EMERGENCY MEDICAL CARE

MA. CHARINA M. MACHICA, EMT, CST

 FIRST AID
An immediate, temporary and
continuing care given to a
person who has been injured or
suddenly taken ill.
 OBJECTIVES OF FIRST AID

• To alleviate suffering
• To prevent added / further
injury
or danger
• To prolong life
RULES IN GIVING EMERENCY CARE

Do’s
Call for HELP
o Identify yourself
o Obtain consent
o Be calm
o Loosen any tight clothing
o Respect victim's privacy
RULES IN GIVING EMERGENCY CARE

Don'ts
oGive fluids to unconscious victim/s.
oArise unconscious victim.
oLet the victim/s see their own injury.
oAssume that the obvious injuries the
only ones.
oLet the victim make their own
decision.
BONE, JOINT
AND MUSCLE
INJURIES
SOFT-TISSUE INJURIES
Closed injuries
- Soft-tissue damage beneath the skin.
Hematoma and contusion
o Accumulation of blood beneath
the skin
o Pooling of blood beneath the skin
FIRST AID MANAGEMENT
OF CLOSED INJURIES

R – Rest
I – Immobilize
C – Cold compress
E – Elevation
S – Splinting
 SPLINTING GUIDELINES

Splinting involves securing an injured

bone or joint to ep it fom moving,
which reduces the risk of further injury
and help reduce pain. however, you
should apply splint only if you must
move a person to get medical help or if
the EMS response will be delayed.
 IMMOBILIZATION TECHNIQUES

Soft splints
Rigid splints
Anatomical splints
Slings
 SPRAIN
Injury to the muscle or tendons
caused by over stretching
TREATMENT FOR SPRAIN
SOFT-TISSUE INJURIES
Open injuries
- Break in the surface of the skin
oAbrasion
oLaceration
oIncision
oPuncture
Open injuries
o Avulsion
o Amputation
o Crushing injuries
o Evisceration
 EXTERNAL BLEEDING

Hemorrhage = bleeding
oBody cannot tolerate greater than
20% blood loss.
oBlood loss of 1 ltr. can be
dangerous in adults; in children,
loss of 100-200 ml. is serious
Characteristics of Bleeding
•Arterial

- Blood is bright red and spurts.

•Venous

- blood is dard red and does not

spurt.
•Capillary

•- Blood oozes out and is controlled

easily
FIRST AID MANAGEMENT
FOR BLEEDING

D – Direct pressure
E – Elevation
P – Pressure points
T – Tourniquet
S – Splinting
 BURNS
- Soft-tissue receives more
energy than it can absorb. This
results from
Thermal , chemical , electrical or
solar and other forms of
radiation.
 CARE FOR FIRST DEGREE
& SECOND DEGREE BURNS:

• Cover the burn with a dry, non-

sticking, sterile dressing or a clean
cloth.
• Do not puncture burn blisters since
this may expose the wound to
infection.
CARE FOR THIRD DEGREE BURNS:

• Cover the burn with a dry, non-

sticking, sterile dressing or a clean
cloth.
• Treat the victim for shock by
elevating the legs and keeping
warm with clean sheet or blanket.
 CARE FOR THERMAL BURNS
Not all thermal burs are caused by flames,
contact with hot objects, flammable vapor
and cause explosion, and streams or hot
liquids are other common causes of burns.
Relieve pain by immersing the burned area
in cold water or by applying a wet, cold cloth.
If cold water in not available, use any cold
water you drink to reduce the burned skin's
temperature.
CARE FOR ELECTRICAL BURNS
The injury severity from exposure to
electrical current depends on the type of
current (direct or altering), the voltage, the
area of the body exposed, and the duration of
contact.
Unplug, disconnect or turn off the power.
Check airway, breathing nd circulation.
Treat the victim for shock
Seek medical attention immediately.
COLD RELATED EMERGENCIES
Hypothermia
- Happens when the core temperature of the
body falls below 35oc
First Aid Management
- Handle the victim gently to avoid further injury
to the skin.
- Do not allow the victim to eat or take coffee,
tea, cola or tobacco
- Give warm fluids for concious victim
- Bring patient to nearest hospital
HEAT RELATED EMERGENCIES
Heat Cramps
- Are painful tightening of the muscles that occur
after prolonged use, as in vigorous exercise.
First Aid Management
- Move the patient away from the potential
source of heat.
- Have them rest
- Drink plenty of water
- Stretch the tightened muscle
- Loosen tight clothing
HEAT RELATED EMERGENCIES
Heat Exhaustion
- The most common serious emergency
caused by heat
Causes
• Heat exposure
• Stress
•Fatigue
HEAT RELATED EMERGENCIES
Heat Exhaustion
- Signs and symptoms
•Excessive sweating
•Pale, moist, cool skin
•Dry tongue and thirst
•Dizziness or faintness
•Irritability
•Confusion
HEAT RELATED EMERGENCIES

Heat Stroke
- Happens when the body is exposed to more
heat than it can handle.
- Temperature may reach 41oc
HEAT RELATED EMERGENCIES
Heat Stroke
- Signs and symptoms
•Striking change in the victims behavior
•Loss of conciousness
•Flushed, hot and dry skin
•Pulse and breathing are rapid and weak
HEAT RELATED EMERGENCIES

What to do with Heat Stroke?

- Call for emergency medical assistance ASAP
- Move the victim to coolest possible place
- Remove as much of the victims clothing as
possible
- Place the victim in comfortable position
 PRE HOSPITAL STROKE SCALE
F-A-S-T
F- Facial asymmetry
A- Arm drop
S- Slurred speech
T- Time to transport the patient to the nearest
tertiary hospital
CARDIAC ARREST VS. HEART ATTACK

Cardiac Arrest is an “electrical” problem

(arrhythmia)
Heart attack is a “circulation” problem
(blocked airway)
 Basic Life Support
• An emergency procedure that consists of
recognizing respiratory or cardiac arrest
or both and the proper application of CPR
to maintain life until a victim recovers or
advanced life support is available
• Includes automated external defibrillation
• Series of noninvasive assessments &
interventions
 Adult Chain of Survival
Early recognition & activation of EMS

Early Access Early Defibrillation

Early CPR Early Advanced Care

Early bystander CPR Early advanced life support
TIME IS GOLD!!!
When to CPR?
• In the absence of breathing and pulse
in an unresponsive victim
• If the victim has agonal gasps
• If victim is in cardiac arrest
How to approach victim?

• *HAZARD
• *HELLO
• *HELP
• *AIRWAY
• *BREATHING
• *CIRCULATION, CPR
• *DEFIBRILLATION
The ABCD’s of CPR
A irway
Does the victim have an open airway?
B reathing
Is the victim breathing?
C irculation
Is the victim’s heart beating?
Is the victim bleeding severely?
C PR
Defibrillation
Position the Victim / Rescuer
• Supine and on a
firm surface
• Head & neck
should be in the
same plane
• Rescuer kneeling
at victim’s thorax to
perform both
rescue breathing &
chest compression
AIRWAY
• First thing to check in initial assessment

• You may need to open airway, maintain its

patency, or clear it when it is compromised

• Open the airway

– Head-tilt chin lift
– Jaw thrust WITHOUT head extension
 Check Airway for Patency

• Open mouth with

gloved hand
• Listen for sounds
indicating liquid in
airway
• Look inside for fluids,
solids, or objects
• Clear using finger
sweep or suction
Head Tilt-Chin Lift
• Simple, safe,
easily learned
and effective
• Choice unless
trauma to neck
is suspected
Head Tilt-Chin Lift

• Place your hand on

victim’s forehead
• Gently tilt head back
• With your fingertips
under point of victim’s
chin, lift chin to open
airway
Jaw Thrust
• For suspected
trauma to the neck
• Place one hand on
each side of victim’s
head
• Rest elbows on the
surface on which the
victim is lying
• Grasp angles of
victim’s lower jaw &
lift with both hands
 BREATHING

• Look for adequate

breathing in
adults
• Look for presence
or absence of
breathing in
children and
infants
LLF

• Check breathing
– Look, listen, & feel
• Evaluation should
take at least 5
seconds & NOT
last more than 10
seconds
Face Masks
• Resuscitation mask seals over
mouth/nose with port through which you
blow air to give ventilations
• One-way valve allows your air through
mouthpiece, patient’s exhaled air exits
through different opening.
• When using face mask, seal mask well to
face while maintaining an open airway
• Use bridge of nose as guide for correct
placement
FACE MASKS
 Position at Top of
Victim’s Head: Head-tilt-
chin-lift
Position at Top of Victim’s Head:
Jaw Thrust
Adult BLS Sequence
If with adequate breathing
• Put in Recovery Position
Adult BLS Sequence

If adequate breathing is NOT detected within

10 seconds OR patient has occasional
gasps
• Give 2 rescue breaths; each over 1 sec
– Enough volume to produce visible chest rise
– Avoid rapid / forceful breaths
 Mouth-to-Mouth Rescue Breathing
Note:
• Pinch nostrils
closed
• Make tight seal
around victim’s
mouth
• Open nostrils
after giving
rescue breath
Mouth-to-Mouth Rescue Breathing
• Open airway
• Create airtight mouth-to-
mouth seal
• Give 1 breath over 1
second
• Take REGULAR (not
deep) breath
• Give 2nd rescue breath
over 1 second
Mouth-to-Mouth Rescue Breathing

• Most common • If NO chest rise with

cause of first rescue breath:
ventilation Perform head-tilt chin
lift again then give
difficulty is an 2nd rescue breath
improperly
opened airway
RESPIRATORY ARREST
(- breathing + pulse)
ADULT (24 cycles 1 breath @ 5 secs.)

Breath: 1 1002 1003 1001 Breath

Breath: 1 1002 1003 100 2 Breath
Breath: 1 1002 1003 100 3 Breath
Breath: 1 1002 1003 100 4 Breath
Breath: 1 1002 1003 100 5 Breath
Up to
Breath: 1 1002 1003 1024 Breath
RESPIRATORY ARREST
(- breathing + pulse)
CHILD/INFANT (24 cycles 1 breath @ 5 secs.)

Breath: 1 1002 1003 1001 Breath

Breath: 1 1002 1003 100 2 Breath
Breath: 1 1002 1003 100 3 Breath
Breath: 1 1002 1003 100 4 Breath
Breath: 1 1002 1003 100 5 Breath
Up to
Breath: 1 1002 1003 1040 Breath
CIRCULATION
Adult BLS Sequence

• Pulse check
– Take at least 5
seconds & NOT
more that 10
seconds
The way of finding the position of the
heart massage

The two finger upper side from the xiphisternal tip

The way of crossing a hand and the
way of the oppression
Give 30 chest compressions at rate of 100 per minute
Then give 2 ventilations
Chest compressions

• Position your body

directly over your
hands
• Shoulders should be
above the hands
• Elbows should be
straight
• Look down on your
hands
Chest compressions

• Push hard & push

fast
• Depress sternum 1
½ to 2 inches (4-5
cm) at a rate of 100
compressions per
minute
Chest compressions

• Allow chest wall to

recoil completely
• Compression &
chest recoil /
relaxation times
should be
approximately equal
CARDIAC ARREST
(- breathing – pulse)
(5 cycles for 2 mins.)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20,
1 2 3 4 5 6 7 8 9 & 1 (2 breaths)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20,
1 2 3 4 5 6 7 8 9 & 2 (2 breaths)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20,
1 2 3 4 5 6 7 8 9 & 3 (2 breaths)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20,
1 2 3 4 5 6 7 8 9 & 4 (2 breaths)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20,
1 2 3 4 5 6 7 8 9 & 5 (2 breaths)
When do you STOP CPR?

• Spontaneous breathing is present

• The rescuer is exhausted
• Orders from the Doctor/DNR Order is
presented
• Paramedics or advanced team arrives
• Patient obviously dead
 Management of Severe Airway
Obstructions in Responsive Patients

• Abdominal thrusts can cause internal

injury, patient should be examined by a
healthcare provider
• When severe obstruction is not cleared,
patient will become unresponsive within
minutes
Severe Foreign Body
Airway Obstruction
(Responsive Adult or Child)
Stand behind victim.
One leg between
victim’s legs.
Head to one side.
Abdominal Thrust
• Stand behind victim & put
both hands around upper
part of abdomen
• Lean victim forwards
• Clench fist & place it thumb
side against victim’s
abdomen between the
umbilicus & xiphoid
 Abdominal Thrust

• Grasp this hand with the

other
• Pull sharply inwards &
upwards
• Repeat until object is
expelled or victim becomes
unresponsive
 Abdominal Thrust

• If you find a
CONSCIOUS
choking victim
lying on the
ground, do
abdominal thrusts
in the supine
position
Relief of FBAO

• Do CHEST THRUSTS
if:
– Abdominal thrusts are
NOT effective
– Rescuer is unable to
encircle obese victim’s
abdomen
– Victim is in late stages of
pregnancy
Management of Airway Obstructions in
Unresponsive Patients

• Make sure additional EMS personnel have been

called
• Provide CPR
• Begin by opening airway
• When opening patient’s mouth, look first for an
object in mouth
• If you see an object in mouth, remove it with
finger sweep
• Then give 2 breaths and check for a pulse
CPR for Airway Obstructions in
Unresponsive Patients

• Chest compressions given in CPR may expel

object
• While giving CPR, each time you open mouth,
check to see if object is visible, and remove it if
so
Foreign Body Airway Obstructions in
Infants/Children
• Most child deaths from FBAOs occur under age
5, mostly in infants
• Foreign bodies include:
– Toys and other small objects
– Pieces of popped balloons
– Food such as hot dogs, round candies, nuts,
and grapes
Foreign Body Airway Obstructions
in Infants/Children
• Suspect FBAO in an infant/child with onset of
respiratory distress associated with coughing,
gagging, stridor, or wheezing
• If responsive infant can cry/cough, watch
carefully to see if the object comes out
Responsive Choking Infant Who
Cannot Cry/Cough
• Ensure that additional EMS personnel have
been summoned
• Give alternating back slaps/chest thrusts to
expel object
• If Choking Infant Becomes Unresponsive
– Give CPR, start with chest compressions
– Check for object in mouth, remove any object you see
Unresponsive Infant when
Encountered
• Open airway; check for breathing
• If not breathing, give 2 breaths
• If first breath doesn’t go in, try again after
repositioning head to open airway
• If second breath doesn’t go in, assume an
airway obstruction—provide CPR
Severe Foreign Body
Airway Obstruction
(Responsive Infant)
Severe Foreign Body Airway
Obstruction in Responsive Infant
• Check for expelled object
• If not present, continue with next step
Give up to 5 back slaps between shoulder blades
Roll infant face up.
Check for expelled
object. If not
present, continue
with next step.
Give 5 chest thrusts. Check mouth
for expelled object.
Repeat back slaps and chest
thrusts as necessary.
Thank You!