EDA hospital BLS and ACLS training center presents

Basic Life Support Training

Resuscitation Practice

Contents

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01

CPR Steps

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CPR

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4

Scene safety: Make sure the environment is safe for rescuers and victim

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1: Check for consciousness.

Ask loudly and gently shake the patient shoulder

Check for consciousness and responsiveness

Check the breathing

-Can you see their chest rising and falling indicating that they are breathing and exchanging oxygen?

Check the pulse.

-Can you find a pulse in their neck?

If not, the person is likely in need of CPR.

No definite pulse felt within 10 seconds

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STEP　1

CPR

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2. Call help

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Call 119.

If two people are present at the scene, one can begin CPR immediately while the other calls 119 for help.

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If you are alone with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR

STEP　2

01

CPR

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C：Chest compressions

（1）Position：Find a line between the nipples and put your hands on the center of the chest right below that line.。

（2）Posture：Kneel besides the patient with your knees shoulder-width apart. Stay close to the patient。Place the hell of your other hand over the first hand with your arms straight, lock your elbows, and position your shoulders directly over your hands.

（3）Method：Chest compression 30 times. To perform chest compressions at a rate of 100 to 120/min and to a depth of at least 5-6 cm 。After each chest compressions，make sure you allow the chest recoil to its normal position

（四） Mnemonics: Push hard, push fast, Chest recoil without stop

STEP　3

01

CPR

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A：Open the airway

With the victim lying flat on his back, place your hand on his forehead and your other hand under the tip of the chin.

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Gently tilt the victim's head backward and lift the chin upward

STEP　4

01

CPR

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STEP　5

B：Breathing

（1）Open the victim’s mouth, make clear of any obstructions

（2）Pinch his nose with your fingertips to prevent air from escaping once you begin to ventilate and place your mouth over the victims

（3）Blow slowly into the victim’s mouth. The patient should receive two breaths delivered 1 second each. Check for the chest movement while delivering breath

（4）Keep ratio of 30:2 （Chest Compression：Mouth-to-mouth resuscitation）.

（Note：If the rescuer does not operate Mouth-to-mouth resuscitation, continue to compress the chest）

01

CPR

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Procedure

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10

02

Automatic External

Defibrillator Performing

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Defibrillation：AED will automatically analyze cardiac rhythm and you should follow the voice instrcution of the AED. If the AED recommends that you deliver a shock to the person, make sure that no one, including you, is touching the person – and tell everyone to "stand clear." Once clear, press the "shock" button.

（If the AED gives a "no shock advised" message after any analysis，continue CPR until help arrives.）

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Procedure

OPEN：Turn on the AED and follow the visual or audio instruction

Place the pads：Pull off the clothes。 Put the electrodes or pads in place as shown in the picture.

Attach the plug：Attach the plug in the connector (if necessary).

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STEP　1

STEP　2

STEP　3

STEP　4

AED Steps

OPAD

03

Heimlich Maneuver

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Heimlich Maneuver

STEP　1

Under 1 year old

Severe airway obstruction with foreign body （Adults Conscious (Awake)）：Progressive decreasing cough strength, difficult breathing , apena, high, pitched noise during inhalation, cyanosis appearance, inability to talk or general weakness, often holding the neck with both hands.

• Ask the person or his/her family if he is choking.

• （ If he informed yes or make no sounds,
• Then: Stand or kneel behind the person and wrap your arms around his or her waist. If the person is standing, place one of your legs between his or her legs so you can support the person if he or she faints

STEP　2

03

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Heimlich Maneuver

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STEP　3

Under 1 year old

• (Place the thumb side of your fist over the midline of epigastric area). Bthe ribcage and above the navel

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• Grasp your fist with your other hand. If the person is obese or pregnant, Do chest compression。

1

2

3

4

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Heimlich Maneuver

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STEP　4

Under 1 year old

• Compress into victum’s upper abdomen with a quick upward thrust, and always pay attention to whether there is any foreign body spit out from the mouth, until the victims lose conscious or until object is expelled.

STEP　5

• If the object cant be removed and the person is unconscious， proceed with CPR.

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Heimlich Maneuver

STEP　1

Under 1 year old

Resurer should hold the baby on the chair or bedside, with one forearm on the thigh holding the baby chin, neck and anterior chest under the lower head and face down position

With palm root of another hand, hitten over the area between two scapula

Protect Baby’s head and neck，make the bady between two forearm area. Carefully turn him over while keeping your other hand and forearm on his front.

Place two fingers in the center of

the baby's chest, do five chest thrusts.

STEP　2

STEP　3

STEP　4

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Heimlich Maneuver

STEP　1

Under 1 year old

When the victim unconscious, open the air way，and check the object. Check inside the mouth for an object.

If you see it. Carefully remove the object with your finger

If you have cleared the obstruction, Give one breaths.

If the baby's chest doesn't rise, re-tilt the head and make sure you have a good seal with your mouth before giving the second breath.

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Place two fingers in the center of the baby's chest, Give 30 chest compressions. Visually check for any vomitus or obstruction improving

STEP　2

STEP　3

STEP　4

If the object does not pop out, and the victim unconscious：

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Heimlich Maneuver

STEP　5

Under 1 year old

Repeat steps 1 to 4 ，until remove the obstruction or you have performed approximately 2 minutes, send to the hospital immediately。

STEP　6

If the object does not pop out, and the victim unconscious：

If you can see the object in the baby’s mouth during resuscitation, unless the baby breathing normally, otherwise, Keep basic life support protocol and giving 2 rescue breaths, then check the pulse.

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04

First Aid Bag

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05

Basic Medical Support Service

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05

Hemostasis and Bandage

Bleeding, also known as hemorrhage, refers when blood escapes from the circulatory system(heart/blood vessels) into tissues, body cavity or external surface.

Bleeding

Types of Hemorrhage

• Internal V.S. External
• Internal bleeding: blood escape from the vessels into the body, including organs and body cavities. No obvious bleeding is seen and rather difficult to recognize. May show bruises, ecchymosis or hematomas
• External bleeding: blood escapes from the vessels and flow to the outside of the body through an open wound in the body surface. For example, mouth, nose, ear, urethra, vagina or anus. Visible bleeding can be seen

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05

Hemostasis and Bandage

Methods of homeostatis

1. Direct compression：

Apply right amount of force directly to the wound to stop the bleeding. This is the most common and effective method

2. With tourniquet：

As a last resort, executed by trained personnel。Tie the tourniquet proximal (closer to the heart) to stop the bleeding. When dressing for the wound, make sure the tourniquet is clearly visible and marked the time clearly. May also use a sling or other accessory devices. It is not mandatory to release the tourniquet before arriving at the hospital, but prompt hospitalization is suggested

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05

Hemostasis and Bandage

止血方式

3. Management for nosebleed

Calm the patient and let him/her sit in an upright position with head tilting forward to prevent aspiration of the blood. If the patient could not sit, lie him/her down and raise the shoulders and head slightly. If no nasal bone fracture is present, gently squeeze the side of the nose and use ice packing the face and nose. If bleeding still could not be controlled, insert a clear gauge into the bleeding nostril, and then apply pressure. Make sure one end of the gauge is showing, for easy removal later.

If the bleeding persists and the patient is awake, try apply pressure in the upper gum and lips. If still bleeding, seek medical attention.

Methods of homeostati

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05

Hemostasis and Bandage

Stop bleeding from open wounds

1. If a wound continuous to bleed, put sterile gauge onto the bleeding point, and apply direct pressure. Then wrap bandage or sling to achieve continuous pressure. If bleeding still present, do not remove the original gauge, but apply more gauges and bandages.
2. If an wound is not bleeding, apply sterile gauge onto the wound, fix with tape, bandage or sling.

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• Note: if bleeding continuous and life maybe in danger, try other methods of homeostasis

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05

Hemostasis and Bandage

Wound dressing principles

• Dirty wounds should be rinsed with normal saline thoroughly, to prevent infection
• Use sterile gauge as standard dressing, size should be larger than the wound. After covering with gauge, wrap it with bandage or sling. This will not only stop the bleeding, but protect the wound from contamination
• Try to dress the wound in a tidy and secure manner

Sterile gauge

bandage

sling

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05

Hemostasis and Bandage

Bandage dressing

Fixed tie： From the distal part wrapping proximally, fold the corner into the bandage and wrap it again

Circular tie：warp the same area repletely in a circular manner。

Spiral tie： Used in large and long wounds that cannot be covered by 1 bandage. Wrap from the distal to proximal part, and cover about 1/2 to 1/3 of the 1^st bandage. This is suitable in limbs that are the same width.

Figure-8 tie： Suitable for joints, usually in the elbow, wrist and ankle. Wrap in figure 8 manner to expose the joint, allow movement.

Circular tie

Spiral tie

Figure 8 tie

Fixed tie

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05

Hemostasis and Bandage

Use of sling(Triangular bandage)

1. Flat knot: after wrapping, the ties can be fixed by a flat knot. Pay attention not to have the knot over wound, neck joint, boney protrusions or medial aspect of limbs where constant movement is required.
2. Head bandage: suitable for fixation of gauge in the head
3. Shoulder bandage: suitable for fixation of gauges in the shoulder
4. Sling bandage: suitable for wounds in the shoulder, elbow, wrist. Also, forearm and upper arm fractures. The sling will ease the patient from pain.

Head bandage

Shoulder bandage

Forearm fixation

Flat knot

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05

Moving patient

Importance

Injured patients may experience immobility or other unstable vital signs, emergency personnel should evaluate the scene and provide the most suitable method of moving the patient. Before moving the patient, one should know how to protect one own safety, and prevent any secondary injury to the patient due to improper mobilization.

Objective

1. To remove the patient from harmful environment
2. Prevent the patient from receiving unnecessary injury
3. Prompt hospitalization

Timing

• Emergency： When the environment pose immediate danger, promptly move to patient to a safe area, try at best to avoid secondary injury while moving .
• Non-emergency： When the patient is awake and vital signs are stable, provide first-aide then consider proper methods of moving.

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Moving patient

Methods of moving

1. Without assisting equipment：single person support、carry、two people support and moving patient by the limb。
2. With assisting equipment：moving pad、moving chair and long boards。

Moving patients with barehand

1. Single person support

• Useful in awake and minor injured patients, who can walk with a little help
• Stand beside the patient on the injured side, wrap the patient’s upper arm around rescuer’s neck and hold the patient’s wrist. The other hand wraps around the patient’s back and hold the patient by the belt to increase stability. Then support the patient to walk.

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Moving patient

Moving patients with barehand

2. Carrying the patient

• Suitable for elderly, children, light weighted and patients that requires prompt movement. But patients with C-spine injury or other fractures are not recommended
• The rescuer squats down with back towards the patient, allow the patient to hang their arms around the shoulder. The rescuer’s hand passes through the patient’s thigh and grab the patient a little bit above his/her wrist and stand up slowly

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05

Moving patient

徒手搬運操作與運用

3. Two men support

• Useful in awake and minor injured patients, who can walk with a little help

The rescuers stands on both sides of the patient, wrap the patient’s arm across the rescuers neck, grab the patient by the wrist. Swing the other hand across the patient’s back and help the patient to walk.

Moving patients with barehand

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05

Moving patient

徒手搬運操作與運用

4. Carries the patient by limb

• Suitable for patients without C-spine injury
• 2 rescuer job, one stands at the feet of the patient, bend the patient’s knees and fixate the patient by the feet. The other rescuer stands behind the patient, hand the patient hand to the first rescuer, and protect the head and neck of the patient. On the mark of the 2^nd rescuer, adjust the patient into a sitting position. The 2^nd rescuer will then put his arms under the patient’s arm pit, and cross the patient arm over his chest and grab the patient by the wrist and hold the patient. The 1^st rescuer will then stand, turn and carry the patient by the legs.

Moving patients with barehand

Q & A

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