kampala police 2010-11 first aider tot. purpose of this course in uganda, police are often the...
TRANSCRIPT
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Kampala Police Kampala Police 2010-112010-11
FIRST AIDERFIRST AIDER
ToTToT
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Purpose of this course
• In Uganda, Police are often the frontline for trauma care
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Police can make a difference
• Without an ambulance or specialized medical equipment you can save lives
• Goal is to empower cadets with knowledge to save lives
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• Stress that you do not need to be a doctor, have an ambulance or other equipment to save lives!
Police can make a difference
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Course Objectives
• Increase your medical knowledge
• Learn the highest-yield first aid techniques that save lives
• Demonstrate proficiency in performing and teaching these skills
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Course Outline
• Safety
• Anatomy
• DR. ABCs & High-yield first aid
• Common medical and injury scenarios
• Skills station
• Post test
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ROLES AND ROLES AND RESPONSIBILITY OF RESPONSIBILITY OF
THE THE FIRST AIDERFIRST AIDER
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Qualities of the First Responder:
• Observant.• Resourceful.
– Use materials available at the time, improvise and implement necessary ones.
• Dexterous (skillfully and cleverly done).• Humanitarian.
– Able to work beyond social, tribal and religious boundaries.
• Perseverance.– Able to work without giving up until qualified help arrives.
• Sympathetic.• Explicit.
– Be clear with your instructions to the casualty and or bystanders.
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Responsibilities of the First Responder:
• Safety
• Scene management
• Patient Assessment
• Patient Care
• Patient Transport
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AnatomyAnatomy
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Respiratory SystemRespiratory System
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Inhalation Air Flows Into LungsInhalation Air Flows Into Lungs
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ExhalationExhalation Air Flows Out of LungsAir Flows Out of Lungs
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http://www.jeffersonhospital.org/diseases-conditions/peripheral-vascular-disease.aspx?disease=063600f1-9f7a-4773-9401-d8229ee8d834
•Away from the Heart•High Pressure
•Back to the Heart•Low Pressure
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Arterial
Capillary
Venous
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Carotid Pulse (find yours)Carotid Pulse (find yours)
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Femoral Pulse (find yours)Femoral Pulse (find yours)
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Radial Pulse (find yours)Radial Pulse (find yours)
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Nervous SystemNervous System
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Spinal ColumnSpinal Column
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Scene Management and Scene Management and SafetySafety
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Personal Safety is #1Personal Safety is #1
•Universal precautions
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Infectious DiseasesInfectious DiseasesWhat diseases can you contract from exposure to blood and body fluids?
•HIV•Hepatitis B and C•Others?
What are the chances of contracting HIV from a needlestick from an HIV infected victim?
What should you do if you are exposed to bodily fluids?
•You cannot get cancer from blood/fluid contact with a victim
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Scene Safety: Assess the sceneScene Safety: Assess the scene
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Scene Safety: Secure the sceneScene Safety: Secure the scene•Turn off ignition & secure brake•Use patrol car to protect the scene
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Scene Safety: Secure the sceneScene Safety: Secure the scene•Protect the bystanders
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Scene Safety: Assess Scene Safety: Assess CasualtiesCasualties
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Scene Management: Get helpScene Management: Get help
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High-Yield First AidHigh-Yield First Aid
Casualty Casualty Management & Management &
Initial AssessmentInitial Assessment
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AAirwayirway
BBreathingreathing
CCirculationirculation
Don’t Panic, use ABCsDon’t Panic, use ABCsDDangeranger
RResponseesponse..
•Personal and scene safety
•“Are you alright?”
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How does a road traffic How does a road traffic accident or any other accident or any other trauma kill a person?trauma kill a person?
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AAirway Assessmentirway Assessment
AAirwayirway
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• Without an open airway, a patient can die within seconds
ABCs for All Victims
AAirwayirway
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Open the Airway-Clear nose and mouth-Lift Chin
ABCs for All Victims
Check if patient is conscious: “Are you ok?”
Victim Does NOT Respond Victim Responds
AAirwayirway
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AAirwayirway
Without chin lift, jaw thrust With chin lift, jaw thrust
Adrian et al, Anesthesiology June 1999 - Volume 90 - Issue 6 - pp 1617-1623
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BBreathing Assessmentreathing Assessment
BBreathingreathing
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ABCs for All Victims
Look
Listen
Feel
If patient not breathing, keep airway open & transport ASAP!
BBreathingreathing
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Adequate Breathing:Adequate Breathing: Normal RatesNormal Rates
Adults Children Infant
12-20/min.15-30/min.25-50/min.
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CCirculation Assessmentirculation Assessment
CC
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ABCs for All Victims
•If bleeding:•Apply pressure•Elevate wound•Wrap with bandage
CCirculationirculation
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Arterial
Capillary
Venous
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Methods for bleeding control
CCirculationirculation
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Pressure, Pressure & more Pressure!!!
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Severe Bleeding• A bleeding patient can lose all of their
blood in ONE MINUTE and die
• DIRECT PRESSURE is best
• DO NOT USE TOURNIQUETS
•Unless amputation AND unable to control bleeding with pressure alone•A tourniquet WILL cause irreversible damage and possibly kill the limb
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Artery Compression Technique
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Artery Compression Technique
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Carotid PulseCarotid Pulse
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Femoral PulseFemoral Pulse
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Radial PulseRadial Pulse
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Infants: Check brachial pulse.Infants: Check brachial pulse.
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AAirwayirway
BBreathingreathing
CCirculationirculation
Don’t Panic, recall ABCsDon’t Panic, recall ABCs
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BASIC LIFE BASIC LIFE SUPPORT,SUPPORT,
CPR & Rescue CPR & Rescue BreathingBreathing
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What have you been What have you been taught and what do taught and what do
you teach about CPR you teach about CPR and rescue and rescue breathing?breathing?
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Old Teaching:
• If patient not breathing, classic teaching has been to give rescue breaths
Trauma 1st Responder Teaching
• If not breathing make sure airway open, no breaths, and transport ASAP
BBreathingreathing
Swenson et al. NEJM, July 2010
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CCirculationirculation Current Teaching:
• If victim does not have a pulse, start chest compressions at 100 per minute
Trauma 1st Responder Teaching
• If no pulse transport ASAP (after ABCs)
• DO NOT DELAY TRANSPORT FOR CPR
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CCirculationirculationTrauma 1st Responder Teaching
• If no pulse and not breathing transport ASAP (after ABCs)
• CPR and rescue breathing will not hurt as long as it does not delay transport!
• 30 chest compressions : 2 breaths
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Lifting and Moving Lifting and Moving
VictimsVictims
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• Secure victim in car
• Drive at a reasonable speed – Will not likely make a difference in
transport time
• If unconscious use the recovery position
Transport Key Points
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Recovery Position: if unconscious
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Emergency Move Emergency Move Blanket DragBlanket Drag
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Emergency Move – Clothes DragEmergency Move – Clothes Drag
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EmergencyEmergency Move - Back Pack Move - Back Pack CarryCarry
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Emergency Move – Direct CarryEmergency Move – Direct Carry
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Body RollBody Roll
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Take positions to log roll patient.Take positions to log roll patient.Leader at head directs.Leader at head directs.
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• Secure victim in car
• Drive at a reasonable speed – Will not likely make a difference in
transport time
• If unconscious use the recovery position
Transport Key Points
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Special Injury Special Injury ConsiderationsConsiderations
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Soft-Tissue InjuriesSoft-Tissue Injuries
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Impaled ObjectImpaled Object
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Impaled ObjectImpaled Object
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Internal BleedingInternal Bleeding
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Abdominal EviscerationAbdominal Evisceration
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BurnsBurns
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BurnsBurns
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BurnsBurns
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Burn CareBurn Care
• Stop the burning process with waterStop the burning process with water• Remove smoldering clothing & Remove smoldering clothing &
jewelryjewelry• ABCsABCs• Cover burn with dry, sterile dressingCover burn with dry, sterile dressing• NO ointments/creamsNO ointments/creams• Don’t break blistersDon’t break blisters• Seek medical attention Seek medical attention
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MusculoskeletalMusculoskeletalInjuriesInjuries
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Types of Musculoskeletal InjuriesTypes of Musculoskeletal Injuries
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Fractures
• Move the limb as little as possible
• Use cardboard, cotton, and tape or cloth ties keep limb clean, still, and stable
ABC Initial Assessment
Patient talking &
Bleeding Controlled
Patient unable to talk or
Bleeding Uncontrolled
Take to hospital immediately!!!
SAFETY
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Fractures
• Splint ONLY AFTER ABCs
• Do NOT delay transport for splinting in a patient who is unconscious or has uncontrolled bleeding
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Improvised SplintsImprovised Splints
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Making cardboard splintMaking cardboard splint
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Splint for Injured ForearmSplint for Injured Forearm
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Injuries to theInjuries to theHead and SpineHead and Spine
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Nervous SystemNervous System
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Spinal ColumnSpinal Column
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Mechanisms of Spinal InjuryMechanisms of Spinal Injury
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• If possible, get others to help, and maintain control of the neck, do not need special collar
• Transport victim onto carrier by log-rolling
Transport: Possible spine injury
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Secure patient and transport.Secure patient and transport.
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Skull Fractures and Concussions
• What do you teach about managing these conditions?
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CommonCommonMedical Medical
EmergenciesEmergencies
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Heart AttackHeart Attack
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CHOKINGCHOKING
• ABCs !!! (check mouth if unconscious)
• If ABLE to speak or cough, then not complete obstruction– Encourage coughing– Heimlich if failed
• If UNABLE to speak/cough attempt then Heimlich
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CHOKING: Heimlich ManeuverCHOKING: Heimlich Maneuver Position yourself behind patient.Position yourself behind patient.
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Place thumb-side of fist in middle of abdomen,Place thumb-side of fist in middle of abdomen,between navel and rib cage.between navel and rib cage.
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Heimlich ManeuverHeimlich Maneuver
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Infant choking - consciousInfant choking - conscious
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Deliver 5 chest thrusts.Deliver 5 chest thrusts.
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Infant choking - Unconscious Infant choking - Unconscious
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Perform tongue-jaw lift & remove Perform tongue-jaw lift & remove visible objects.visible objects.
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DrowningDrowning
What do you teach What do you teach about managing a about managing a drowning victim?drowning victim?
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DiabetesDiabetes
High Blood Sugar Need insulin If too much medication can have low blood sugarIf too little medication, high blood sugarCan cause fits, loss of consciousness or confusion
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STROKESTROKE
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Altered mental status Slurred speech or difficulty speaking Facial droop Unequal pupil Unable to move half of body Difficulty swallowing
Stroke: Signs & SymptomsStroke: Signs & Symptoms
(Continued)(Continued)
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Fits (Seizures)Not Contagious!
Put patient in recovery
position ASAP
ABCs
Transport ASAP
SAFETY Make sure victim is clear of obstacles that could cause injury
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Shock & FaintingShock & Fainting
What do you teach What do you teach about fainting?about fainting?
What about shock?What about shock?
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Gabon ViperGabon Viper Puff AdderPuff Adder
Snake BitesSnake BitesCoin coverage and blackstones are ineffectiveOne review in Gulu, 108 snake bite patients, none received antivenom, all survivedDo not cut and suckImmobilization, cleaning of limb and immediate transport are key (Below the heart, light compression wrap)
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Common Causes of Allergic ReactionsCommon Causes of Allergic Reactions
Insect StingsInsect Stings
FoodsFoods
MedicationsMedications
PlantsPlants
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Four Routes of PoisoningFour Routes of Poisoning
INHALATION INJECTION
INGESTION
ABSORPTIONAcid – Intentional Burns
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Acid BurnsAcid Burns
• ABCs !!!
• Rinse well with water – Even if no pain
• Acids and bases can cause damage without causing pain
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Obstetrics andObstetrics andGynecologyGynecology
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AnatomyAnatomy
PerineumPerineum
VaginaVagina
CervixCervix
Pubic BonePubic Bone
UterusUterus
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AnatomyAnatomy
Amniotic SacAmniotic Sac
Umbilical CordUmbilical Cord
PlacentaPlacenta
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Multiple-CasualtyMultiple-CasualtyIncidentsIncidents
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Tasks for Mass Casualty Tasks for Mass Casualty
Extrication
Triage
Staging
Treatment
Transportation
Supply
Command
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Mass Casualty: STEP 1Mass Casualty: STEP 1
Triage officer announces that Triage officer announces that all all patients that can walk should get up patients that can walk should get up
and walk to a designated area for and walk to a designated area for eventual secondary triage.eventual secondary triage.
Color codingColor coding
© Lou Romig MD, 2006. Used with permission.
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Mass Casualty: STEP 2Mass Casualty: STEP 2
• If no breathing and no pulse, leave If no breathing and no pulse, leave alonealone
• If no breathing but has pulse, evaluate If no breathing but has pulse, evaluate ABCs and consider for immediate ABCs and consider for immediate transportationtransportation
• If breathing and has pulse, also If breathing and has pulse, also evaluate ABC and prepare for transportevaluate ABC and prepare for transport
© Lou Romig MD, 2006. Used with permission.
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DeathDeath
• Do not decide if a patient is dead at the Do not decide if a patient is dead at the scene!scene!
• This must be done at a health facility!This must be done at a health facility!
• Live patients have been transported to Live patients have been transported to the morguethe morgue
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QUICK REVIEWQUICK REVIEW
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Police can make a difference
• Without an ambulance or specialized medical equipment you can save lives
• Goal is to empower cadets with knowledge to save lives
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• You do not need to be a doctor, have an ambulance or other equipment to save lives!
Police can make a difference
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Personal Safety is #1Personal Safety is #1
•Universal precautions
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AAirwayirway
BBreathingreathing
CCirculationirculation
Don’t Panic, recall ABCsDon’t Panic, recall ABCs
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AAirwayirway Chin lift & jaw thrust
Adrian et al, Anesthesiology June 1999 - Volume 90 - Issue 6 - pp 1617-1623
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ABCs for All Victims
Look
Listen
Feel
If patient not breathing, transport ASAP!
BBreathingreathing
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CCirculationirculation
Pressure, Pressure & more Pressure!!!
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CPRCPR• If no pulse and not breathing trauma victim
transport ASAP (after ABCs)
• CPR and rescue breathing will not hurt as long as it does not delay transport!
• 30 chest compressions : 2 breaths
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• Secure victim in car
• Drive at a reasonable speed – Will not likely make a difference in
transport time
• If unconscious use the recovery position
Transport Key Points