You should suspect head, neck or back injuries in victims who have sustained a violent force, such as that which results from a car crash or a dive. If you suspected a neck injury, you should use jaw thrust, and not head tilt and jaw support.
Read more...Because an infant's tounge is proportionally larger it is more likely to block the airway, so be sure the airway is open when you give EAR. The breathing rate is the same as for children: 1 puff every 3 seconds. The EAR technique is similar to that for children with the following differences:
EAR for a child is performed slightly different to take into account the child's underdeveloped physique and slightly faster breathing and heart rates. Follow the same sequence as for an adult, with the following exceptions:
1. Check for breathing with the jaw supported and the head in neutral position. If necessary, tilt the head back slightly to open the airway.
2. Check breathing by looking for movement of the chest and upper abdomen while listening and feeling for air escaping from the nose and mouth.
3. Gently puff air into the child, using just enough pressure to make the chest rise.
4. If the breath does not go in, check that the airway is open. Sometimes gentle head tilt is needed to open the airway. The older the child, the more head tilt is needed top open the airway.
5. Because children breathe faster than adults, give a small breath or puff of air every 3 seconds (20 per minute) for a child.
If the child begins breathing unaided, turn the child onto the side and maintain an open airway.
Expired air resuscitation (EAR) is a way of breathing air into someone to supply that person with the oxygen needed for survival. EAR is given to victims who are not breathing but still have signs of circulation.
EAR works because the air you breathe into the victim contains more than enough oxygen to keep that person alive. The air you take in with every breath contains about 21% oxygen , but your body uses only a small part of that. The air you breathe out of your lungs and into the lungs of the victim contains about 16% of oxygen , which is enough oxygen to keep someone alive.
You will discover whether you need to give EAR during the first two steps of the ABC in the primary survey when you open the airway and check for breathing. If you can't see, hear, or feel any signs of breathing, you must begin EAR immediately.
EAR TECHNIQUE
Ti give EAR, first turn the victim onto the back and keep the airway open with head tilt and jaw support. Place one hand on the top of the head and tilt the head back. Support the jaw with your fingers in a "pistol grip" position. Head tilt and jaw support not only open the airway by moving the tongue away from the back of the throat, but they also move the soft tissue flap, called epiglottis, from the opening of the trachea. If you know or see that the victim is wearing dentures, don't automatically remove them. Dentures can help the EAR process by supporting the victim's mouth and cheeks during mouth-to-mouth resuscitation. If the dentures are loose, the head-tilt and jaw- support technique may help keep them in place. Remove the dentures only if they are broken or become so loose that they block the airway or make it difficult for you to give breaths. Begin the mouth-to-mouth method of EAR by giving full 5 breaths in 10 seconds. If you don't see the victim's chest rise and fall as you give each breath, you may not have the head tilted back far enough to open the airway adequately. Tilt again the victim's head and try again to get air into the lungs. If your breaths still don't go in, the victim's airway may be blocked and need to be cleared. Check for signs of circulation after giving the 5 full breaths. If the victim has signs of circulation but isn't breathing, continue EAR by giving 1 breath every 4 seconds (15 breaths per minute). Take a breath yourself and breathe into the victim.
Do not stop EAR unlesson of the following occurs:
In a remote area or in a unusual circumstance, you might consider transporting the victim to the hospital yourself if the victim's condition is not severe. This is an important decision. Don't transport a victim with a life- threatening condition or one who has many chance of developing a life- threatening condition. As a general rule, call for an ambulance because a car trip can be painful for the victim and may aggravate the injury or cause additional injury. If you must transport the victim yourself, ask someone else to come with you. One person should drive while the other helps keep the victim comfortable. Be sure you know the quickest route to the nearest medical facility with emergency care capabilities. Pay close attention to the victim and watch for any changes in the victim's condition. Discourage any ill or injured person from driving to the hospital. An injury may restrict movement, or the victim may become giddy or faint. The sudden onset on pain may be distracting. Also, an injured or ill person may drive faster or more erratically than normal. Any of these conditions can make driving dangerous for the victim, passengers, pedestrians, and other road users.
Read more...Once you complete the secondary survey, provide care for any specific injuries you find. To provide care for the victim until ambulance personnel arrive, follow these general steps:
The emergency action principles are:
1. Survey the scene.
2. Conduct a primate survey and care for life-threatening problems.
3. Conduct a secondary survey, when appropriate and care for additional problems.
These actions, done in this order, can ensure your safety and that of the victim's chance of survival.
SURVEY THE SCENE
Once you recognize that an emergency has occurred and decided to act, you must make sure that emergency scene is safe for you and any bystanders. Take time to survey the scene and answer these questions:
1. Is the scene safe?
2. What happened?
3. How many victims are there?
4. Can bystanders help?
When you survey the scene, look for anything that may threaten your safety and that of the victim and bystanders. Example of dangers that may be present are fallen power lines, falling rocks, traffic, fire, smoke, dangerous fumes, extreme weather and deep or swift-moving water. If any of these or other dangers are threatening, do not approach the victim. Call emergency personnel immediately for help. Nothing is gained by risking your own safety. An emergency that begins with one victim could end up with two if you are hurt. Leave dangerous situations for emergency professionals who have the training and proper equipment to handle them. If you suspect the scene is unsafe, wait and watch until emergency personnel arrive. If conditions change, you may then be able to approach the victim.
Find out what happened. Look around for clues about what caused the emergency and the type and extent of the victim's injuries. By looking around, you may discover a situation that requires your immediate action. As you approach the victim, take in the whole picture. Nearby objects, such as shattered glass, a fallen ladder or a spilled bottle of medicine, might tell you what happened. If the victim is unconscious, your survey of the scene may be the only way to tell what happened. Look carefully for more than one victim because you may not spot everyone at first. For example, in a car crash, an open door may be a clue that a victim is bleeding or screaming loudly, you may overlook another victim who is silent and unconscious. It is easy to overlook an infant or small child. Ask anyone present how many people may be involved. If you find more than one victim, ask bystanders for help.
Look for bystanders who can help or who can help or who may be able to tell you what happened or help in other ways. A bystander who knows the victim may know of any relevant medical problems or allergies. Bystanders may call emergency professionals for help, meet and direct the ambulance to your location, keep the area free of unnecessary traffic or help you provide care. If there is no one nearby, shout for help to summon someone who can help you.
CONDUCT A PRIMARY SURVEY FOR LIFE-THREATENING CONDITIONS
In every emergency situation, you must first look for conditions that are an immediate threat to the victim's life. This is called the primary survey.
In the primary survey, you check each of the following:
1. Conscious state.
2. Airway.
3. Breathing.
4. Circulation.
5. Severe bleeding.
CHECK A SECONDARY SURVEY
If you find any life-threatening conditions during the primary survey, do not waste time with the secondary survey.Check the airway, breathing, circulation at regular intervals, and provide care only for the life- threatening conditions. Once you are certain that there are no life- threatening conditions needing attention, you can begin the secondary survey. The secondary survey is a systematic method of finding other injuries or conditions that may need care. These are injuries or conditions that are not immediately life- threatening but could become so if not attended to. To establish a complete picture, you need to obtain the history of the incident, the symptoms described by the victim and any additional signs that you may observe. For example, you might find possible broken bones, minor bleeding, or a specific medical condition such as epilepsy.
The secondary survey has three basic steps:
1. Question the victim and bystanders.
2. Check the vital signs.
3. Do a head-to-toe examination.
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