3 Minutes to Brain Death. What Would You Do?

Last week we discussed CPR and the use of a defibrillator. Thankfully your chances of coming across this situation are quite slim; however you are now armed with the basic knowledge for this scenario.

A far more common problem is that of a person who starts to choke. Suddenly a family dinner can turn into a terrifying experience for all present, not least the casualty! If they can’t breathe, a casualty can die in front of your eyes within 3 minutes, unless you know what to do.

Choking

We have all had something “go down the wrong way” from time to time and this is often mistakenly described as choking.

A Partial Blockage

If a casualty can breathe, talk or cough they are not actually choking but may have a partial airway blockage. While this is extremely uncomfortable for the casualty, it is not life-threatening. Remain calm, and encourage them to cough up the offending item while leaning forward. Do not give backslaps in case you dislodge the object while the casualty is breathing in to cough. This could make the situation much worse and lead to the object causing a complete blockage. If they cannot cough up the object, sit the casualty down in a comfortable position and simply call for help. Keep the casualty as calm as possible while you await the arrival of an ambulance.

A Complete Blockage

If a casualty really is choking the will often grip at their throats, their eyes will start to bulge and the veins in their neck may stick out. You will also hear them attempt to clear their own airway and you will see them in obvious distress. This is life threatening, and giving back slaps is now the right thing to do! Stand them up, lean them forward and encourage them to cough out. As they attempt to cough out, give 5 good solid backslaps between the shoulder blades. If this is unsuccessful start the ‘Heimlich manoeuvre’.

To do this, stand behind the casualty and put the finger of your left hand into their belly button. This is important because we want to have our hands over the casualty’s diaphragm muscle which is the main muscle used for breathing. Place the fist of your other hand above your finger. Grab your fist now with the first hand and encourage the casualty to lean forward.

As aggressively as you can, pull your hands up towards your face at a 45 degree angle, through the casualty’s stomach. This forces the diaphragm up and in turn forces air from the casualty’s lungs to rush up and can dislodge the choking object.

Keep doing this until the airway is cleared. Should the airway not clear and the casualty collapses, ring for help straight away and commence 30 chest compressions (this compresses the heart and the lungs, helping blood and oxygen to keep flowing to the brain and around the body). Follow this with an airway inspection. After confirming the airway is clear, attempt 2 breaths to make the chest rise, but if the air does not go in then adjust the airway and attempt to breathe again. If the airway remains blocked go back to chest compressions. Repeat these steps, compressions followed by inspecting the airway followed by breaths until either the choking object is dislodged or the emergency services arrive and they take over from you.

You can use this procedure with anyone from a year old upwards. Simply use as much force as is necessary to dislodge the object. Don’t be afraid to hurt the casualty if you really think it could be a life or death situation!

If the choking object is removed place the casualty into the recovery position because there is a high risk they will get sick and maintaining a clear airway is now your priority.

Aiden Thompson is a state registered paramedic employed on the Irish Coast Guard search and rescue helicopter based in Sligo. He is also the director of First Aid Plus, the leading provider of first aid courses here in the Northwest.

Find out more about first aid today. Go to Aiden’s website at www.firstaidplus.ie for more life-saving information.

Chain of Survival, CPR and the Use of a Defibrillator

18 people will die today from out of hospital cardiac arrest, while one young person under the age of 35 will die every week form SADS (sudden Adult Death Syndrome)

In this column Aiden will discuss the chain of survival, CPR and the use of a defibrillator.

Last week we discussed the importance of keeping ourselves safe and calling for help when in doubt.

We also talked about the ABC’s of life... Airway, Breathing and Circulation.

When we have a casualty who is unconscious and has stopped breathing we always try to put into action the chain of survival. This simple set of procedures will maximise the casualties’ chances of survival.

The first link is to ensure we call for help. The quicker an ambulance arrives the better.

The second link is that someone commences CPR. This buys times and keeps the casualty’s body oxygenated.

The third link is early use of a defibrillator. The quicker we can achieve this, the more chance the casualty has of surviving!

The final link is advanced care in a hospital.

Cardio Pulmonary Resuscitation

Ensure you are safe, and assess the casualty. Do they respond to your voice or if you inflict pain?

If not, ring for help straight away. Inform the operator your casualty is unresponsive. (Link 1 complete).

Open up the airway and look for any obstructions.

Look, listen and feel for breathing for 10 seconds. If breathing is absent you must give 2 breaths that make the chest rise and commence CPR.

Place your hands in the center of the breastbone and push the breastbone down about 2 inches 30 times. Try to keep a steady rate and done be afraid you are hurting the casualty.

After every set of compressions give 2 breaths. Keep going until the casualty shows signs of life or more professional help arrive. (Link 2 complete)

Defibrillation

When our heart beats, it does so by an electrical impulse that causes the heart muscle to contract and relax.

A defibrillator is a machine that reads the electrical impulse in the heart muscle and it decides if the heart is still in a shockable rhythm or not.

If a defibrillator is present where the casualty collapses then get it onto the casualty as soon as possible.

Take the machine out of the bag and switch it on first.

Place the 2 sticky pads onto the casualty’s bare chest and move everyone back. Follow the diagrams on the pads to make sure they are in the correct position. The machine will tell you that it is analyzing the casualty’s heart. You are not allowed to touch the casualty while the machine analyzes. The machine is now scanning for this electrical impulse and is very sensitive.

The defibrillator will say “shock advised” or “no shock advised”. If it says shock advised keep everyone back and when the shock button illuminates, ensure everyone is clear and press the button. Once a shock has been delivered the machine will tell you to commence 2 minutes of CPR.

If there is no shock advised, then commence 2 minutes of CPR. Follow the prompts from the machine. Keep going until the casualty is revived or more professional help arrives. Follow the prompts from the machine at all times. (Link 3 complete)

When the ambulance crew arrives they will take control of the situation and transport the casualty to hospital where the casualty will receive more advanced care. (Link 4 complete)

Next week we will discuss the recovery position and how to treat the choking casualty.

If you have found this article informative or would like to do a first aid course in your area why not log onto Aiden’s website www.firstaidplus.ie for details of courses available for you!

How to Recognise and Treat Common and Life Threatening Emergencies

In this column Aiden discusses your safety, calling for help, the ABC’s of life and important questions to ask your casualty.

Staying Safe at an Accident

In every situation, regardless of circumstances, staying safe must always be your primary concern!

STOP! Look for any danger to you or the casualty. If you’re concerned for your safety, do not become involved in the situation. Call for help and keep bystanders back to protect them too. Wait for professional help to arrive.

If however, you are able to help, before you do, consider the risk of infection to you and the casualty. Wear medical gloves and use any barrier devices so you can to keep yourself safe! Ask for a first aid box that might be available.

In the event of a road traffic accident, use your hazard lights, a high visibility jacket and a torch if necessary. Flag down any oncoming traffic, call for help as soon as you can and be alert for danger!

Switch off the ignition and apply the hand brake of the vehicle. Where possible treat the casualty in their vehicle.

Check the casualty’s condition. Do they appear to be seriously injured; are they conscious, can they speak to you or do you need help?

Calling for Help

The emergency numbers are 999 or 112.

State which service you require, where you are, your name and number, the nature of your casualties’ injuries, the number of casualties and any other dangers at the scene. You need one ambulance for every seriously injured casualty. Don’t hang up until told to do so!

Keep calm and give as much clear and concise information as you can.

The ABC’s of life

In first aid after your own personal safety, nothing takes precedents over the casualty’s A B C’s

A is for Airway

If someone is unconscious on their back, their tongue can go limp and roll back and cover their airway. This is life threatening!

You must ensure this does not happen regardless of any other injuries.

Tilt the head back and look into the airway for any obstructions such as vomit or blood. If there are obstructions you must remove them. With as much help and control as possible, place the casualty onto their side allowing fluids to drain out.

B is for Breathing

Once you’re sure the airway is open and clear check if they are breathing. Look, listen and feel for breathing for 10 seconds. If they are breathing you do not need to do CPR!

C is for Circulation

If the casualty is breathing there is no need to check for a pulse. If unsure check for signs of circulation which include moving, coughing, blinking or a response to your voice or pain.

At this stage use pressure to control any bleeding, be aware of concealed injuries.

Important Questions you Must Ask:

In first aid we always try to get as much information from a casualty. We use a series of questions called the SAMPLE history

S Signs and symptoms of injury. Can you see an injury or is the casualty complaining of an injury

A Allergies. Are they allergic to medications or any other agent that may have caused this episode? ( peanuts, eggs, bee stings, penicillin etc..)

M Medications. Is the casualty taking any medication and if so what is it for?

P Past history. Has this happened before and if so what was done to help the casualty?

L Last oral intake. When did they last eat or drink?

E Events. How did you come to be in this situation?

Never be afraid to call for assistance if an accident occurs. Keep calm and ensure your casualty has an open airway, is breathing and shows signs of circulation.

Next week we will talk about CPR and using a defibrillator. Until then stay safe!

If you have found this article informative or would like to do a first aid course in your area why not log onto Aiden’s website www.firstaidplus.ie for details of courses available for you!

First Aid Plus Gives Away 1 FREE Defibrillator to Mark Irish Heart Month

First Aid Plus will give an organisation in Co. Donegal a FREE defibrillator along with training for up to 10 people to mark Irish Heart Month which takes place during September.

The campaign organised by the Irish Heart Foundation aims to raise awareness of, and increased interest in, heart disease and associated conditions. Local paramedic with the Coastguard Search & Rescue Helicopter and First Aid trainer Aiden Thompson from Stranorlar feels so strongly about this issue that he has decided to offer one free defibrillator to schools, businesses, organisations or sports clubs who demonstrate a strong need for one.

To be in with a chance to win, email aiden@firstaidplus.ie and outline your reasons why you should receive this invaluable piece of medical equipment along with free training. More information is available on www.firstaidplus.ie and the First Aid Plus Facebook page.

Occupational First Aid Training Survey & Competition

Complete our survey and stand a chance of winning a FREE First Aid Training Course for up to 8 staff members worth €500! Voluntary and not-for-profit organisations are eligible to enter.

Fill in our survey here: http://tinyurl.com/2359mbm

With this survey, we hope to ascertain the market demand for Occupational First Aid training in the North West and would be delighted to receive your feedback!

Is It Worth “Not Being Prepared”?

First Aid Plus is the leading provider of Occupational First Aid Courses in the North West. All our instructor’s are certified with the OFAAA (Occupational First Aid Assessment Agency) and are registered Paramedics, Emergency Medical Technicians and Cardiac First Responders with PHECC (Pre Hospital Emergency Care Council).

We are also the only training providers in the North West to be awarded training site status with the Irish Heart Foundation.

Contact us now to learn vital life saving skills. Employers, let us help you to meet your legal obligations as required under the Health, Safety and Welfare at Work Act 2007.

Is it worth “not being prepared”?