable Incidents

The Work Health and Safety Act defines that when an incident is deemed to be ‘dangerous’ or ‘serious’, it must be reported to the relevant State Work Health and Safety Authority, or regulator, such as WorkCover. These are called “notifiable incidents”.

How long should records of an incident be kept?

Records of the incident must be kept for at least 5 years from the date that the incident was notified. Ensure strict security practices are upheld to restrict access as required and keep personal information private. Security practices are also required to ensure the records are kept and not lost and that back-ups are made.

Q

To provide first aid in the workplace, you must adhere to:

Workplace policies and procedures

Australian Resuscitation Council guidelines

State/territory regulations

All of the above

Q

Which of the following workplace regulations and procedures are covered in the First Aid Code of Practice?

The contents of first aid kits in the workplace

How to identify, assess and manage hazards

The training requirements for first aiders

All of the above

Q

Duty of care requires first aiders to:

Undertake an advanced first aid course

Provide first aid appropriate to their training, skills and limitations

Treat a casualty, even if not sure of what to do, they must do anything to save a life

Take the casualty to the nearest hospital as quickly as possible

Q

A first aider must keep their skills and knowledge up to date by:

Practicing on friends and family

Conducting a search on the internet

Attending refresher courses and being aware of changes to legislation, policies, procedures and ARC guidelines

Watching documentaries and medical programs weekly

Q

What information about a casualty may be helpful to paramedics and included in a report, but should be kept confidential from the others?

Their symptoms and what happened to them

First aid given

How they responded to first aid treatment

All of the above

Q

After filling out a report about a first aid incident, what should you do?

Share the details with friends to help with emotional stress

Put photos and a story on your Facebook page

Keep the details private and confidential

Distribute details of the incident as public awareness overrides any privacy issues

Q

In relation to an adult casualty while receiving first aid treatment, which of the following is true?

If conscious and responsive, you must gain their consent before commencing any treatment

A first aid certificate gives you automatic right to treat anyone

There is no need to communicate as it just slows down treatment

A casualty has no rights and must comply

Q

Important considerations when providing first aid include:

Displaying respectful behaviour towards the casualty

Trying to maintain respect for their beliefs

Gaining consent and keeping personal information confidential

All of the above

Q

Why is it important to attend a debriefing session after being involved in a first aid incident?

People can react adversely to traumatic events and may need support

It may help to process the event in a positive way

Traumatic events may leave devastating emotional residue

All of the above

Q

Which of the following could be signs of traumatic stress after attending to an emergency?

Fatigue, headache, insomnia

Decreased concentration, loss of sense of humour

Anxiety, nervousness, depression, anger

Any or all of the above

Q

Which of the following may be signs of an emergency that requires a first aider assistance?

The sound of someone in distress

TV or news broadcasts

Evidence such as a spilled chemical container

Both A and C

A medical emergency is a sudden illness such as heart attack, which requires immediate medical attention. An injury is damage to the body, such as broken arm, which results from a violent force. Some injuries can be serious enough to be considered emergencies. An emergency can happen anywhere, on the road, at home, work or play. It is important to recognise when a situation is an emergency. You may become aware of an emergency because of certain things you observe e.g. the sound of someone in distress, a spilled chemical container, unusual behaviour (e.g. panic) and/or symptoms and signs of the casualty such as severe bleeding. You will not know if first aid is needed until you approach the scene or the individual. For example, you may see a person slip, they may not be in need of any help at all, or the person may be unconscious and need immediate medical assistance.

What to do

In a medical emergency call Triple Zero (000). If you are not sure, call 000 anyway. Calling an ambulance can be the difference between life and death. Ambulance paramedics can always attend, assess and then leave the person at home if they do not require further emergency treatment. Calling for the paramedics will enable you to handover the care and responsibility of the casualty/casualties. A first aider must accurately provide the facts about the incident (not what they think is wrong). Paramedics will appreciate a quick and efficient handover so they can assist the casualty.

Hazard and risk assessment

It is important that a first aider understands how to evaluate the scene of an emergency as they approach the sick or injured using hazard identification. When hazards have been identified, it is important to assess the risk that they pose. This is called risk assessment. The next step is to decide what to do to remove the risks, or make them safer, before providing first aid. Personal safety is of the utmost importance. This process must be done very quickly in an emergency situation. It must be done and done effectively.

Infection control & standard precautions

In every first aid situation you should try to minimise the risk of transmission of infection to yourself, the casualty and to any bystanders. To do this, you must follow standard precaution procedures to ensure a basic level of infection control, especially when handling blood or body substances. Standard precautions are practices that are applied to injured or ill casualties and their blood and body substances, regardless of their infectious status. Standard precautions include hand hygiene, use of personal protective equipment (PPE), and working safely, such as appropriate handling and disposal of sharps and waste, cleaning techniques and managing spills of blood and body substances.

Infection control for resuscitation-

It is recommended that resuscitation masks be used for performing rescue breaths. It may be prudent to allow the partner of the casualty to do the rescue breathing if you do not have a resuscitation mask available. There are several types of resuscitation masks available, even ones that can be carried on your key ring. Compression only resuscitation may be used if there are obvious signs of blood or vomit and you don’t have a mask, or if you do not want to do the rescue breaths for fear of infection.

Workplace procedures and safe work practices

A workplace should have established procedures to avoid workers becoming ill and exposing others to illness when handling blood or body substances. These procedures could include:
  • how and when to use and store personal protective equipment (PPE);
  • proper hand hygiene practices;
  • how to clean surfaces;
  • how to use, clean and store re-usable equipment;
  • how to manage spills, and handle and clean soiled laundry;
  • how to handle and dispose of sharps and infectious waste;
  • training requirements, such as completing an accredited sharps handling course.
First aid - If a first aider does have accidental contact with blood or body substances, a sharps injury, or contact with a person known to have a contagious illness, they should follow procedures immediately. For example, any part of the body that comes in contact with blood or body substances, should be washed with soap and water immediately, reported and prompt medical advice obtained. All first aiders in a workplace should be offered Hepatitis B virus vaccination.

Contaminated items - Follow the procedure for the workplace, industry and jurisdiction (state or territory). All items that are soiled with blood or body substances should be placed in plastic bags and tied securely. Waste disposal should comply with any state or local government requirements. Sharps, including scissors and tweezers that have become contaminated with blood or body substances should be disposed of in a rigid-walled, puncture-resistant sharps container by the person that used them. The materials, design, construction, colour and markings of sharps containers should comply with Australian standards.

Cleaning spills - Cleaning should commence as soon as possible after an incident involving blood or body substances. Safe work practices and procedures should be followed in accordance with the situation and the workplace.
FAQ
Closex

How can diseases be transmitted?

  • droplet transmission – e.g. sneezing or coughing;
  • airborne transmission – e.g. ventilation systems and air conditioning units;
  • contact – e.g. blood or body fluids coming into direct contact with skin, eyes etc.;
  • contaminated objects – e.g. skin contact with needles, mosquitoes etc.
Providing first aid safely - Always assume that there is a risk of being exposed to infection. Wash hands with soap and water or apply alcohol-based hand rub before and after administering first aid. Use and wear personal protective equipment to prevent contact with blood and body substances, including disposable gloves. Eye protection, masks and protective clothing may also be necessary, if splashes of blood or body substances are likely to occur.

Before first aid:
  • wash your hands;
  • always use plastic or disposable gloves, check they are in good condition first;
  • if you have cuts or wounds on your hands, ensure that they are covered by a waterproof dressing before applying gloves;
  • use a plastic apron and eye protection if available.
During first aid:
  • use a resuscitation mask if available;
  • wear gloves and ensure that they don’t get torn;
  • if you come into contact with body fluids, wash the area immediately with running water and seek medical advice.
After first aid:
  • safely dispose of any used dressings, bandages and disposable gloves;
  • after removing disposable gloves, always wash your hands thoroughly with soap and water.

Emergency Action Plan

An emergency action plan is a guideline a first aider can follow to assist them to remain calm, but respond quickly and provide effective treatment. Following an emergency action plan also ensures safety.

Q

What is the very first thing you should do you when arrive at an incident scene?

Assess a casualty breathing

Identify, assess and manage immediate hazards

Ignore the dangers, saving a life is more important

Check for a pulse

Q

Depending on the situation, which of the following are standard precautions during providing first aid?

Washing your hands

Using gloves and masks

Appropriate handling and disposal of sharps

All the above

Q

What could you to help reduce the risk of infection performing CPR?

Use a resuscitation mask to deliver rescue breaths

Have the casualty partner deliver the rescue breaths

Consider compressions only CPR if a mask is not available

Any or all of the above

Communication and emergency services

Communication with medical and emergency services support may involve:
  • establishing and maintaining communication links to medical services;
  • requesting ambulance support or appropriate medical assistance according to relevant circumstances;
  • administering medication under direct instruction from an authorised health worker as required;
  • assisting in the evacuation/transportation of the casualty by following directions given by emergency services.

Phone the ambulance

The first aider should arrange for the ambulance to be called and send someone to obtain resources such as masks, gloves and a defibrillator as per the situation and the casualty’s condition. If there is no-one else to assist, they should call the ambulance themselves. When calling for help, the “phone first” concept is recommended by the Australian Resuscitation Council, especially for cardiac arrest situations. This job can be delegated so that first aid can begin but always ensure that the person who rings for the ambulance confirms with you that the call was made and that the location given is exact. Triple Zero (000) is the Australian primary emergency call service number and should be used to access emergency assistance from all telephones (landline, mobile phones and payphones) in the first instance. *Please note: you must have reception to make the call from a mobile phone;

Making the casualty comfortable

The casualty should be made as comfortable as physically possible by using available resources and equipment. This might mean placing pillows under broken limbs or behind a head or back to rest on. Covering them to keep them warm or providing pain relief using bandages and slings, hot or cold packs etc. The resources you use must be available at the scene or close by. They could be commercially made items from a first aid kit such as bandages, slings, gauze or an emergency blanket. They can be make do items such as rolled up jumpers for a pillow, towels or large coat for a blanket, a t-shirt torn into strips for a bandage etc. All first aid equipment must be operated according to the manufacturer’s instructions. Never use an item for anything other than what it is intended for. The casualty will also feel better knowing that you are going to stay with them and care for them until further help arrives. A first aider should monitor the casualty and respond to changes to their condition in accordance with first aid principles.

Reporting, record keeping, documenting

Verbal reporting

A verbal report to a supervisor, a parent or caregiver of a minor, or emergency services, such as Paramedics may be required. All first aiders should have sufficient oral communication skills in order to make an accurate verbal report. Incident details must be conveyed clearly and accurately. Only facts should be stated. Advise the time of the incident, exactly what happened, what first aid was provided and the casualty’s response to the treatment. Do not embellish or add thoughts and comments about the incident unless asked. A quick, accurate and efficient handover will mean the casualty receives appropriate further treatment sooner.

Handover

After providing first aid treatment, it is most likely that you will need to refer the casualty on for further medical assistance. This may be to their own doctor or if taken to the emergency department by car and handed over to a nurse or in an emergency, to emergency response services and paramedics. It is important that you provide a quick and efficient handover so they can take over care of the casualty. A first aid officer for a workplace will also be required to report the details of the incident to the workplace supervisor.

Written reports

Although the initial report is done verbally, it can be useful to also do a written report. Memory often fails us when having to respond urgently in an emergency situation. First aiders should try to make notes, if possible, during first aid provision or fill out official report forms soon after attending an incident. Recording treatment and events will assist with recalling what happened if required to do so in the future. Workplaces will require an official incident report to be filled out and kept on record. Forms must be filled out in accordance with the workplace policy and procedures, state or territory legislation, and privacy and confidentiality requirements. Only state facts and do not make comments you are not qualified to make judgement on. For example “the casualty is an alcoholic”. All incidents, regardless of whether there is an injury or not, must be reported to the relevant person in your organisation or work site, (e.g. supervisor, etc). This includes near misses or dangerous occurrences where there is no injury. Certain reports and documents are to be sent to appropriate bodies as per workplace requirements and legislation. There are strict guidelines and time frames that must be adhered to.
FAQ
Closex

Providing first aid for children, the aged or infirmed

It pays to be mindful of the age of the person you are treating and act accordingly. There are differences in the way you should communicate for moral reasons and also to gain acceptance and trust.

Children – Must be approached with care and compassion. They may be frightened, especially if the first aider is a stranger. Children don’t like being away from their parents or carers. Reassure them, use a soft kind voice, and give them a distraction to take their mind off the situation, consider giving them something to hold like a band aid. The details of any incident involving children or babies when the parent or caregiver is not present, must be reported to the parent or caregiver. It is important to remember that children may react differently to adults in a first aid situation. Whether they are injured or sick themselves, or they are concerned about one of their fellow students or friends, they will feel affected by the incident. Always find someone to talk to children about their feelings, emotions and responses.

Aged or infirmed casualties – As for all casualties, respect and dignity are very important. Things to remember with older people is reduced ability, such as trouble walking and moving or hearing impairment and they may be fragile e.g. brittle bones, skin is thin and damages or tears easily. Be gentle and provide support and assistance with movement, positioning and making comfortable.

How to reach emergency services

Australian emergency call services numbers:

  • Triple Zero (000) is the Australian primary emergency call service number and should be used to access emergency assistance from all telephones (landline, mobile phones and payphones) in the first instance. *Please note: you must have reception to make the call from a mobile phone;
  • 112 is an international standard emergency number which can only be dialled on a digital mobile phone. It can be dialled in areas of GSM network coverage with the call automatically translated to that country’s emergency number. It does not require a sim card or pin number to make the call, however phone coverage must be available (any carrier) for the call to proceed;
  • 106 is the text-based emergency call service for people who are deaf or have a hearing or speech impairment. This service operates using a TTY (teletypewriter) and does not accept voice calls or SMS messages. For more information go to: http://relayservice.gov.au/making-a-call/emergency-calls/

How to make a triple zero (000) call

  • Stay calm and dial Triple Zero (000) from a safe place;
  • An operator will answer and ask you if you need Police, Fire or Ambulance. State the service that you require. If you are calling using a mobile or satellite phone, the operator will ask you for additional specific location information;
  • You will then be connected to the nominated emergency service operator, who will take details of the situation;
  • Stay on the line, speak clearly and answer the operator's questions.
Providing the location:
  • Give the nominated emergency service operator the details of where you are, including street number, name, nearest cross street and locality;
  • In rural areas, give the full address and distances from landmarks and roads, not just the name of the property;
  • If possible, wait outside at a prearranged meeting point or in a prominent location for emergency services to arrive to assist them to locate the casualty/casualties;
  • If you make the call whilst travelling on a motorway or on a rural road, identifying the direction you are travelling and the last exit or town you passed through will assist emergency services to correctly locate the incident.

Communication

A first aider will be required to communicate in many different ways. It may be directly with the casualty, their relatives, parents or carers. It may be to direct bystanders, ask for assistance, consult witnesses, call emergency services or provide a verbal handover. No matter what the situation effective communication is of utmost importance. The aim is to, gain trust, provide reassurance, and get others to assist you. Those assisting will need clear direction and coordination. To communicate effectively is to speak clearly, be precise, direct and get straight to the point. Use a confident firm tone of voice, don’t yell or order abruptly. Consider culture and ethics. Show leadership, check that directions are understood, and followed, for example making sure the person you asked to call the ambulance, has actually done so. Effective listening is also an essential part of communication.

Q

What is the primary telephone number used to contact emergency services in Australia?

Double Zero (00)

Triple Zero (000)

911

111

Q

Make the casualty comfortable, monitor them and respond to changes in their condition

Make them comfortable and leave them alone

Go and get lunch, they may take a while

Do nothing as you have fulfilled your duty of care

Q

When the ambulance arrives, you must be ready to:

Continue to treat the casualty asking them to assist where needed

Hand over copies of your first aid certificate

Put on a uniform and help with treatment

Provide paramedics with a quick and efficient handover about what you did

Manual handling

You must be aware of possible injuries you can receive whilst providing first aid. Most common are injuries to the back, a result of poor manual handling. The shape of our spinal column, which curves forward in the neck and lumbar region means this area receives the greatest stress when moving or lifting (manual handling) and the majority of back injuries occur in the lower lumbar area. Avoid using back muscles to lift a casualty and most importantly never lift a casualty while your back is bent over them.

Steps for effective lifting:

Mental preparation:
  • what - weight and size of casualty;
  • where - casualty is to be moved to;
  • how - lifting technique and number of helpers;
  • know - your limitations;
  • ask - for help if required.
Position:
  • arms and casualty - close to your body;
  • feet - shoulder width apart;
  • hips - flex at hips, not waist, bend at the knees;
  • back - keep in alignment with shoulders and pelvis;
  • head - hold straight;
  • grip - load securely.
Lifting:
  • use - thigh and leg muscles;
  • avoid - twisting, rotating or jerking;
  • communicate - take charge, provide good instruction;
  • team work - co-ordinate and work together.

Moving the injured

Where possible, do not move the casualty

The condition of a collapsed or injured casualty may be worsened by movement, causing increased pain, injury, blood loss and shock. However, all casualties who are in danger must be moved to safety. Concern for protecting the neck should not hinder the evaluation process or lifesaving procedures. Remember - the airway takes precedence over any fracture or other injuries; the breathing unconscious casualty must remain on his/her side. Where possible someone (the most experienced first aider would be best) should stay with the casualty, whilst others seek assistance. When moving the casualty becomes necessary and others are available to help, the most experienced first aider should take charge and explain clearly and simply the method of movement to the assistants and to the casualty, if conscious.

Moving techniques

Emergency moves - there are a range of lifting and moving techniques that can be used for moving a casualty. The most common emergency techniques used when the casualty or rescuer are in immediate danger include:
  • clothing drag - dragging the casualty by their clothing;
  • blanket or sheet drag – using a blanket or sheet to drag the casualty;
  • bent arm drag - reach under the casualty’s armpits from behind, grasp the forearms or wrists and drag.
Non-emergency moves- the type of move used will depend upon the illness or injury the casualty is suffering from, factors at the scene, equipment and personnel resources available. These moves involve 2-3 rescuers to transfer a casualty to a better location, to a stretcher or other device:
  • direct ground lift - 2-3 rescuers to lift to a stretcher;
  • extremity lift - not if spinal injury suspected, short distances, to stair chair;
  • blanket lift – not if head/spinal injuries suspected;
  • draw sheet method - roll casualty from bed to stretcher;
  • log roll – trained team, roll casualty from supine to side for examination of back or place a spine board under.

Safety

  • ensure safety when preparing to move the casualty;
  • always inform the casualty of your intentions prior to the move. The uninformed casualty may suddenly reach out or attempt to grab onto something. This may result in the rescuers stumbling or falling which could cause an unexpected injury.
Casualty safety whilst moving:
  • use resources if available, such as spine boards, stretchers, blankets etc., to assist with the move;
  • make sure carrying device is locked in position and ready to use as per manufacturer’s instructions;
  • cover the casualty if possible with a sheet or blanket and secure them to the device, tuck loose straps and items away, never leave casualty alone;
  • avoid bending or twisting the casualty’s neck and back, spinal injury can be aggravated by rough handling;
  • try to have 3 or 4 people to assist with support of the head and neck, chest, the pelvis and limbs, and spinal immobilisation if required.

First aider safety whilst moving a casualty:

  1. Communicate - Decide ahead of time how the casualty is to be moved and what verbal commands will be used. During the lift, be in charge and provide appropriate instructions to those assisting.
  2. Safe manual handling- Consider the weight of the casualty and the weight of the stretcher or other equipment being carried before lifting. Determine if additional help is needed. e.g. 4 people on all corners over rough terrain. Know your own physical limitations, consider that of others assisting.
  3. Lift without twisting or rotating your body - This can put additional strain on the back muscles resulting in injury. Flex at the hips, not the waist and bend at the knees.
  4. Maintain a firm grip - Turn corners slowly and squarely, avoid any sideways movements. Be aware of trip hazards such as rugs, grates, door jams etc.

Spinal immobilisation

Manual stabilisation - Can be provided by standing behind an upright casualty or lying/kneeling above the head of a casualty lying on their back. Hold the casualty’s head firmly, whilst stabilising arms by locking elbows together or resting elbows on the ground. The aim is to maintain the casualty’s head in a neutral position aligned with the body, thus avoiding side to side movements. Using devices - There are risks associated with using specific devices. Consider the time taken in application, which may lead to delays in getting them to a hospital or providing other necessary first aid.

Reasons for moving a casualty may include:
  • to ensure safety for yourself and the casualty in danger if they are not moved (e.g. lying on a road or railway line, etc);
  • to protect from extreme weather conditions; difficult terrain making it impossible to treat the casualty; to prepare for evacuation (e.g. from remote areas, to a helicopter etc);
  • to make possible the care of airway and breathing (e.g. turning casualty onto side, or onto his/her back for CPR); to make possible the control of severe bleeding (e.g. move out of a car to reach the bleeding wound); to conduct a basic triage for a multiple casualty incident.

FAQ
Closex

Cervical Collars

The most common collars are made from hard plastic, with soft foam padding, and are applied to the neck of the casualty to maintain the cervical spine in a neutral position and prevent head movement. A cervical collar may be used to decrease the range of motion in the neck immediately after an injury. The use of a cervical collar should be limited because minimising the activity of the neck can cause its own problems. These devices should only be used by those trained in their use. They need to be accurately sized and fitted. Manual stabilisation should be maintained in addition to the cervical collar. The cervical collar serves as a precaution and it should only be removed by trained personnel who can clinically assess and clear the neck of spinal injury. Cervical collars have been shown to be associated with potential harm, the risks increasing with duration of use. Adverse effects may include: discomfort and pain; restricted mouth opening and difficulty swallowing; airway compromise should the casualty vomit; pressure on neck veins raising intra-cranial pressure (harmful to head injuries); hiding potential life-threatening conditions.

Spinal Boards

Rigid backboards placed under the casualty can be used by first aiders should it be necessary to move them. Casualties will usually have a cervical collar in place and should be adequately immobilised prior to moving. Cervical spine immobilisation will not be beneficial unless the motion of the trunk is also controlled effectively.

Where resources allow, manual stabilisation should be applied to further stabilise the head and neck during movement of a casualty on a spinal board. Casualties should not be left on rigid spinal boards. Healthy people left on spinal boards develop pain in the neck, back of the head, shoulder blades and lower back. Conscious casualties may try to move around in an attempt to get comfortable, potentially worsening their injury.

Children - After road traffic accidents, conscious infants should be left in their rigid seat or capsule until assessed by ambulance personnel. If possible, remove the infant seat or capsule from the car with the infant/child in it.

Types of spine boards and stretchers

Types of spine boards and stretchers may include: short backboard - used when a spinal injury is suspected and the casualty is in a seated position. A vest type (such as a Kendrick extrication device) is also used when a casualty needs to be removed from a car or a confined space. It wraps around the casualty and has all the straps attached or enclosed. long backboard - used when a spinal injury is suspected requiring spinal immobilisation, for rapid extrication, also provides secondary support when using a short spine board. flexible stretcher - not for spinal injury, for limited space, on stairs, cramped corners, when other equipment is not available. basket stretcher – commonly used in rescue situations e.g. winching patients into helicopters. Will fit onto wheeled stretchers. scoop (orthopaedic) stretcher - not for spinal injury, designed to easily lift supine patients, used to ‘scoop’ casualty from ground without changing their position, good in confined spaces where other stretchers cannot fit, can be placed with casualty onto a wheeled stretcher for transport. stair chair - for casualty that can sit up while being carried, useful for down stairs, or through narrow passageways, must be transferred to stretcher once at the ambulance. portable / folding stretchers - use to go down stairs, downhill, over rough terrain, move from a narrow spot, used as a backup to a wheeled stretcher, easily loaded/off loaded into ambulance, types: basic / breakaway / with folding wheels. wheeled stretcher - 2 basic types: one person e.g. roll in with special wheels; and two person to move/carry in narrow spaces e.g. lift in, one rescuer on each side; adjustable to different heights and angles; adjustable to elevate the legs or raise head and shoulders; additional equipment may be attached including oxygen, IV lines, cardiac monitors, defibrillators, can take up to 200kg.

Triangular Bandages

After being bandaged, an injured forearm or wrist may require an arm sling to lift the arm and keep it from moving. The usual slings are commercially made bandages called triangular bandages. The most effective sling can be found in your first aid kit, but there are many alternatives that do not require a commercially made sling. For example, using a head scarf or piece of material, or turning a person’s clothing up over their arm is a quick method, especially in sporting accidents, and may be the quickest and easiest alternative.

Uses - Triangular bandages may be folded to create an upper arm sling, lower arm sling and a collar and cuff sling. They may also be used to create a broad bandage for splinting fractures of the upper legs and a narrow fold bandage for lower leg fractures.

How to fold a triangular bandage:

  • place an open triangular bandage on a clean flat surface;
  • to create a broad bandage for splinting fractures of the upper legs - fold again in the same direction;
  • to create a narrow fold bandage for lower leg fractures - fold one more time in the same direction;
  • to create a sling - fold from the (point) to the middle of the bandage.

Slings from triangular bandages

Upper arm sling: support the injured arm in a ‘V’ so that it is held in front of their body and bent at the elbow with the hand resting in the hollow where the collarbone meets the shoulder; with the point of the triangular bandage positioned at the elbow, place the bandage over the top of the arm; tuck the upper point under the casualty’s fingertips; pass the base of the bandage up under the forearm to create a cradle or hammock; join the bandage together at the elbow and twist towards the casualty into a long spiral; bring the long spiral around and then up the person’s back; tie the two ends together firmly at the person’s fingertips; secure at the elbow with a pin, tape or twist; check circulation to the arm, wrist and fingers; secure additional bandages to support the sling, if needed. Lower arm sling: support the injured forearm parallel to the ground; with the point of the triangular bandage at the elbow, place under the arm; extend the upper point of the triangular bandage over the shoulder on the uninjured side; bring the lower end of the bandage up to meet the other end and tie in the hollow of the neck just above the collarbone on the uninjured side to avoid any pressure on the neck; check for circulation to the arm and fingers. Collar and cuff sling: for a shoulder injury where the arm is already in a natural 45-degree position; form two loops - one over and one under; put the loops together; place the casualty’s wrist through the loops and tie in the hollow of the neck just above the collarbone on the uninjured side; check circulation.

How to Apply a Roller Bandage

How to apply a roller bandage: the injured person should sit or lie down; position yourself in front of the casualty on their injured side; support the injured body part in position before starting; the casualty may be able to help by holding the padding in place; wrap the ‘tail’ of the bandage one full turn around the limb to anchor it; if there is no assistance and there is padding over a wound, wrap the ‘tail’ of the bandage directly around the padding; roll upwards continuing to unwind the bandage around the limb; overlap the bandage by about two thirds its width as you unwind and secure the end with tape (alternatively bandage in a ‘figure eight’ fashion); Make sure the bandage isn’t too tight. Check by pressing on a fingernail or toenail of the injured limb. If the pink colour returns within a couple of seconds the bandage isn’t affecting the circulation. If the nail remains white for some time, loosen the bandage. Keep checking and adjusting the bandage, especially if swelling is a problem.

Triage

Triage is the sorting of casualties by the severity of injury or illness, so that resources can be utilised more efficiently, to do the most good for the most people. The goal of triage is to identify casualties who have—obstructed airway, excessive bleeding or shock— and to treat them immediately. Triage generally applies to large numbers of casualties and is a tagging system often used by paramedics; however, the principle can be applied in any situation with two or more casualties. Triage usually begins at the incident site, as soon as casualties are located. Conducting a triage evaluation: Check airway/breathing; Check bleeding/circulation. The principle of triage involves dividing casualties into groups, ranging from those most in need of assistance, to those that have only minor injuries. For example, those needing immediate life-saving interventions such as obstructed airway, excessive bleeding or shock, which will be treated first, then those that are stable, but need monitoring and medical attention, to those that will require care but not urgently. In conducting triage, you must be concerned with the safety of yourself, other first aiders and bystanders, as well as that of the casualties. If you don't protect yourself, you can make the situation worse.

Resuscitation

Any casualty who is gasping or breathing abnormally and is unresponsive requires resuscitation. Breathing may be absent or ineffective as a result of:
  • upper airway obstruction;
  • cardiac arrest;
  • problems affecting the lungs;
  • drowning;
  • suffocation;
  • paralysis or impairment of the nerves and/or muscles of breathing.

Cardiac arrest

Cardiac arrest is a term that is used to describe that the collapsed casualty is unconscious, unresponsive, not breathing normally, or at all, not moving. Cardiac arrest is the single largest cause of death. The best way to increase the chance of saving sudden cardiac arrest casualties outside of a hospital setting is to follow every link in the chain of survival.

Chain of survival

The first link: Early access to the ambulance; includes early recognition of the cardiac emergency and early notification of ambulance service. Dial Triple Zero (000). Time is essential to preserve life. Send for defibrillator immediately if one is available.

The second link: Early CPR assess and support airway, breathing and circulation. Cardiopulmonary resuscitation (CPR) is the technique combining chest compressions and rescue breaths (ventilations) for all ages regardless of the numbers of rescuers present. The purpose of cardiopulmonary resuscitation is to temporarily maintain a circulation sufficient to preserve brain function until specialised equipment is available to re-start the heart.

When to stop CPR - a first aider should continue cardiopulmonary resuscitation until:
  • the casualty responds or begins breathing normally;
  • it is impossible to continue (e.g. exhaustion);
  • someone else can take over CPR;
  • a health care professional directs CPR to be ceased.
The third link: Early defibrillation to treat cardiac arrest caused by Ventricular Fibrillation (VF, an abnormal, irregular heart rhythm with rapid, uncoordinated contractions). Defibrillation is a process in which an electronic device, called an automated external defibrillator, or AED, helps re-establish normal contraction rhythms in a heart that's not beating properly. External defibrillation provides a brief, effective shock through the person's chest to their heart, interrupting the abnormal rhythm and hopefully allowing the heart's natural rhythm to regain control. The time to defibrillation is a key factor that influences survival. For every minute defibrillation is delayed, there is approximately 10% reduction in survival, if the casualty is in cardiac arrest due to Ventricular Fibrillation (VF). An AED can safely be used on pregnant casualties.

The fourth link: Early advanced care relates to the response of highly trained paramedics who can assist the casualty, provide for the administration of drugs, advanced airway procedures and other interventions and protocols.
FAQ
Closex

Q

What could cause abnormal, ineffective or absence of breathing?

An upper airway obstruction (choking)

Cardiac arrest

Drowning

Any of the above

When a casualty is sick or injured, we need a system to evaluate their condition or illness.

Danger

Firstly, you must ensure that it is safe for you to assist the casualty. Protect everyone from any danger, protect yourself with gloves and other protective equipment, and call for help immediately. Do not proceed with treatment if it is too dangerous, call for experts.

Response

Secondly, you must try to get a response from the casualty. If they appear unconscious, gently shake their shoulders, firmly ask questions (but don’t shout), like “can you hear me?” Ask them to try to squeeze your hand. If the casualty responds and can talk, assess their state of consciousness (slurred speech, dizzy etc) and move onto the verbal secondary survey. If they are not responding, treat them as unconscious and call the ambulance immediately.

For casualty assessment there are 2 stages:

  1. Primary survey - the first stage follows the DRSABCD action plan. This is where you try to get a response from the casualty as described above.
  2. Verbal secondary survey - the second stage is carried out using the ‘no touch technique’ and involves a visual and verbal examination of his/her injuries without touching them. Gain consent from the conscious casualty, or their carers, and explain what you are going to do. Listen carefully to the casualty’s responses to the questions that you ask.
  3. If injuries are found during these examinations, then further evaluate what treatment is required. Where there is more than one casualty, THE CARE OF THE UNCONSCIOUS CASUALTY HAS PRIORITY.

Unconscious NON-BREATHING casualty

An unconscious casualty that is not responding, not breathing at all, or has minimal response and is not breathing normally, needs urgent treatment. Even if the casualty takes occasional breaths or gasps, first aiders should suspect that cardiac arrest has occurred and should start CPR.

First aid - unconscious non breathing casualty - do not roll onto his/her side, immediately follow the steps for the chain of survival, and DRSABCD emergency action plan.

One method for turning a casualty onto their side

Single first aider:

  • kneel beside the casualty;
  • if the casualty is on his/her back, bend the arm nearest to you and place their hand comfortably beside their head;
  • bring the other arm across their chest and hold their hand near their closest cheek;
  • bend the leg on same side as the arm placed across chest, keeping their foot on the ground;
  • keeping their hand on their cheek, pull the bent leg, and very, very gently roll the casualty onto his/her side;
  • special care should be taken to provide support and avoid any forward movement to the head, neck and spine in case of spinal injury;
  • adjust them accordingl, the casualty should be on his/her side with their head gently tilted back to allow free drainage of fluid;
  • the bent knee prevents rolling;
  • the bent arm provides stability;
  • once a casualty is on his/her side, the first aider should be positioned facing their front.

More than one first aider:

  • it is better to have as much assistance as possible. When two or more first aiders are available, head support and spinal alignment is much easier to maintain.

FAQ
Closex

Casualty History

A history is the complete story concerning the accident or illness. What happened prior to the illness or accident can be vital when working out what is wrong with the casualty, especially if they are unconscious. It is a short story that leads up to and includes the incident. It includes any previous or current health conditions and medications. The casualty, bystanders or relatives can be invaluable in these cases.

Ask questions such as:

  • “Do they suffer from any allergies?”
  • “Are there any previous relevant illnesses?”
  • “Are they on any medications?”
  • “Has this happened before?”
  • “What were they doing at the time?”
  • “What signs or symptoms were they showing?”
Medic alert - Is an internationally recognised emblem that is custom engraved on bracelets and necklets providing instant access to primary medical conditions/allergies or “special needs”. A 24hr telephone hotline number and individual membership ID registration number, are also engraved on these items, to ensure confidential identification.

Signs - Are observations about the casualty’s condition. Look for visible signs of injury or illness. For example, is the casualty pale? Is the casualty sweaty? Is the casualty bleeding?

Symptoms - Are how the casualty feels. Ask them to tell you what they are feeling. For example, are you suffering from a headache? Are you in pain? Do you feel sick, dizzy or unwell?

Blood pressure (BP )- When a person loses blood, the blood pressure falls and the casualty will have pale, cold, clammy skin. The pulse is usually faster than normal and they may become thirsty. Another good indicator of blood loss is the colour of the tongue. If it’s pale, it means blood loss. Although taking a blood pressure is not part of first aid, there are several indicators or signs that would lead the first aider to suspect blood loss.
  • Normal or adequate - A person is said to have an adequate blood pressure if the colour immediately returns when you press and release pressure on a fingernail or skin;
  • Inadequate - If the area is still pale after 2 seconds, this indicates their blood pressure is low, which may be a cause for concern.
  • Pale skin colour - A person who has suffered significant blood loss will be pale;
  • Reduced oxygen - If the oxygen levels are reduced, they could have a blue colour to the ear lobes, lips and fingers.

Skin Colour

A casualty may experience different levels of consciousness.

Conscious - A person is walking, talking, doing normal things, is said to be ‘conscious’.

Unconscious - A person is said to be ‘unconscious’ when they cannot be woken from what looks like a sleep, but they are still breathing and they have a pulse. The casualty is ‘unresponsive’.

Cardiac arrest - A collapsed casualty that is unconscious and not breathing normally or at all.

Q

What is the best method for assessing a casualty?

Start with a primary survey (DRSABCD), followed by a secondary survey, if the person is conscious, including verbal questioning and observation

Placing them carefully onto their stomach and feeling your way all over their body

Manually bending and rotating each of the limbs

Asking them to stand up and run to assess their reaction times

Q

How do you check for a response to determine whether someone is unconscious?

Use verbal questioning like Can you hear me n Can you squeeze my hand

Whisper in their ear and assess response

Slap the casualty cheeks to try to get a response

Shake them firmly and vigorously, it is important to try to wake them up

Q

How can you tell if a person is unconscious?

They look like they are asleep

They cannot be woken

You cannot obtain a purposeful response from them

All of the above

Q

providing first aid to an unconscious breathing casualty, how would you position them?

Keep them on their back and raise their legs

Turn the casualty carefully onto his/her side, keep the airway open

Leave them exactly where you found them

Gently roll the casualty onto his/her stomach with their head to one side

Cardiopulmonary resuscitation

Cardiopulmonary resuscitation (CPR) is the technique of chest compressions combined with rescue breathing. The purpose of cardiopulmonary resuscitation is to temporarily maintain a circulation sufficient to preserve brain function until specialised equipment is available to re-start the heart. First aiders should start CPR if the casualty is not responding. The indicators would be that the casualty is unconscious, unresponsive, not moving and not breathing normally. Even if the casualty takes occasional breaths, or gasps, first aiders should suspect that cardiac arrest has occurred and should start CPR.

1. Manage airway

Roll the casualty onto their back, open the airway, for adults, use the head tilt / chin lift manoeuvre, for infants under 1 year old, do not tilt the head, just support the jaw and keep the mouth open. Failure to maintain backward head tilt and chin lift is the most common cause of obstruction during resuscitation.

Backward head tilt / chin lift:
  • Adults - place one hand on their forehead. The other hand provides chin lift. Hold the chin up using your thumb and fingers (pistol grip). Tilt the head backwards (NOT the neck). The jaw is held open slightly and pulled away from the chest. Avoid excessive force.
  • Infants - do not use this for children under 1 year old, gently support the lower jaw at the point of the chin maintaining an open mouth.

2. Breathing

After an unconscious casualty’s airway is cleared, the next step is to check whether or not the casualty is breathing normally using the ‘Look, Feel and Listen’ technique. Casualty’s that are gasping or breathing abnormally and are unresponsive require immediate resuscitation.
  • LOOK & FEEL for movement of the upper abdomen or lower chest.
  • LISTEN for the escape of air from the nose and mouth.

3. CPR

30 chest compressions, 2 rescue breaths alternatively and continuously until recovery, defibrillator arrives, someone else takes over or you are directed to stop by a medical professional. If airway becomes obstructed during CPR, promptly roll onto side and clear, reassess response and breathing, then recommence CPR as required. Resuscitation can be done with a single operator; however, it is more beneficial to complete CPR with two first aiders, i.e. one person completing the rescue breaths and one person doing compressions.
  • Chest compressions - helps oxygen circulate around the body. Compressions should be paused when doing rescue breaths and for defibrillation if required. Casualties should be placed on their back on a firm surface. Compressions are done on the centre of the chest, rhythmically at 100 compressions per minute and around one third of the depth of the chest. If there is more than one first aider present, rotate approximately every 2 minutes to reduce fatigue.
  • Rescue breaths or ventilations - can be done by mouth to mask (preferable), mouth to mouth, mouth to nose (usually for infants and small children) or rarely mouth to stoma (hole in the front of the neck). Kneel beside their head. Maintain an open airway (backward head and chin lift). If using a mask position it and hold in place. Blow into the mask and inflate the lungs. Look for chest rise. Remove your mouth from the mask to allow exhalation. Turn your head to listen and feel for the release of air. If the chest does not rise, re-check head tilt, chin lift and mask seal. Do this 2 times then go back to compressions. Do the same if not using a mask, only create a seal with your mouth over theirs.
  • Protection - rescue breathing is a life-saving manoeuvre and whilst protective devices such as standard precautions and masks and gloves should be used if available, they are not mandatory and rescue breaths should not be delayed if such a device is unavailable. Concern about disease transmissionis one of the causes for the reluctance to perform rescue breathing in different settings. A resuscitation mask is a protective device that prevents direct contact between the mouth, face or nose of the first aider and the casualty. The main reasons for their use are to avoid unpleasant, intimate contact with vomit, blood and saliva and to overcome the associated fear of transmission of an infectious disease. Risk of disease transmission during rescue breaths is very low; however use of a resuscitation mask reduces the risk even further. If the first aider is unwilling or unable to complete the rescue breaths, they should do ‘compressions only CPR’.
  • Compressions only CPR- if unwilling or unable to do rescue breathing, do chest compressions only. Follow all requirements for compressions continuously, only pausing if response or breathing returns, for defibrillation or handover.
  • Resuscitation in late pregnancy - in the obviously pregnant woman, the uterus causes pressure on the major abdominal vessels when she lies flat on her back, reducing the venous return of blood to the heart. Position her on her back with shoulders flat using padding under the right buttock to give pelvic tilt to the left side.

4. Defibrillation with an AED

An automated external defibrillator (AED) can accurately identify the cardiac rhythm as “shockable” or “non-shockable”. Anyone can use a defibrillator, however, formal training assists with speed of use, correct pad placement and confidence.
  • If available, use as soon as possible. Continue CPR until the AED is turned on and pads attached. Quickly check the equipment. Turn on AED, attach pads to bare chest, attach leads to AED, allow AED to analyse, STAND CLEAR, follow the prompts, do not touch the casualty during shock delivery.
  • Continue to follow AED prompts (Defibrillator machine - AED makes decisions on what to do) until responsiveness and normal breathing returns, ambulance arrives and takes over CPR, you can no longer continue due to fatigue or a health care professional directs that CPR be ceased.
  • Pad placement - Pads are placed on the exposed chest. All pads have a diagram on the outer covering demonstrating the area suitable for pad placement. Avoid placing pads over implantable devices. Standard adult AEDs and pads are suitable for use in children older than 8 years. Ideally, for children between 1 and 8 years paediatric pads should be used. If paediatric pads are not available, then the standard adult pads can be used.

FAQ
Closex

Q

What do chest compressions achieve during CPR?

Help move oxygenated blood to the brain

Remove toxins

Put air into the diaphragm

Stop the flow of blood

Q

Once you have started CPR,would you make a decision to stop?

After 6 sequences

either the casualty recovers you too exhausted you directed to stop by a health care professional

Never! You have to continue no matter what

After 5 minutes without any improvement

Q

Which technique can help you manage an adult casualtyairway whilst doing rescue breaths?

Pressure Immobilisation Technique

Backward head tilt and chin lift

The recovery position

Holding the tongue

Q

After analysing, what an AED (defibrillator) identify?

The injuries the casualty has received

Whether to provide a shock to the casualty or not

The casualty blood pressure

Amount of oxygen in the casualty blood

Q

using a defibrillator, how do you know to place the pads?

You must advanced medical text books

Google it

pads have a diagram on the outer covering demonstrating areas for suitable pad placement

Send a runner to the closest doctor

Q

Which body system is responsible for pumping blood around the body?

Respiratory system

Circulatory system

Skeletal system

Muscular system

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