EAR for Victims with Suspected Head, Neck or Back Injuries

Tuesday, August 10, 2010

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.

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EAR for Infants (less than 1 year old)

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:

  • Steady the infant's head continuously because it is unstable.
  • Do not tilt back the head, but support the jaw.
  • Avoid putting any pressure on the soft tissues under the infants chin because this could obstruct the airway.
  • Cover both infant's mouth and nose with your mouth.
  • Use gentle puffs of air from your cheeks only. Use just enough pressure to make the chest rise to avoid distending the infant's stomach.
  • After giving 5 puffs, check for signs of circulation.

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EAR for Children (1 to 8 years of age)

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.

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Expired Air Resuscitation

          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:

  • The victim begins to breathe unaided.
  • The victim has no signs of circulation. If so, begin CPR.
  • Another first aider takes over for you. 
  • Emergency personnel arrive on the scene and take over.
  • You are physically unable to continue. 

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Transporting the Victim

Monday, August 9, 2010

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.

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How to Provide Care

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:


  • Prevent further injury.
  • Monitor the ABC.
  • Help the victim to rest in the most comfortable position.
  • Maintain normal body temperature.
  • Reassure the victim.
  • Provide any specific care needed.

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Emergency Action Principles

Sunday, August 8, 2010

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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Preparing for Emergencies

If you are prepared for unforeseen emergencies, you can help ensure that care begins as soon as possible - for yourself, family and friends, and others in your community. First aid training will help you to focus on the most important aspects of care by giving you a basic plan of action that can be used in an emergency. By knowing what to do, you will be better able to manage your fears and overcome your barriers to action. You can be ready for most emergencies if you do the following things now:

  • Keep important information about you and your family in a handy place such as on the refrigerator door and in your car's glove compartment. Include everyone's date of birth, medical conditions, allergies, and prescriptions and dosages. List doctors' names and phone numbers.
  • Keep medical and insurance records up to date.
  • Find out if your community is served by an emergency 000 telephone number. If it's not, look up the numbers for police, fire brigade, ambulance service and The Poisons Information Center. As soon as they are old enough to use the telephone, teach your children how to call for help.
  • Keep emergency telephone numbers listed in a handy place such as by the telephone and in your first aid kit. Include the phone and office phone numbers of family members, friends, and neighbors who can help. Be sure to keep both the list and the telephone numbers current.
  • Make sure your house or unit number is easy to read. Numerals are easier to read than spelled out numbers. Report any missing street signs to the proper authorities. 
  • Wear a medical alert tag if you have a potentially serious medical condition such as epilepsy, diabetes, heart disease or allergies. A medical alert tag, usually worn on a necklace, bracelet, or a personal medical ID card provides important medical information if you can't communicate. 
  • Keep a first aid kit readily available in your home, car, workplace, and recreation area. Store each kit in a dry place and replace used contents regularly. Different first aid kits are required for various circumstances. A first aid kit should contain a variety of dressings and bandages together with scissors, forceps, and other items.

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Preventing Emergencies

Saturday, August 7, 2010

Being responsible means that you take reasonable precautions to prevent emergencies from occurring. Injuries remain the leading cause of death and disability in children and young adults. Thousands of people die each year in a certain country due to injuries. No one knows for sure how many of these victims die needlessly from preventable incidents. Emergencies also occur as a result of unhealthy lifestyles. For example, your exercise and dietary habits influence the health of your heart. Unhealthy habits such as over eating, smoking and lack of exercise, can increase your chances of heart attack.

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Legal Considerations

People are sometimes afraid that in the stress of an emergency they may make mistakes when they give first aid and cause harm to victim. When giving first aid to stranger, people may worry further that a mistake may lead to a legal problem or that they will be sued if they do wrong thing.
Be reassured that in the eyes of the law, first aiders are not expected to be perfect. The general legal principle is that the first aiders is expected to act reasonably and prudently with a genuine concern for the best interests of victim. If you follow this principle, you should not worry about being sued.

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Responding to Emergencies

In an emergency, your involvement as a trained first aider may be crucial.
Every year, countless first aiders and bystanders recognize and respond to emergencies. Some phone for help, some comfort the victim or family members, some give first aid to victims and others help keep order at the emergency scene.
There are many ways you can help, but in order to help, you must first decide to act.

BARRIERS TO ACTION

Sometimes people do not recognize that an emergency has occurred. At other times, people recognize an emergency but are reluctant to act.
People have various reasons for hesitating or not acting. These are called barriers to action. Some are very personal. Common reasons people give for not acting include:

1. Presence of bystanders.
2. Uncertainty about the victim.
3. Nature of the injury or illness.
4. Fear of disease transmission.
5. Fear of doing something wrong.

Thinking about these thing now and mentally preparing yourself to act in an emergency will enable you to respond more confidently.

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How to Recognize Emergencies

Recognizing an emergency is the first step in responding. An emergency is a situation requiring immediate action. A medical emergency is a sudden illness such as heart attack, which requires immediate medical attention. An injury is a damage to the body, such as broken arm, which results from a violent force. Some injuries can be serious enough to be considered emergencies.
The victim of an emergency can be anyone- a friend, family member, a stranger, or you. An emergency can happen anywhere- on the road, at home, work, or play. Recognizing an emergency may be difficult at times. You may become aware of an emergency because of certain things you observe such as unusual noises, sights, smells, symptoms and signs, or behavior.

UNUSUAL NOISES

Noises are often the first thing you may call your attention to an emergency. Some noises that may indicate emergency are:

1. Noises that indicate someone is in distress, such as screaming, yelling, moaning, crying, and calling for help.
2. Alarming identifiable noises, such as breaking glass, crashing metal or screeching tires.
3. Abrupt or loud noises that aren't identifiable such as collapsing structures or falling ladders.

UNUSUAL SIGHTS

Unusual sights that indicate a possible emergency can go unnoticed by the unaware observer. Some examples of sights that may signal emergencies are:

1. A stalled vehicle.
2. An overturned saucepan on the kitchen floor.
3. A spilled medicine container.
4. A fallen chair.

UNUSUAL SMELL


Many smells are part of our everyday lives, for example, petrol fumes at petrol stations, the smell of chlorine at swimming pools or smoke from a fire. However, when a smell is stronger than usual, is not easily identifiable or otherwise seems odd, it may indicate an emergency. You should always put your own safety first if you are in a situation in which there is unusual or very strong smell as many fumes are poisonous.

UNUSUAL SYMPTOMS OF SIGNS OR BEHAVIOR

It may be difficult to tell if someone's appearance or behavior is unusual, particularly when the person is a stranger. However, certain symptoms and signs or behaviors could indicate an emergency. For example, if you see someone collapse to the floor, that person obviously requires your immediate attention. However, you will not know if first aid is needed until you approach the individual, who may have merely slipped and not be in need of any help. On the other hand, the person may be unconscious and need immediate medical assistance. Other symptoms and signs and behavior that could indicate an emergency may be less obvious. They include:

1. Breathing difficulty.
2. Clutching the chest or throat.
3. Slurred, confused, or hesitant speech.
4. Confused or irritable behavior.
5. Sweating for no apparent reason.
6. Uncharacteristic skin color- pale, flushed, or bluish skin.

These and other signs may occur alone or together. For example, a heart attack may be indicated by chest pain alone, or chest pain may be accompanied by breathing difficulty and sweating.

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Guidlines to Follow During Training

To protect yourself and other participants from infection, you should adhere to the following guidelines:

1. Provide a manikin.Wash your hands thoroughly before working with the manikin, and repeat hand washing before each new contact with the manikin.
2. Don't eat,drink, use tobacco products or chew gum when manikins are used.
3. Only stimulate clearing a partner's airway of foreign material; don't insert fingers in a colleague's mouth.
4. Practice mouth-to-mouth and mouth-to-mask techniques of ventilation on the manikin, not on other people.
5. Following use, scrub the manikin's face or mouth-nose pieces with a nailbrush using a solution of soap and water. Rinse the pieces in clean water and dry them before disinfecting.
6. Discard lung bags and other disposable items into an appropriate container; don't contaminate the manikins or the surrounding area with used equipment.

PHYSICAL STRESS AND INJURY


CPR requires strenuous activity. If you have a medical condition or disability, don't do CPR.

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About This Blog

This blog has been designed to facilitate your learning and understanding of how to do First Aid especially when responding to emergencies. You can follow the step-by-step plan of action for an emergency and provide care for injuries or sudden illness until professional medical help arrives. First aid training will clarify for you when and how to call for emergency medical help, eliminating confusion that can occur in an emergency.

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