CPR & Defibrillation National Units of Competency HLTCPR201B – Perform CPR 22101VIC Course in Automated External Defibrillation Paradise First Aid Pty

CPR & Defibrillation

National Units of CompetencyHLTCPR201B – Perform CPR

22101VIC Course in Automated External Defibrillation

Paradise First Aid Pty Ltd – Registered Training Organisation 32268

© Copyright Paradise First Aid Pty Ltd

03/04/2012 V1.0

Course Induction & Housekeeping

© Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

= Picture of real/makeup injury on next slide

Emergency Exits Mobile Phones Breaks Refreshments Smoking Toilets Certification Assessment Policies & Procedures Enjoy!

Paradise First Aid

Trainer to spend time talking through housekeeping requirments as shown on slide.Trainer should give a thorough overview of assessment requirments and emergency evacuation plans.

Legal Considerations First-aiders could be expected to;1: Act in accordance with their level of training and do so to the best of their ability2: Stabilise the casualty until advanced assistance is available 3: Maintain a consistent level of training

Scope of Practice

First Aid Code of Practice 2004 (Qld)

Duty of Care / Obligation

Consent

Recording

Negligence


Andy

Trainer to discuss and use Q&A to establish an understanding of all legal considerations of a first aider, as detailed on slideTime shoukd be taken to explain how the First Aid Code of Practice 2004 (Qld) impacts first aid in the workplace

What is First Aid?

Immediate and temporary treatment of a person of sudden illness or injury while

awaiting the arrival of medical aid

Basic lifesaving skills

Doing the best you can with the resources you have


Andy & Ella

Trainer should discuss what 'First Aid' is, and ensure that all students are aware that first aid is basic skills designed to assist a casualty immediately after an accident or illness situation.

What is First Aid?

Culturally aware, sensitive and respectful

Reassuring

Confidentiality

Skills & Limitations

Australian Resuscitation Council

Debriefing © Copyright Paradise First Aid Pty Ltd

03/04/2012 V1.0

Andy & Ella

Trainer should discuss points as shown on the slide. Give examples of each.


Perform a Scene Survey

Andy & Ella

Trainer should get students to identify hazrads present in the picture

Emergency Action Plan

DRS ABCD D – Danger

R – Response

S – Send

A - Airway

B - Breathing

C – CPR

D – Defibrillation © Copyright Paradise First Aid Pty Ltd

03/04/2012 V1.0

Help

Defibrillator

Andy & Ella

Trainer should explain what the emergency action plan is and how its applied. Discuss each of the stages of the emergency action plan.

Danger & Safety Hazard – A source or situation with the potential for harm in terms of human injury or ill-health, damage to property, the environment, or a combination of these.

Risk – The potential of the hazard being realised

Environmental / Physical DangersFire, fumes, fuel, electricity, gas, trip & slip hazards, visibility, sharp objects, chemicals, bystanders/relatives,

Communicable DiseasesDiseases or infections transmitted by bodily fluid or touch

Manual Handling Always follow safe manual handling practices when dealing with first aid situations. Use help to lift if available


Andy

Trainer should discuss what is a hazard and what is a risk.Trainer should discuss a range of dangers and hazards as shown on slide. Trainer should show examples of PPE to prevent the risk of cross contamination of communicable diseases.Discuss safe manual handling and back injury prevention

Response

Is the casualty conscious or unconscious?“Talk & Touch”

COWSC – Can you hear me?O – Open your eyesW – What’s your name?S – Squeeze hands / shoulders


Andy

Trainer to explain how to assess a casaulty's response as part of the emergency action plan.Explain how 'COWS" can assist the first aider in establishing response.Trainer should demonstrate checking for reposnse as part of the emrgency action plan. Trainer should explain that excessive movemnt of the casualty should be prevented

000 – Emergency number for all emergency services in Australia

112 – International standard emergency number

106 – Text emergency number (deaf)

ICE – In Case of Emergency (mobile phone)

Send for Help


Andy

Trainer should discuss options for contacting emergency services. Discuss questions asked by the operator and place emphasis on importance of staying calm and providing clear information. Also ensure that students are aware that they should stay on the line with the operator until they are informed to hang up.

Airway

Remember ‘pistol grip’ Check the mouth before performing head tilt / chin lift Clear the mouth of foreign material if required


Andy

Trainer should discuss what happends to an unconscious persons airway.Trainer should discuss the importance of checking the airway before assessing for breathing.Trainer should demonstrate assessing a casualty's airway as part of the emergency action plan. Trainer should ensure that all students are aware of how to use the 'pistol grip'A head model should be used to reinforce the importance of checking/clearing the unconscious casualty's airway

Breathing

“Look, Listen & Feel”for NORMAL BREATHING


Andy

Trainer to discuss what is meant by 'normal breathing', reinforcing that gasping is not normal breathing. Trainer to explain the process of checking breathing as part of the emergency action plan.Trainer to demonstrate the process of checking breathing as part of the emergency action plan.Trainer to explain the treatment of a casaulty who is unconscious, breathing normally ( i.e recovery position).

Recovery Position

All casualties who are unconscious andbreathing normally must go into the recoveryposition regardless of their injuries.

Important PointsHead must have full head tiltFace should be angled towards the floor

Spinal Injuries – Use the spinal log roll if possible © Copyright Paradise First Aid Pty Ltd

03/04/2012 V1.0

Andy

Trainer to explain why unconscious casualty's must be placed in the recovery positon.Trainer to explain the process of placing a casualty in the recovery position.Trainer to reinforce the importance of the casualty having full head tilt and the face being angled towards the floor. Trainer should discuss recovery position options for a casualty who may have suffered a spinal injury (i.e. spinal log roll) Trainer to demonstrate how to place a casaulty in the recovery position as part of the emergency action plan.Students to demonstrate on each other the process of checking danger, assessing airway, checking breathing and placing a casualty in the recovery position.

Important note – Pregnant women must be rolled on to their left side


Andy

Trainer to discuss and explain why pregnant women must be placed in the left side recovery position

Cardiac Arrest

Recognition of Cardiac ArrestUnresponsiveNot Breathing Normally

Always ensure that the ambulance has been called. Then start CPR!


Andy

Trainer to discuss the term 'cardiac arrest".Trainer to discuss and explain what is meant by 'signs of life'Trainer to reinforce that checking a pulse is not used to determine signs of lifeTrainer to discuss importance of calling emergency services before commencing CPR

What is CPR?

Cardiopulmonary Resuscitationits purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage. Defibrillation and advanced life support are usually needed to restart the heart.


Andy

Trainer to discuss what CPR is- as per slide.Reinforce that a casualty is unlikely to repond to CPR alone

CPR

Ratio30 Compressions - 2 Breaths

Depth1/3 the depth of chest

Rate 100 min

Same for Adults, Children & Infants© Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

REMEMBERHARD & FAST!

Andy

Trainer to discuss the ratio, depth and rate of CPR.Reinforce that interuption of compressions should be avoided

CPR

If during CPR… the casualty starts to breath normally

- put the casualty into the recovery position- monitor airway and breathing

the casualty vomits or regurgitates

- put the casualty on their side and clear the mouth- reassess breathing- continue CPR if needed


Andy

Trainer to discuss as per slide.Reinforce that the casualty is very unlikely to start showing signs of life during CPR

CPR

If you are unable or unwilling to give rescue breaths, do chest compressions only.

“Any attempt at resuscitation is better than no attempt”


Andy

Trainer to discuss as per slide.Reinforce that any attempt of resuscitation is better than no attempt


Hands Only CPR Video

Andy

Trainer to discuss as per slide.Reinforce that any attempt of resuscitation is better than no attempt

When to Stop CPR

Another first aider takes over Professional help arrives The casualty starts to breath normally The situation becomes too dangerous to continue You become too exhausted to continue A medical Doctor tells you to stop


Andy

Trainer to discuss times when CPR can stop - as per slide

CPR Practical


Andy

Trainer to demonstrate the emrgency action plan through to providing CPR.Trainer should use props to demonstate hand position for chest compressions.Student to demonstrate the emrgency action plan throught to providing CPR Trainer to assess students performing CPR and correct as required

Children & Babies

Children 1 – 8yrs Infants 0 – 1yrsRatio30 Compressions - 2 Breaths

Depth1/3 the depth of chest

Rate 100 min


Andy

Trainer to discuss CPR on children and babies.Trainer to demonstrate CPR on children and babies.

Early Access(call for help)

Early CPR Early Defibrillation

Early ALS

Chain of Survival


Andy

Trainer to discuss the chain of survival and rates of cardiac arrest survival.Reinforce why the chain of survival is critical to the sucessful resuscitation of a casualty.


Resuscitation Video

Andy

Trainer to discuss the chain of survival and rates of cardiac arrest survival.Reinforce why the chain of survival is critical to the sucessful resuscitation of a casualty.

Choking

Mild Airway Obstruction Treatment

Reassure the casualty

Encourage the casualty to lean forward

Encourage the casualty to keep coughing

Call 000/112 if object is not clearing


Andy

Trainer to discuss signs and symptoms of a partial airway obstruction. Trainer to discuss and demonstrate the treatment of partial airway obstructions.

Choking

Severe Airway Obstruction Treatment

Call 000/112 quickly, but attend to the casualty first if alone

Give up to 5 firm back blows between the shoulder blades

If unsuccessful – give up to 5 chest thrusts

If casualty becomes unconscious, start CPR© Copyright Paradise First Aid Pty Ltd 03/04/2012 V1.0

Andy

Trainer to discuss signs and symptoms of a complete airway obstruction.Trainer to discuss and demonstrate the treatment of a complete airway obstruction.

Choking – Children & Babies


Andy

Trainer to discuss and demonstrate treatment of choking for children and babies.

Defibrillation


Andy

Trainer to discuss the importance of defibrillation as part of the emergency action plan. Trainer to discuss what defibrillation does.Trainer to discusss public access defibrillation.Trainer to discuss and show an automated external defibrillator. Trainer to demonstrate the use of an AED with student participation. Trainer to answer questions regarding defibrillation.

Paradise First Aid Pty Ltd 27/05/2010 V1.0

The Heart

Located in the centre of the chest behind the sternum.

A muscle (myocardium) comprised of four hollow chambers which fill with blood and empty as the hearts contacts and relaxes.

Must have a continuous oxygen supply via the coronary arteries to function effectively

Has an electrical action and a mechanical action which work together in a normal healthy heart to circulate blood around the body.


The Electrical Action of the Heart

Most muscles in the body require an electrical stimulus from a nerve to make then work

The heart is a specialised form of muscle tissue that can generate its own electrical impulse without stimulation from a nerve

These impulses travel a well defined pathway through the heart muscle called the conduction pathway

The heart muscle responds to the electrical impulses with a mechanical action called a contraction


The Mechanical Action of the Heart

The heart muscle receives an impulse from the electrical system

The muscle contacts in a synchronised and coordinated motion causing the blood in the four chambers to be pumped around the body and to the lungs

After each contraction the heart muscle relaxes which allows the chambers to refill with blood ready for the next contraction

This contraction of the heart muscle can be felt as a pulse


Normal Heart Function

The electrical impulse is generated by the SA nodeIs conducted normally through the conduction pathwayCauses normal contraction of the heart muscleNormal circulation of blood throughout the body

Normal Sinus Rhythm (NSR)


Sudden Cardiac Arrest (SCA)

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. When this

happens, blood stops flowing to the brain and other vital organs.

Can happen to people that appear well and healthy, at any age.

The patient will be unresponsive and not breathing normally


Ventricular Fibrillation ‘VF’

Electrical activity within the heart is chaotic and not following the conduction pathway

The heart muscle has a useless quivering action and is unable to pump blood around the body

This is the most common cause of cardiac arrest and the one most likely to respond to treatment by a defibrillator

Often a result of a heart attack (Myocardial Infarction)


Ventricular Tachycardia ‘VT’

A very fast heart rate above 130 beats per minute

Can be so fast that the heart cannot refill with blood between contractions causing the heart muscle to be starved of oxygen

If this rhythm is not treated it will deteriorate into Ventricular Fibrillation (VF)


Shockable Rhythms

Ventricular Fibrillation

Ventricular Tachycardia

These rhythms can be treated by shocking the patient with a defibrillator


Pulseless ElectricalActivity ‘PEA’

Pulseless Electrical Activity is caused when the electrical activity is working correctly, but the mechanical activity is not.


Asystole

When all electrical and mechanical activity within the heart has ceased

Often described as “flat line”


Non Shockable Rhythms These rhythms cannot be treated by shocking

the patient with a defibrillator

Chance of survival from these rhythms is low

Pulseless Electrical Activity

Asystole


Causes of Cardiac Arrest

Heart AttackAirway ObstructionMassive Blood LossPoisoningElectrical ShockDrug OverdoseDrowningStroke


Treatment of Cardiac Arrest

DangerResponseSend for HelpAirwayBreathingCPRDefibrillation


Automated ExternalDefibrillators (AED)


Preparation of CasualtyFor Defibrillation

• Fully expose casualties chest. Remove clothing by ripping or cutting.Do not waste time “undressing” the casualty.

• Remove all metal objects from the casualties chest.

• If the casualties chest is wet or sweaty, dry with a towel.

• Remove any medication patches.

• Remove casualty from metal surfaces.

• If the casualty is excessively hairy, shave the chest using a disposable razor. (at the location of pad placement)

Ensure that CPR continues at all times when preparing the casualty.


Safety Precautions

• Ensure no person is in contact with the casualty while machine is analysing or when delivering the shock.

• Be aware of the explosive properties of oxygen and other substances.

• Do not place pads over medication patches or implanted pacemakers.

• Ensure that pads are firmly attached to the casualties chest.

• Only use batteries, pads and cables supplied for the model of AED.


Pad Placement > 25kg(8yrs +)

Right Pad • To the right of the sternum• Between the collarbone and right nipple

Left Pad • Outside the left nipple • Several inches below left armpit

If the pads are applied the wrong was around the AED will still work. Do not remove them once applied, as they may not re stick.


Pad Placement < 25kg(0 – 8 yrs)

Front Pad• Centre of the chest• Between the Childs nipples

Back Pad • Centre of the back• Between the shoulder blades

If the pads are applied the wrong was around the AED will still work. Do not remove them once applied, as they may not re stick.

If no child pads are available adult pads may be used as per the diagram on the pads. Ensure the pads are not touching each other. If the pads are two large use the front back position.


STAND CLEAR!


D R S A B C

CALL 000 / 112LOCATE DEFIBRILLATOR

ANALYSE

SHOCK ADVISED NO SHOCK ADVISED

DELIVER 1 SHOCKCPR FOR 2 MINUTES

IF NO NORMAL BREATHINGCPR FOR 2 MINUTES

SWITCH DEFIBRILLATOR ONATTACH PADS – FOLLOW VOICE PROMPTS


Maintenance

• Refer to manufacturers instructions

•The unit may be cleaned with a damp cloth. Do not submerge in water.

• Pads are single use only. Dispose of once used.

• Always keep a spare set of pads and spare battery with the AED

• Daily checks should be made to ensure the AED is operational. Including checking battery status indicator

Questions


Andy

Trainer to take time to answer any questions. Stop for break

Documents

CPR & Defibrillation National Units of Competency HLTCPR201B – Perform CPR 22101VIC Course in Automated External Defibrillation Paradise First Aid Pty