CPR + First Aid + AED Course

Quiz

1) Read material and/or watch video for each unit. 

2) Answer each question.

3) Save and submit to print your certificate.

 

CPR Basics

Assess

Assess the scene for safety. Assess the victim for age and responsiveness.

C-A-B Order

Rescuers should assume cardiac arrest has occurred when encountering adults who have collapsed or are found unconscious. Immediately call or have a bystander call 911 and begin CPR.
Use the C-A-B (Compressions-Airway-Breathing) Order

  • Begin 30 Compressions
  • Open Airway with head tilt–chin lift and check breathing, AT THE SAME TIME
  • Give 2 rescue Breaths

Compressions

Chest compressions keep oxygen flowing to the brain and are the single most important factor in life saving procedures. Compressions should be swift, hard and consistent. 30 compressions each time at a rate of 100-120 per minute. 

Airway

To clear the airway, use the Head Tilt/Chin Lift method. Place one hand on the forehead to tilt the victim's head back and AT THE SAME TIME place the other hand under the victim's chin. Lift the chin to open the airway and displace the tongue. Look into the victim's mouth for an obstruction. If you see an obstruction, remove it immediately. 

Breathing

  • Administer 2 rescue breaths (1 second each).

If the first breath does not make the chest rise:

  • Re-tilt the head and try the breath again

After administering 2 rescue breaths:

  • Resume compressions

Continue CPR Cycle until:

  • EMS arrives and takes over
  • AED becomes available
  • Victim is revived
  • You are too tired to continue
  • A second rescuer takes over

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Adult CPR Demonstration

If alone, call 911 and retrieve AED machine.

Hand position:

  • Two (2) hands - on the breastbone (sternum)

Compression depth:

  • Adult: At least 2 inches, but no more than 2.4 inches  

Begin CPR
30 compressions
Check and open airway
Give 2 rescue breaths (optional)
Repeat

Continue CPR Cycle until:

  • EMS arrives and takes over
  • AED becomes available
  • Victim is revived
  • You are too tired to continue
  • A second rescuer takes over

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Adult CPR Overview

For teenagers and adults.

Immediately have a bystander call 911 and begin CPR. If you are alone with an adult victim first call for help, then begin CPR.

CPR Cycle

  • 30 Compressions
  • Check and Open Airway
  • 2 Breaths (REPEAT)

Perform cycles of 30 compressions (at a rate of 100-120 per minute) and then administer 2 rescue breaths

C-A-B Order

Rescuers should assume cardiac arrest has occurred when encountering adults who have collapsed or are found unconscious. Immediately call or have a bystander call 911 and begin CPR.

Use the C-A-B (Compressions-Airway-Breathing) Order

  • Begin 30 Compressions
  • Open Airway with head tilt–chin lift and check breathing, AT THE SAME TIME
  • Give 2 rescue Breaths 

Compressions

For an unconscious adult immediately begin 30 chest compressions, at a rate of 100-120 compressions per minute.  Administer to the breastbone (sternum). Compressions should be swift, hard and consistent with a depth of at least 2, but no more than 2.4 inches of the chest.  Avoid leaning on the victim’s chest between compressions to allow for full chest recoil.

Compression depth:

  • Adult: At least 2 inches, but no more than 2.4 inches  

Hand position:

  • Two (2) hands - on the breastbone (sternum)

Airway

Open the victim’s airway, using the head tilt-chin lift method and AT THE SAME TIME check for breathing (5-10 seconds).  Look into the victim’s mouth for an obstruction.  If you see an obstruction, remove it immediately.

If the victim is breathing OR begins breathing after providing CPR:

  • Place the victim in the recovery position

If the victim is not breathing:

  • Administer - Rescue breaths

Breathing

Administer 2 rescue breaths (1 second each).

If the first breath does not make the chest rise:

  • Re-tilt the head and try the breath again 

After administering 2 rescue breaths:

  • Resume compressions 

Continue CPR Cycle until: 

  • AED becomes available
  • Victim shows signs of life
  • A second rescuer takes over
  • EMS arrives and takes over
  • You are too tired to continue

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Child CPR Demonstration

If alone, perform 5 cycles of CPR, then call 911 and retrieve AED machine

Hand position:

  • One (1) hand - on the breastbone (sternum)

Compression depth:

  • Child: At least 1/3 the depth of the chest. Approximately 2 inches.

Begin CPR
30 compressions
Check and open airway
Give 2 rescue breaths (optional)
Repeat

Continue CPR Cycle until:

  • EMS arrives and takes over
  • AED becomes available
  • Victim is revived
  • You are too tired to continue
  • A second rescuer takes over

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Child CPR Overview

For children between toddler aged and puberty.

Immediately have a bystander call 911 and begin CPR. If you are alone with a child victim first complete 5 cycles of CPR before calling for help.

CPR Cycle

  • 30 Compressions
  • Check and Open Airway
  • 2 Breaths (REPEAT)

Perform cycles of 30 compressions (at a rate of 100-120 per minute) and then administer 2 rescue breaths

C-A-B Order

Rescuers should assume cardiac arrest has occurred when encountering children who have collapsed or are found unconscious. Immediately call or have a bystander call 911 and begin CPR.

Use the C-A-B (Compressions-Airway-Breathing) Order

  • Begin 30 Compressions
  • Open Airway with head tilt–chin lift and check breathing, AT THE SAME TIME
  • Give 2 rescue Breaths 

Compressions

For an unconscious child immediately begin 30 chest compressions, at a rate of 100-120 compressions per minute. Compressions should be swift, hard and consistent. Avoid leaning on the victim’s chest between compressions to allow for full chest recoil.

Compression depth:

  • Child: At least 1/3 the depth of the chest. Approximately 2 inches.

Hand position:

  • One (1) hand - on the breastbone (sternum)

Airway

Open the victim’s airway, using the head tilt-chin lift method and AT THE SAME TIME check for breathing (5-10 seconds).  Look into the victim’s mouth for an obstruction.  If you see an obstruction, remove it immediately.

If the victim is breathing OR begins breathing after providing CPR:

  • Place the victim in the recovery position

If the victim is not breathing:

  • Administer - Rescue breaths

Breathing

Administer 2 rescue breaths (1 second each).

If the first breath does not make the chest rise:

  • Re-tilt the head and try the breath again 

After administering 2 rescue breaths:

  • Resume compressions 

Continue CPR Cycle until: 

  • AED becomes available
  • Victim shows signs of life
  • A second rescuer takes over
  • EMS arrives and takes over
  • You are too tired to continue

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Infant CPR Demonstration

If alone, perform 5 cycles of CPR, then call 911 and retrieve AED machine.

Hand position:

  • Two (1) fingers - on the breastbone (sternum)

Compression depth:

  • Infant: At least 1/3 the depth of the chest. Approximately 1.5 inches.

Begin CPR
30 compressions
Check and open airway
Give 2 rescue breaths (optional)
Repeat

Continue CPR Cycle until:

  • EMS arrives and takes over
  • AED becomes available
  • Victim is revived
  • You are too tired to continue

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Infant CPR Overview

Infants are from birth to toddler aged.

Immediately have a bystander call 911 and begin CPR. If you are alone with an infant victim first complete 5 cycles of CPR before calling for help.

CPR Cycle

  • 30 Compressions
  • Check and Open Airway
  • 2 Breaths (REPEAT)

Perform cycles of 30 compressions (at a rate of 100-120 per minute) and then administer 2 rescue breaths

C-A-B Order

Rescuers should assume cardiac arrest has occurred when encountering children who have collapsed or are found unconscious. Immediately call or have a bystander call 911 and begin CPR.

Use the C-A-B (Compressions-Airway-Breathing) Order

  • Begin 30 Compressions
  • Open Airway with head tilt–chin lift and check breathing, AT THE SAME TIME
  • Give 2 rescue Breaths 

Compressions

For an unconscious infant immediately begin 30 chest compressions, at a rate of 100-120 compressions per minute. Compressions should be swift, hard and consistent. 

Compression depth:

  • Infant: At least 1/3 the depth of the chest. Approximately 1.5 inches.

Hand position:

  • Two (1) fingers - on the breastbone (sternum)

Airway

Open the victim’s airway, using the head tilt-chin lift method and AT THE SAME TIME check for breathing (5-10 seconds).  Look into the victim’s mouth for an obstruction.  If you see an obstruction, remove it immediately.

If the victim is breathing OR begins breathing after providing CPR:

  • Place the victim in the recovery position

If the victim is not breathing:

  • Administer - Rescue breaths

Breathing

Administer 2 rescue breaths (1 second each).

If the first breath does not make the chest rise:

  • Re-tilt the head and try the breath again 

After administering 2 rescue breaths:

  • Resume compressions 

Continue CPR Cycle until: 

  • AED becomes available
  • Victim shows signs of life
  • A second rescuer takes over
  • EMS arrives and takes over
  • You are too tired to continue

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Hands Only CPR

HANDS ONLY: Bystanders who witness a sudden cardiac arrest and try CPR can skip the mouth-to-mouth breathing. The American Heart Association says doing chest compressions alone, or “Hands Only” CPR, until help arrives can be just as good as performing full mouth to mouth CPR.
 
WHO'S IT FOR? Everyone who is not breathing. Any adult who collapses, stops breathing and is unresponsive. Children, infants and drowning victims still need mouth-to-mouth breaths if at all possible. If not possible, still perform compressions. 
 
WHAT TO DO: 
  • Call or have a bystander call 911.  
  • Then press hard and fast, about 100-120 times per minute, on the middle of the victim's chest. 
  • Check the victims condition for breathing every 30 compressions.
  • Continue care until EMS arrives, an AED becomes available or you are too tired to continue.  
 
*Conventional CPR is recommended for children and infants, however due to the asphyxial nature of most pediatric cardiac arrests(If the child or infant is choking on an object), rescue breaths may not be possible.  In these instances, the hands only method is preferred to no CPR.
 

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Airway Obstruction

*If you KNOW the victim is choking

Adult or Child

Responsive adult or child: Heimlich Maneuver

  • Abdominal thrusts just above navel
  • Continue until object is removed or victim is unresponsive
  • Chest thrusts should be used for larger or pregnant victims

Unresponsive adult or child 

  • Begin CPR
  • Compressions (30)
  • Check Airway Head Tilt/Chin Lift
    • Remove object if dislodged
  • Breaths (2)
  • If breath does NOT go in due to blocked airway
    • Re-tilt head
    • Reattempt breath
    • If breath STILL does not go in, move on to compressions
  • Continue CPR Cycle
  • Remove object if dislodged
  • If victim regains consciousness, move onto their side to recovery position

Infant

Responsive infant: Infant Back Blows

  • Support infant’s head and lay face-down over your forearm
  • Support forearm with thigh
  • Give five back blows
  • Roll infant face up
  • Check for breathing/Check airway
  • Continue until object is removed or victim becomes unresponsive

Unresponsive infant 

  • Begin CPR
  • Compressions (30)
  • Check airway and open using head tilt/chin lift
  • Perform 5 back blows
    • Remove object if dislodged
  • Breaths (2)
  • If breath does NOT go in due to blocked airway
    • Check airway
    • Perform 5 back blows
    • Check for dislodged item
    • Check airway and re-tilt head
    • Reattempt breath
    • If breath STILL does not go in, move on to compressions
  • Continue infant obstructed airway CPR Cycle:
    • 30 Compressions - Check Airway - Perform 5 Back Blows - Check Airway - Give 2 Breaths - Repeat
  • Remove object if dislodged
  • If victim regains consciousness, encourage vocalization

Tongue and Airway Obstruction

Airway obstruction in an unresponsive victim lying on his or her back is usually the result of the tongue relaxing in the back of the mouth, restricting air movement.  Opening the airway with the head tilt-chin lift method may be all that is needed to correct this problem.

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First Aid Basics

Fear of being sued has caused reluctance for bystanders to become rescuers in emergency situations. However, initial rescuers are rarely sued and in most emergencies you are not legally required to provide first aid.

Good Samaritan Law – provides protection against lawsuits for persons who are acting in good faith, while providing reasonable first aid. These laws are not a substitute for competent first aid or for staying within the scope of rescuer training. Laws vary from state to state, and it is important to become aware of your state’s guidelines.

Although laws vary, Good Samaritan protection generally applies when the rescuer is:

  • Acting in an emergency situation
  • Acting in good faith, indicating that he or she has good intentions
  • Acting without compensation
  • Not guilty of malicious misconduct or gross negligence toward the victim (intentionally NOT following established medical guidelines)

Duty to Act – requires an individual to provide first aid when they have a legal duty. If a rescuer does not have a legal duty to provide care he or she is not required to provide first aid.

Duty to act may imply in the following situations:

  • When it is a requirement of employment. If you are designated as responsible for providing first aid to meet Occupational Safety and Health Administration (OSHA) requirements and you are called to emergency, you are required to provide first aid. (some examples of occupations that may require a duty to act include, but are not limited to: park rangers, athletic trainers, law enforcement officers, life guards, teachers)
  • When a pre-existing responsibility to a person exists. If you have a pre-existing relationship and are responsible for a person, for example a parent, you must give first aid if they need it (some examples of pre-existing relationships are parent/child, driver/passenger).

Consent

  • Permission from a responsive (alert) person allowing you to provide care.

Implied Consent

  • When a victim is unconscious, it is understood that if the person were responsive (alert), he or she would request and allow you to provide care.
First Aid Basics
 
First aid is the immediate care given to someone in an emergency situation, due to an illness or injury before EMS (Emergency Medical Services) arrives and takes over. Most of the time first aid is provided by a bystander (or by the victim) with minimal or no medical equipment. First aid is usually provided for minor illnesses and injuries. However, first aid may also be provided to someone who has a more serious illness or injury, such as a heart attack or severe bleeding.
 
Action at an Emergency
 
In an emergency situation, the bystander is a vital link between the victim and Emergency Medical Services (EMS). When entering the scene of an emergency situation, it is important to recognize the severity of the emergency before deciding how to respond.
 
Assess the Scene
 
Always remember to check the scene for safety hazards BEFORE providing care, it is important to ensure if you and the victim(s) are in a safe location, free of imminent danger or hazards.
 
Determine:
   • if it is safe to help
   • number of victims
   • if you will need additional assistance from EMS
   • what personal protective devices are readily available to you
 
Safety
    If the area is unsafe for the victim or rescuer, move the victim to a safe location, if can be done safely
    Do not put you or the victim’s safety at risk
    If you cannot safely provide care, do not become another victim, call EMS and wait for EMS to arrive
 
Activate EMS
•For serious situations, it is best to err on the side of caution and call 911
•Provide vital information to EMS dispatcher
    •Your name and number
    •Location of emergency
    •Information about the type of emergency
    •Number of victims
    •Victim(s) condition
    •What care is being provided at the scene
 
Assess the Victim
•Check the victim for responsiveness
•Tap on the shoulder and shout, “Are you okay?”
•Ask the victim if you he or she would like you to provide care
•If the victim is face down and unresponsive, turn the victim over
•Check the victim for breathing
    • If victim is NOT breathing – begin CPR
    • If victim is breathing – check the victim and provide care
•Check the victim for obvious signs of injury, such as bleeding, broken bones, burns, or bites
•Look for medical information jewelry to determine if the victim has a serious medical condition
•Place the victim in recovery position (on side) if:
    • the victim has difficulty breathing because of vomiting, or other secretions
    •you have to leave an unresponsive victim to get help
•If the victim shows signs of shock, have the victim lie flat on back
•If the victim does not show signs of trauma or injury, raise the feet about 6-12 inches
•Do not raise the feet if it causes the victim any pain
 
Provide Care
•Decide to provide care
•Determine what type of care is needed
•Begin care immediately – early care is critical for a victim’s survival
 
Victim Assessment
When providing care to a victim it is important to identify and correct any condition that may not be immediately life threatening, but may have the potential to become life threatening if it is not corrected.
 
SAMPLE
Gather information about victim using the SAMPLE history method. Ask victim about the following information
    •Signs and symptoms
    •Allergies
    •Medications
    •Past medical history
    •Last meal eaten
    •Events leading to the injury or illness
Medical information tags may identify allergies, medication, or medical condition
 
DOTS
Use the DOTS method to check the victim head to toe for the following conditions
    •Deformity
    •Open wounds
    •Tenderness
    •Swelling
 
Head to Toe exam
Head – look for blood, check eyes, check mouth for loose teeth or blood, check the nose and ears for fluid or blood, look for bruising of the eyes or behind the ears
Neck – look for bleeding, distention of the jugular vein, open wounds, or tracheal deviation
Chest –look for blood, broken ribs, open wounds, accessory muscle breathing
Abdomen –look for bleeding, abdominal wounds, tenderness, bruising
Legs –look for bleeding, bruising, open wounds, broken bones, deformities
Pelvis –look for bleeding and instability
Arms –look for bleeding, bruising, open wounds, broken bones, deformities
 
Ongoing Care until EMS arrives 
•Monitor the victim’s condition using ABC assessment:
    •Airway – use head tilt-chin lift method
    •Breathing – look, listen and feel for breathing
    •Circulation – check for severe bleeding
Treat for shock
    •Help victim lie on back
    •Keep covered and warm
    •Do not give anything to eat or drink
Remain with victim and record any changes in the victim’s condition
Report your findings and care to EMS when they arrive
If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR immediately.
    •Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute
 
*Agonal breathing is a sign of final stages of life. Agonal breathing is an abnormal pattern of breathing and brain stem reflex characterized by gasping, labored breathing, accompanied by strange vocalizations and/or gurgling. It is a sign that the body is not receiving the oxygen it needs. It occurs when a person is actively dying. If a victim is experiencing agonal breathing CPR must begin immediately.

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Medical Emergencies

Asthma
Look for wheezing, coughing, vomiting, shortness of breath and/or fainting
    •Administer inhaler, if available
    •Encourage victim to remain calm and relax
•If victim loses consciousness call 911 and begin CPR immediately 
    •Remain with victim until EMS arrives 
 
Choking
•Elicit response to question, “Are you choking?” 
•Observe signs of obstruction (speaking and breathing)
•Responsive Adult or Child - begin Heimlich Maneuver ( see Airway Obstruction)
•Unresponsive Adult, Child– begin CPR (see CPR)
ANY choking Infant-begin CPR/Airway Obstruction protocol.
     Check for debris/5 back blows/5 chest compressions
If victim loses consciousness call 911 and begin CPR immediately
 
Allergic Reaction
    •Administer Epinephrine Pen
    •Call 911
If victim loses consciousness call 911 (if not already called) and begin CPR immediately 
    •If victim does not respond to first dose, and EMS does not arrive within 5-10 minutes a repeat dose may be administered
 
***Anaphylaxis is the most severe form of allergic reaction. It has a rapid onset and may cause death
 
Heart Attack 
•If victim loses consciousness or is NOT breathing when found - begin CPR immediately
•Call 911
•If victim is breathing
    • Encourage victim to remain calm and in a comfortable position (recovery position if possible)
    • Offer 1 adult dose or 2 low dose aspirin, if certain the victim is experiencing a heart attack and has no known allergy
 

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Medical Emergencies 2

Fainting 
Instruct the victim to remain lying flat on the ground until he/she can sit up and feel normal
If the victim fell – check for injuries caused by the fall
Remain with victim until he/she feels normal and alert
    •Can stand and walk without assistance
    •Is aware of what happened and who he/she is
 
Diabetic Victim
It is important to recognize the signs of a diabetic episode to prevent the progression of symptoms.
Symptoms of a diabetic episode are:
    •A change in behavior
    •Confused, irrational or irritable
    •Sleepiness or lack of response
    •Hunger, thirst or overall weakness
    •Victim appears sweaty and/or pale
 
If the victim can sit up and swallow 
    •Give glucose tablet if available OR
    •Give a food or drink that contains sugar (chocolate does not contain enough sugar)
    •Fruit juice
    •Milk
    •Sugar
    •Honey
    •A regular soft drink
    •Diet foods and drinks do not have sugar
 
If the victim cannot sit up and swallow
    •Do NOT give food or drink
    •Have victim sit quietly or lie down until EMS arrives
 
Stroke
Use FAST assessment to determine if stroke is occurring    
  • F - Facial droop
  • A - Arm weakness
  • S - Speech difficulty
  • T - Time to call EMS
    •Encourage the victim to remain calm and quiet
    •DO NOT give anything to eat or drink
    •Monitor victim and be prepared to begin CPR
 
Seizure
    •Protect the victim from injury
    •Move furniture or other unsafe objects out of the way
    •Place a small pad or towel under the victim’s head, if possible
    •Do NOT place objects in the victim’s mouth
    •Encourage the victim to remain calm
    •Remain with the victim until EMS arrives and takes over
 
Shock
Shock is a life-threatening medical condition as a result of insufficient blood flow throughout the body. Shock often accompanies severe injury or illness. Medical shock is a medical emergency and can lead to other conditions such as lack of oxygen in the body's tissues (hypoxia), heart attack (cardiac arrest) or organ damage. It requires immediate treatment as symptoms can worsen rapidly.
*DO NOT move a shock victim with a suspected neck, back, spine or head injury.
    •Help the victim lie on his/her back
    •Cover the victim to keep him/her warm
    •Check the victim using ABC method:
        •Airway – use head tilt-chin lift method
        •Breathing – look, listen and feel for breathing
        •Circulation – check for severe bleeding
    •Record any changes in the victim’s condition
    •Report your findings and care to EMS when they arrive 

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Injury Emergencies

Massive blood loss, either external or internal, is a leading cause of shock and can be fatal in minutes. Always call 911 for obvious or suspected bleeding.
 
External Bleeding
    •Treat wound according to severity
    •Apply pressure or tourniquet
    •Immobilize partial amputations
    •Do NOT remove bandages
    •Take care that dressing does not become occlusive (sealing wound) in open chest wounds
    •Provide care for shock, if necessary
        •Victim lies on back
        •Cover and keep warm
        •Do not give anything to eat or drink
 
Internal Bleeding
Internal bleeding is difficult to identify. If the victim has suffered trauma to the head or torso assume they may have internal bleeding.
    •Have the victim lie down and remain still
    •If vomiting occurs, roll victim on his or her side
    •Check the victim using ABC method:
        •Airway – use head tilt-chin lift method
        •Breathing – look, listen and feel for breathing
        •Circulation – check for severe bleeding, rapid swelling or hard, distended torso
    •Provide care for shock, if necessary
        •Victim lies on back
        •Cover and keep warm
        •Do not give anything to eat or drink
    •Record any changes in victim
    •Report findings to EMS when they arrive
 
Nose Bleeds
    •Pinch victim’s nose
    •Tilt the victim’s head forward
    •Keep constant pressure on both sides of the nostrils until the bleeding stops
    •If bleeding continues, press harder
    •Apply a cold pack to the bridge of the nose
    •Call or direct a bystander to call EMS if:
        •The bleeding doesn’t stop in approximately 15 minutes
        •Bleeding is heavy (gushing)
        •The victim has trouble breathing
        •Do NOT have victim tilt head back
 
Bleeding from the Mouth
Determine if the injury is IN the mouth or if the blood is coming from the throat.
•If you can reach the area
    •Apply pressure with clean, sterile dressings
•Check the mouth for any missing teeth, or parts of teeth
    •Clean the wound with saline or clean water
    •If the victim has a loose tooth
        •Have the victim bite down on a piece of gauze to keep the tooth in place
        •Call a dentist
        •If the tooth is chipped, clean the area and call a dentist
   •If tooth is missing
       •Apply pressure with gauze to stop bleeding at the empty tooth socket
       •Place tooth in a cup of egg white, coconut water or milk
       •Take victim to dentist or emergency room
 
Eye Injury
    •Instruct victim to keep eyes closed
    •Use clean water to rinse the eye(s)
    •If the eye(s) have been punctured or penetrated by an object, stabilize and leave the object in place until EMS arrives and takes over
 
Embedded (Impaled) Objects
    •Expose the injured area
    •Stabilize the object
    •Do NOT remove the object
    •Control bleeding around the object
    •Seek medical attention or wait for EMS to arrive

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Injury Emergencies 2

Head, Neck or Spine Injury Victim
    •Minimize movement
    •Encourage victim to remain as still as possible
    •Do not apply a cervical collar or move the victim
    •Stabilize the head and neck with your hands, if possible
    •Advise victim to remain calm and still
    •Call 911- Evaluation by a healthcare provider should occur as soon as possible
Move ONLY to move the victim out of a life threatening location to a safe area.
 
Victim with a Broken Bone or Sprain
    •Advise the victim to remain still and avoid using or moving the injured body part
    •Apply a cold pack to the injured area
    •Do NOT try to straighten a bent or deformed body part
    •Do NOT try to move a broken bone that has come through the skin
    •Make a splint if you are unable to access EMS support immediately (example hiking in the woods)
        •Use something to support the arm or leg from moving (magazine, stick, rolled up towels)
        •Place the splint so that it goes beyond the injured area and supports the joints above and below the injury
        •Tie the splint to the injured body part for support
        •Use tape, gauze or cloth to secure it
        •Check to make sure the splint is not too tight
         (You should be able to put a few fingers between the splint and the injured body part)
    •If the injured part is bleeding, apply direct pressure to stop the bleeding and apply dressing to the wound BEFORE applying the splint
    •If there are no materials to make a splint, have the victim self-splint by using his/her arm to hold the injured arm in place
    •Do NOT try to straighten body parts when applying a splint
 
Burn Injuries
    •Victim is on fire:
        •Direct the victim to stop, drop and roll
        •Cover the person with a wet blanket to put the fire out
        •Remove the blanket after the fire is out
    •Victim is burned:
        •Determine the type and severity of burn
        •Stop the burning process
        •Open airway and check breathing
 
Always seek medical attention if:
    •Victim is younger than 5 and older than 55
    •Victim has difficulty breathing
    •Victim has other injuries or electrical injuries
    •Face, feet, hands and/or genitals are burned
    •Child abuse is suspected
    •Second degree burn larger than 20% BSA
    •Third degree burn
 
First Degree Burns (superficial)
    •Cool burn with cold water – no ice
    •Apply moisturizer, such as aloe-vera gel
    •Adult: administer ibuprofen for pain relief
    •Child: administer acetaminophen for pain relief
 
Second Degree Burns (partial thickness)
    •Cool burn with cold water – no ice
    •Apply antibiotic ointment
    •Cover burn with dry, nonstick, sterile dressing
    •Adult: administer ibuprofen for pain relief
    •Child: administer acetaminophen for pain relief
    •For larger Second Degree Burns – see caring for third degree burns
 
Third Degree Burns (full thickness with peeling and/or burnt flesh)
    •Seek medical attention immediately
    •If the person is on fire, put the fire out
    •Remove jewelry and clothing that is not stuck to the skin
    •Cover the person with a blanket
    •Open airway and check for breathing
    •Monitor breathing
    •Care for shock – see shock section
    •Call 911 and remain with the victim until EMS arrives
 
Chemical Burns
    •Flush skin
    •Remove contaminated clothing
    •Cover burn
    •Seek medical care
    •Monitor breathing
    •Care for shock – see shock section
    •Call 911 and remain with the victim until EMS arrives
 
Electrical Burns
    •Turn off the main power source, if possible
    •Cover burns
    •Check for spinal injuries
    •Assess the victim, once safe
    •Record any changes in the victim’s condition
    •Call 911 and remain with the victim until EMS arrives

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Environmental Emergencies

Animal Bites
Move away from the animal, if possible
    •Snake bites: Assume it is venomous if you are unsure. DO NOT cut the bite or attempt to suck the venom out by mouth. Call 911. DO NOT apply a tourniquet.
    •Bat bites: Do NOT kill the bat. Catch if possible, Rabies test cannot be completed on a dead bat.
 
Insect Bites and Stings
Observe the victim and ask about allergies. If the victim has allergies or loses consciousness, call 911 and begin CPR. Administer epi-pen if available.
    •Bee stings: scrape the stinger with a hard card type object.
 
All Bites and Stings
•Advise the victim to remain still and calm
    •Victim should avoid moving the part of the body that was bitten
    •Remove any clothing that covers the area
    •Flush the wound with running water
    •Clean it with soap and water
    •Stop any bleeding by applying pressure and dressings
    •If a bite breaks the skin, see a healthcare provider
    •Place an ice pack over any area that has bruising or swelling
    •For serious bites, call 911 and remain with victim until EMS arrives

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Weather Emergencies

Heat Cramps 

    •Advise the victim to lie down, rest and cool off
    •Stretch cramped muscle
    •Provide drink that contains electrolytes, such as juice or a sports drink
        •Give the victim water if the others are not available
    •A cool ice pack may be applied to the sore muscle for up to 20 minutes, if the victim can tolerate it.  
    •Call or direct a bystander to call EMS if victim’s condition does not improve
    •Monitor breathing
 
Heat Exhaustion
    •Stop activity and rest in a cool place
    •Remove excess or tight clothing
    •Provide drink that contains electrolytes, such as juice or a sports drink
    •Give water if other drinks are unavailable
    •Advise victim to lie down, raise legs 6 to 12 inches
    •Apply cool damp cloths to the neck, armpit and groin area, if possible
    •Spray with a cool water spray, if possible
    •Call or direct a bystander to call EMS if victim’s condition does not improve
    •Monitor breathing
 
Heatstroke
Heatstroke can rapidly become fatal if the victims core body temperature is not lowered.   
    •Begin cooling the victim immediately
    •Place in cool water up to neck, if possible
    •Cool with a cool water spray, if possible
    •Stop cooling the victim once behavior is normal again – continued cooling can lead to hypothermia
    •If the victim is able to drink 
        •Provide drink that contains electrolytes, such as juice or a sports drink
        •Give water if other drinks are unavailable
  Call 911 and remain with victim until EMS arrives and takes over
 
Frostbite
    •Move the victim to a warm place
    •Remove tight clothing and jewelry from the frostbitten area
    •Remove wet clothing 
    •Pat the body dry
    •Put dry clothes on the victim, if possible
    •Cover with a blanket
    •Do not try to thaw the frozen part if you think there may be a chance of refreezing
    •Try not to touch the frostbitten area
    •Do NOT rub the damaged area
    •Remain with victim until EMS arrives
 
Hypothermia (Low Body Temperature)
    •Move the victim out of the cold
    •Remove wet clothing
    •Pat the body dry
    •Put dry clothes on, if possible
    •Cover with a blanket and any other coverings you may have
    •Cover the head, but not the face
    •Place victim near a heat source and place containers of warm – not hot – water in contact with the skin
    •Remain with victim and record any changes
    •Report changes to EMS when they arrive

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Poison Emergencies

Many types of products can be poisonous to people.  When victims come into contact with poisonous products either by swallowing, breathing or contact with skin and eyes, serious sickness and even death can occur.  If you are unsure of a victim's exposure, call 911 immediately, before calling poison control
Caring for Poison Emergencies
The number for the American Association of Poison Control Centers (Poison Control) is 
    •1-800-222-1222
    •Follow all workplace guidelines about poisonous items in your workplace
***Naloxone, or Narcan, if available, may be administered if suspected, life-threatening opioid overdose has occurred.

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Rescuing and Moving

It is important to know when and how to rescue and move victims in an emergency situation. However, as a bystander becoming a rescuer in an emergency situation it is imperative that you DO NOT put your own safety at risk, in an attempt to help others, unless it is your duty to act. Instead activate EMS and remain on the scene, record important information to report when someone who is better trained arrives. 

Types of Rescue

Water Rescue
  • Reach-Throw-Go
    • Reach for the victim
    • Throw anything that floats
    • Go by swimming (must be trained)
  • Enter the water as a last resort
Ice Rescue
  • Extend a pole or throw a line, with floatable object to victim
  • Pull victim to shore
Electrical Emergency Rescue
  • Turn off power at circuit breaker, fuse box or outside switch, if possible
  • Unplug power cord, if possible
  • Stay clear of high-voltage power lines
  • Wait for trained personnel with proper equipment if scene is unsafe
Hazardous Materials Incidents
  • Look for signs on hazardous materials
  • Look for signs on vehicle
  • Look for spilled liquids or solids
  • Avoid strong, unusual odors
  • Stay away and upwind
  • Wait for trained personnel to arrive
Motor Vehicle Crashes
  • Park in a safe area and call or direct bystander to call EMS
  • Turn on emergency hazard lights
  • Assess the scene for safety
  • Apply PPE
  • Turn off ignitions of involved vehicles, if possible
  • Activate flares and/or reflectors, if available
  • If you suspect spinal injuries in victim, stabilize head and neck - see head, neck and spine injury section
  • Check and care for life threatening injuries first
  • Remain with victim(s) until EMS arrives and takes over
Fires
  • Call EMS or direct a bystander to call EMS
  • Assess the scene for safety
  • Quickly remove people from the site
  • Use a fire extinguisher for small fires
  • Check and care for life threatening injuries first
  • Remain with victim(s) until EMS arrives and takes over
Confined Space
  • Any area not intended for human occupancy may have dangerous atmosphere (low oxygen levels)
  • Rescue requires special training and equipment
  • Call or direct bystander to call EMS
  • Only enter the space if you are trained and have protective equipment
  • Check motionless victims first
  • Remove victim(s) and provide care

Moving Victims

Only move victims if:
  • There is immediate danger to the victim
  • It is necessary to provide care
  • It does not put you, the rescuer in danger
  • You can protect victim’s head, neck and back
Recovery Position
  • Keeps victim’s airway open
  • Allows any fluid to drain from the mouth 
  • Can prevent aspiration
  • How to place victim in position
    • Extend out victim’s closest arm above his/her head
    • Place victims leg farthest from you over the other leg
    • Support victim’s head and neck
    • Place victim’s other arm across his/her chest
    • Roll victim toward you
    • Use victim’s knee of the top leg to prop the body
    • Place victims hand under the chin

Emergency Rescue Moves

When moving the victim, drag with the victim’s body position at the longest axis
   
Clothing Drag
  • Apply PPE 
  • Stand behind victim’s head, looking toward victim’s feet
  • Grasp victim’s shirt, near shoulders
  • Lift up and walk backwards while dragging the victim to safety
Blanket Drag
  • Apply PPE
  • Stand behind victim’s head, looking toward victim’s feet
  • Place the victim on a blanket, sheet or large fabric
  • Grasp blanket above victim’s head
  • Lift up and walk backwards or crawl while dragging the victim to safety
Extremity Drag
  • Use victim’s legs or forearms
  • Stand holding firmly to arms or legs and pull victim to safety

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AED 

AED Basics

***AED’s are designed for use on adult victims, however most can be used with pediatric victims with proper pediatric pads.

Heart Attack vs Cardiac Arrest
A heart attack and cardiac arrest are often confused with each other. Although a heart attack can lead to cardiac arrest, they are different. A heart attack is usually slow or prolonged death or damage to the heart muscle, whereas cardiac arrest is a sudden electrical malfunction caused by an outside source. Cardiac arrest often results in death if not treated quickly. The only effective lifesaving treatment for cardiac arrest, outside of a hospital, is CPR or the use of an AED.
 
Signs and Symptoms of Heart Attack
   •Pain, fullness, and/or squeezing sensation in the chest
   •Jaw pain, toothache, headache
   •Shortness of breath
   •Nausea, vomiting and/or general upper abdominal discomfort
   •Heartburn and/or indigestion
   •Arm pain (commonly in the left arm, but may be both)
   •Overall fatigue
   •Sweating
   •Some victims (about ¼ of all heart attacks) are silent, without chest pain or symptoms

**Women, the elderly and people with diabetes are more likely to have atypical signs of a heart attack – ache in the chest, heartburn or indigestion, or an overall uncomfortable feeling in the back, jaw, neck or shoulder.

Signs and Symptoms of cardiac arrest
Cardiac arrest symptoms are sudden and immediate and include:
   •Collapse
   •No pulse
   •No breathing
   •Loss of consciousness
 
Treating a heart attack OR cardiac arrest
 
If victim is NOT breathing:
   •Call or direct a bystander to call EMS
   •Retrieve AED
   •Check breathing
   •Perform CPR (if the victim is NOT breathing or only gasping)
       •Victims in cardiac arrest often have agonal breathing (also known as agonal gasps)
       •Agonal breaths do not provide adequate oxygen to the body and can be described as gurgling, moaning, snorting, agonal or labored breathing
       •Healthcare providers must be able to distinguish between agonal breathing and adequate breathing
   •Continue CPR Cycles until EMS or second rescuer takes over, AED becomes available or you are too tired to continue.
 
If victim IS breathing:
   •Call or direct bystander to call EMS
   •Encourage victim to remain calm and in a comfortable position (recovery position if possible)
   •Offer 1 adult dose of aspirin
   •Stay with victim until EMS takes over
CPR must be started and continue until defibrillator (AED) becomes available.  
**If an AED is immediately available, following an adult's collapse, perform 2 minutes of the CPR cycle BEFORE attaching electrodes.
 
AED Use
 
About AEDs
   •Analyzes the victim’s heart rhythm
   •Determines and advises when shock is needed
   •Delivers electrical shock to victim in cardiac arrest
   •Reestablishes a heart rhythm which will generate a pulse
 
 
DO NOT DELIVER SHOCK IF ANY OF THE FOLLOWING CONDITIONS EXIST:
  • Someone is touching the victim.    
  • The victim is alert.   
  • The victim is wet or in water.
 

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AED Guidelines and Use

AED Pad Placement

When placing pads, be sure they do not touch each other
  Adult:
   •Place one pad on the upper right chest
   •Place the second pad on the left of ribcage (4-6 inches below the armpit)
   •If victim has a pacemaker, place the AED pad at least 1 inch to the side of the implanted device
  Child: 
   •Use adult or pediatric pads
   •Place one pad between right nipple and collarbone
   •Place the second pad on the left rib cage (3-4 inches below the armpit)
  Infant: 
   •Use infant pads only
   •One pad should be placed in the center of the CHEST and the second pad to the center of BACK
 
AED Shock Administration
After pads are placed, wait for AED to analyze the rhythm
If a shock IS indicated
   •Do NOT touch the victim
   •Ensure no one else is touching the victim
   •Press the shock button
After shock is delivered
   •Keep pads on the victim
   •Complete 2 minutes of CPR cycle
   •Reassess the victim’s condition
   •Follow AED voice prompts to repeat cycle
Continue following AED voice prompts, administering CPR cycle and AED shock until
   •The victim shows signs of life
   •A second rescuer or EMS takes over
   •You are too tired to continue     
 
If NO shock is indicated
   •Continue CPR cycle if the victim is unresponsive
   •Reassess the victim’s condition
   •Check heart rhythm with AED at end of each cycle and follow AED voice prompts
   •Continue CPR cycle/AED check until a second rescuer or EMS takes over or you are too tired to continue

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