SEMINAR CLASS PROGRAM

Learning Objectives CHAPTER I : INTRODUCTION

A. The background
In this unit you will learn B. The goal of writing
how to; 1. General
1. Recognize nursing 2. Specific
seminar in C. The writing method
English D. The scope
2. Know to make the E. The Systematic of writing
paper in English
3. Know to make the CHAPTER II : THE BASIC OF THEORY
NCP in English A. Basic Concept
1. Definition
2. Patophysiology (etiology, clinical
manifestation, process, and
Direction: complication)
1. This Seminar in 3. Medical treatment
group, each group B. Nursing Care
composed of 4 to 1. Assessment
5 students 2. Nursing diagnose
2. Topic seminar is 3. Intervention (Specific)
free case
3. The paper is made CHAPTER III : THE CASE REPORT
in four chapters A. The Assessment
4. A meeting 2 B. The Nursing Diagnose
groups for C. The Intervention
presentation D. The Implementation
5. One of audience E. The Evaluation
to be Observer to
give comment and CHAPTER IV : DISCUSSION
suggestion
CHAPTER V : CLOSING
A. Conclusion
B. Suggestions

BIBLIOGRAPHY
APPENDIX

1
NURSING CARE IN Mr. X WITH STROKE IN JAKARTA DR.
SUYOTO HOSPITAL AT ANGGREK 3RD FLOOR

WRITTEN BY:

1. Desy Aydilah
2. Gita prasetya Putri
3. Luthfia Hanum
4. Melur Mayang Miasti
5. Rizky Aulia Faradibah
6. Siti Indriyanti Octavia
7. TioPanna Dame Pangaribuan

PEMBANGUNAN NASIONAL VETERAN UNIVERSITY

HEALTH SCIENCES FACULTY S-1 NURSING PROGRAM
JAKARTA
2014

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 CHAPTER III: CASE REPORT
A. ASSESSMENT
The assessment was done on (month / date / y) at 27-01-2014
1. Identity
a. Client Identity.
Complete Name : Mr. N
First Name :N
Age : 88 years old
Address : Perum Kostrad Jl. Darma Putra 7/R. Keb.Lama
Phone : (021) 8828825
Religion : Moslem
Education : SMA
Occupation / Job title : gooverment employe
Nationality : Indonesia
Race : Mongoloid
Sex (M/F) : Male
Blood Group :O
Marital Status (S/M/D) : Married
Entrance Date : 27-01-2014
Reg. Number : 13-70-22

b. Nearest Contact Person

Name : Mr. T
Age : 46
Phone : (021)8828825
Address : Perum Kostrad Jl. Darma Putra 7/R. Keb.Lama
Job : gooverment employe
Relationship with Client : children

2. The Main Complaint : weakness, the right hand weak suddenly

3. Medical History
a. Medical Present History
- The history of complaint : if he sits , his body would be fall down to thefront
or back
- Predisposing factor : hipertense, smoking
- Duration : 3 moths ago
- Appear pattern : gradually / suddenly
- Bear-down efforts to overcome : massage with tradisional healer
b. Medical Past History :
- Allergy history (drugs, food, animal, environment) : none
- Accident history : none

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 Hospitalized history (when, reason, and how long) : 3 months ago hospitalized
because of stroke along a
week

- History of drugs taking : captopril

c. Medical Family History (Genogram and explanation):
Diseases had ever been gotten by family member that to be risk factor

d. Psychosocial and Spiritual History

- Is there any nearest person with patient : his children
- Interaction in family (communication pattern, decision making, and society activity): He
lack to communicate with his family, he handled decision after hear other family
members arguments, he rarely to make socialization
- Effect patients disease toward family : his family bocome worry
- Problem that influence the patient : patient becomes silent
- Coping stress mechanism : he sometimes ask about his wife and ask to
go home
- Health perception : have strong faith to get well soon
- Value belief system : partial, he belief that even he in weakness
he still able to live normaly again
e. Home environment state : urban
f. Daily habitual pattern before be sick
- Nutritional - metabolic pattern :three time a day
- Elimination pattern : once in three day
- Personal hygiene pattern :bath twice a week
- Rest sleep pattern : lack of rest, three hours a day
- Activity exercise pattern : he take care of his farms
- Life style pattern : lack of excercise, and often consumed fast
food, also smoking two packs aday
g. Habitual pattern during in hospital
- Nutritional metabolic pattern : have no apetite. Eat only a half portion
- Personal hygiene pattern : using diaper
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 - Sleep rest pattern : insomnia
- Activity exercise pattern : helped and limited
4. Physical Assessment
a. Eyes system : left eye have insensitivity with light
respond
b. Ears system :insensitivity of hearing
c. Respiratory system : normal
d. Cardiovascular system : increased of heart rate 100 tpm in while rest
Increased of blood pressure 130/80 mmHg
Decreased of vascularization
e. Hematology system : normal
f. Nervous system :
Nevous I Olfactorious : good, patient able to make adifferent of
odor
Nervous II Oculomotorius : there is no extra oculer movement
Nervous III Throclearis : left eye having an insensitivity of light
respond
Nervous IV Thrigeminus
- Optalmicus branch : blink reflex good
- Maxlaris branch : there is temporal muscle
contaction
- Mandibularis branch : there is masester muscle
contraction
Nervous VI Abdusen : insensitivity of light respond in left eye
Nervous VII Facial : patient able to lifted up his eyebrow,
smiling, and pursed lips
Nervous VIII Vestibula Choclearis : decreased of bility tohear in 30 cm distance
Nervous IX Glosopharingeal : good swllowing reflex
Nervous X Vagus : good Pallatum Mole
Nervous XI Accessorius : decreased of left shoulders against
Nervous XII Hypoglosal : there is a difficulty in speak a words

g. Musculoskeletal system

Examination the strengthen of muscle tone

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5
Value of the muscle Information
strengthen
5 (100%) Normal strengthen

4 (75%) Able to moving joints with active and againts captivity

3 (50%) Able to moving limbs to captivate weight (gravitation)

2 (25%) Able to moving limbs without gravitation (hands shifting)

1(10%) Looks or palpable muscle contraction but there is no movement at all

0 (0%) Paralize, there is no muscle contraction at all

h. Digestive system : altered of peristaltic manifestation by bowel

sounds negative
i. Endocrine system : altered of hormone secretion such as
adrenal hormone that caused of altered of
micturition pattern
Also there is decreased of libido
j. Urogenitalia system :urinary inkontinence
k. Integument system : decreased of perifer tissue humidity
l. Immune system : decreased of body immunity
5. Supportive Data (diagnostic tests) :
- Rotgen photo: with impression, lungs in the condition of hiperaerasy and
enlargement in anterior also posterior at lateral photo. Found a scattered patches of
consolidation. Result: suspect lungs tuberchulosis
- CT-Scan: multiple infarct periventricel lateralis bilateral, right ganglia basalis, left
capsula interna

6. Treatment (Therapy) :
- Brain act: 2x80mg
- Clopidogrel: 1x75mg
- Captopril: 3x2,5mg
- Zypras
- Ranitidin
- Ceftriaxone

7. Resume (Admit patient to the actions have been done):

6
 B. PROBLEM LIST
Name : .. Reg. No. :
Age : . Room :

Acquired Numb Focus Data Problem / NDX Resolved Sign

Date Date
1 Subjective data: Impaired
Family said that: physicaly
1. Weakness mobolity
2. Left hand suddenly weak
3. If he sits his body will fall
down to the front or back
4. Three moths ago have been
hospitalized because of stroke
in the right
5. Patient is smoker and have a
history of hipertense
Objective data:
1. Patient looks hemipharase
2. Pateint looks weak

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4444 2222

2 Subjective data: Impaired verbal

Family said that: communication
1. Patient have a difficulty in speak
a words
2. Others nurse helped by family to
translate what he means
3 3. Every words he said unclearly

Objective data:
1. Disartria
2. Unclearly words
3. Toothless
4. Difficulty in communicate

C. NURSING CARE PLAN

7
 Name : . Reg. No. :
Age : . Room :
Date Time Numb NDX Goal Intervention Sign
27 1 1 After doing nursing 1. Assess functional of
care along 3x24 physical ability
hours. Problem 2. Change patient
Of diagnose position while in bed
impaired physicaly every two hours
mobility resolved (supine, oblique)
With criteria results: 3. Ask to do an axcercise
1. Defend of active and pasive
optimal movement such as
position quadricep, squeezing
2. Increased arubber ball, spley toes
strethen and 4. Place pillow under the
physical axilla to do an
function abduction to the arms
3. Able to do 5. Lifted hands up and
an activity head
4. Muscle 6. Position the knee and
strength in hips in extension
normal term position
7. Help to develop sits
balance
- Lift up the bed
in part of the
head
- Help to sit
beside the bedd
- Increased time
to sit excersion
- Learn to
balance while
standing
8. Assess if there any
spray folding which
can increased pressure
to the patients body
9. Assess the humidity of
spray
10. Evaluate pupil reflex
with light
Colaborate:
1. Consultation to
fisioterapist

8
 2. Give relaxant muscle
medicine; antispasmodic
as the indicate

27 After doing nursing 1. Assess the type of

care 3x24 hours disfunction such as,
impaired verbal pateint looks understand
communication a word or have a
could be resolved speaking difficulty or
with criteriaof having his own
results: understanding
- Make a 2. Make a diffrent between
communication afasia and disartria
method where 3. Watch the fault of
patients communication of giving
necessary could a feed back
be expressed 4. Ask patient to follow a
simple command such as,
open eyes, smiling
5. Point to object and ask
patient to mention those
object
6. Ask patient to say a
simple words

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D. NURSING NOTES
Name : Reg. No :
Age : Room :
Date Time NDX. Implementation Pt. Response Sign
Numb
27 07am 1 1. Changing spray
Result: no folding
which can increased
decubitus risk
- Excerssice to sit
in the bed
2. Checking vital sign
Result:
-BP=130/80mmHg
-HR: 100tpm
-RR: 20tpm
-T: 36,5 C
10am Giving captopril
3. Letting to rest in supine
position
4. Having a lesson to the
family about changing
Mr.N position
5. Having an assesment
11am 6. Assassing the type of
12am communication verbal
disfuction
7. Making a diffrent
between afasia and
disartia
Result: disartia
8. Watching every mistake
in the communication
and giving a feed back
9. Asking Mr.N to follow
the simple command
such ass, opening eyes,
smiling
10. Pointing to object and
asking Mr.N to mention
those things
11. Making a consultation
with terapist about his
disartia
12. Checking vital sign:
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 Result:
01pm --BP=130/80mmHg
-HR: 100tpm
-RR: 20tpm
-T: 36,5 C

28 07am 1. Assessing if there any

spray folding which can
increased pressure to
the patients body
2. Assesing the humidity
of spray

3. Assesing vital sign

08am Results:
-BP: 150/100
-T: 36,5 C
-HR: 84 tpm
4. Giving a medicine:
captopril

5. Assessing functionaal
physical ability
6. Asking to do an
10am exercise of active and
passive movement such
as, quadricep,
squeezing
Helping to develop sits
balancing
- Lifted up the bed in
part of the head
- Helping to sit
beside the bed
- Increasing time to
sit excerssion
Result: - right hand able to
flexion and extension
- The left hand
cannot do flexion
and extension
- The right hand able
to squeeze
- The left hand only
felt vibration and

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 effort to do the
command
- Left leg little bit
able to flexion and
extension, though
weak
- Right leg able to
flexion and
extension

7. Checking vital sign

01pm Result:
-BP: 150/90
-RR:20 tpm
-T: 36,5 C
-HR: 72 tpm

8. Helping to changing
01.45 diaper
Result: spray doesnot
have any folding, neat,
and humid enough
29 02pm 1. Helping changing diaper
2. Helping changing spray
Result: neat, clean, no
folding which can
increased a decubitus
risk, humid enough
3. Assessing muscle
4pm strength

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5pm 4. Giving medicine

-through IV: cefotaxime
5. Asking Mr.N to saying a
simple word. Result:
Mr.N hard to saying a
word
6. Talking with Mr.N slowly
and quite, result; Mr.N
understand and
cooperative

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 7. Asking about his family,
result: Mr.N trying to
cooperative while
answering the question,
though communication
verbal still poorly to be
understood

7pm 8. Visit doctor with Dr.Adi

Result: -make a
consultation to the lungs
expert, asking abouth the
photo thorax
-keep the exercise of each
extremities
08pm 6. giving medicine
through IV; Brain act
2x1gr and ranitidin
8.45pm 7. Checking vital sign:
BP:150/90
RR: 20 tpm
HR:72tpm
T: 36,5C

30 07am 1 1. Changing spray. Result; not

humid, no folding, neat and
clean
2. Change Mr.N position into
semi fowler
Result: patient looks quite
and relax
08am 3. Putting pillow under axila
sinistra to prevent shoulder
adduction
4. Positioning knee to the
extention to make a
functional position

09am 5. Evaluating pupil reflex

with the light, results:
- Lighting reflex in the
right eye:
insensitivity of
lighting reflex
- Lightingreflex in lef

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 eye, result: miosis
10am 6. Making assessment
capability of cranial
nervesfunction:
- N I: good
- N II; decreased of
eyesight in left eye
- N III, IV, VI; left eye
no light respond
- N V: contraction of
temporal and
maseter muscle
- N VII; Mr.N able lift
up his eyebrow,
smiling, closing
eyes, pursed lips
- N VIII: Mr.N able to
hear in distance 10
cm, but in distance
30 cm decreased
- N IX: swallowing
reflex is good
- N X: palltum mole is
good
- N XI: decreased in
againts captivate at
the left shoulder
- N XII: dfficulty in
saying a word,
slowly in speaking

11am 7. Assessment capability

of tendon reflex
functional
Result:
-R.bicep: good
- l Bicep: decreased of
reflex
R.patella: good
L.Patella: decreased of
reflex

12am 8. Asking Mr.N to have an

exercise of active and
passive movement
Result;each left
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 extremities above and
under still having a
decreased in doing
flexion and extension,
mostly for the hand
9. Asking Mr.N to saying
a simple word
10. Disscussing about the
things he likes to
exercise Mr.N in
speaking
11. Checking vital sign:
01pm result BP:150/90
RR: 20 tpm
HR:72tpm
T: 36,5C
Giving medicine:
captopril

E. PROGRESS NOTES
Name : Reg. No. :
Age : Room :
Date Time NDX. Numb. Evaluation Sign
27 02pm
1 and 2 S: weakness,left hand weaks, if he sits he
will fall down to the front or to the
back, 3 moths ago have been
hospitalized because of stroke
O: patient looks hemipharese, weak, slow
respond and slow in speaking
A: problem have not resolved
P: Intervention continued
- Change Mr.N position every 2
hours
- Doing an active and passive
movement for exercise
- Assess functional of stregth
- Help to develop sits balancing

15
28 02pm S: the left hand still weaks and difficult to
1 make a movement
O:Mr.N having an effort to make a
movement in every command, though
the left hand still having a difficulty in
doing the command
A: problems have not resolved
P: intervention continued
- Assess muscle streght
- Change Mr.N position every 2
hours
- Doing an active and passive
movement for exercise
- Assess verbal communication

29 09pm 1 S; Mr.N said that he stil weak, left hand

weaks and hard to be moved
O: poorly balancing while sitting, bed rest
A: Problems have not resolved
P: Intervention continued:
- Change position every 2 hours
- Execise active and passive
movement
- Helps to develop sit balancing
- Assess lighting reflex and capable
of cranial function

2 S: family said that his word hard to be

understood and unclearly
O: Disartia, words poorly understood and
unclearly, speaking slowly
A; Problem have not resolved
P: Intervention continued
- Disscusion about things he likes
- Asking patient to saying simple
word

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30 02pm 1 S; Mr.N said that he stil weak, left hand
weaks and hard to be moved
O: poorly balancing while sitting, bed rest
A: Problems have not resolved
P: Intervention continued:
- Change position every 2 hours
- Execise active and passive
movement
- Helps to develop sit balancing

2 S: family said that his word hard to be

understood and unclearly
O: Disartia, words poorly understood and
unclearly, speaking slowly
A; Problem have not resolved
P: Intervention continued
- Disscusion about things he likes
- Asking patient to saying simple
word

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 NANDA taxonomy of nursing diagnoses

PATTERN I Exchanging (Mutual giving and receiving)

Altered nutrition: More than body requirements
Altered nutrition: Less than body requirements
Altered nutrition: Risk for more than body requirements
High risk for infection
High risk for altered body temperature
Hypothermia
Hyperthermia
Ineffective thermoregulation
Dysreflexia
Constipation
Perceived constipation
Colonic constipation
Diarrhea
Bowel incontinence
Altered urinary elimination
Stress incontinence
Reflex incontinence
Urge incontinence
Functional incontinence
Total incontinence
Urinary retention
Altered (specify type) tissue perfusion (renal, cerebral, cardiopulmonary, gastrointestinal,
peripheral)
Fluid volume excess
Fluid volume deficit
High risk for fluid volume deficit
Decreased cardiac output
Impaired gas exchange
Ineffective airway clearance
Ineffective breathing pattern
Inability to sustain spontaneous ventilation
Dysfunctional ventilatory weaning response
High risk for injury
High risk for suffocation
High risk for poisoning
High risk for trauma
High risk for aspiration

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 High risk for disuse syndrome
Altered protection
Impaired tissue integrity
Altered oral mucous membrane
Impaired skin integrity
High risk for impaired skin integrity

PATTERN II Communicating (Sending messages)

Impaired verbal communication
PATTERN III Relating (Establishing bonds)
Impaired social interaction
Social isolation
Altered role performance
Altered parenting
High risk for altered parenting
Sexual dysfunction
Altered family processes
Caregiver role strain
High risk for caregiver role strain
Parental role conflict
Altered sexuality patterns

PATTERN IV Valuing (Assigning relative worth)

Spiritual distress (distress of the human spirit)

PATTERN V Choosing (Selecting alternatives)

Ineffective individual coping
Impaired adjustment
Defensive coping
Ineffective denial
Ineffective family coping: Disabling
Ineffective family coping: Compromised
Family coping: Risk for growth
Ineffective management of therapeutic regimen (individual)
Noncompliance (specify)
Decisional conflict (specify)
Health-seeking behaviors (specify)

PATTERN VI Moving (Involving activity)

Impaired physical mobility
High risk for peripheral neurovascular dysfunction
Activity intolerance
Fatigue
High risk for activity intolerance
Sleep pattern disturbance
Diversional activity deficit
Impaired home maintenance management
Altered health maintenance
Feeding self-care deficit
Impaired swallowing
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 Ineffective breast-feeding
Interrupted breast-feeding
Effective breast-feeding
Ineffective infant feeding pattern
Bathing or hygiene self-care deficit
Dressing or grooming self-care deficit
Toileting self-care deficit
Altered growth and development
Relocation stress syndrome

PATTERN VII Perceiving (Receiving information)

Body image disturbance
Self-esteem disturbance
Chronic low self-esteem
Situational low self-esteem
Personal identity disturbance
Sensory or perceptual alterations (specify visual, auditory, kinesthetic, gustatory, tactile, olfactory)
Unilateral neglect
Hopelessness
Powerlessness

PATTERN VIII Knowing (Associating meaning with information)

Knowledge deficit (specify)
Altered thought processes

PATTERN IX Feeling (Being subjectively aware of information)

Pain
Chronic pain
Dysfunctional grieving
Anticipatory grieving
High risk for violence: Self-directed or directed at others
High risk for self-mutilation
Post-trauma response
Rape-trauma syndrome
Rape-trauma syndrome: Compound reaction
Rape-trauma syndrome: Silent reaction
Anxiety
Fear

EMERGENCY ACTION PRINCIPLES (E.A.P)

When responding to an emergency situation, remain calm and apply the four emergency action principles:
1. Survey the scene.
2. Do a primary survey of the victim.
3. Phone the emergency medical services (EMS) system for help.
4. Do a secondary survey of the victim.

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A. Survey the Scene
In survey the scene, consider the following as you do your survey:
1. Is the scene safe?
2. What happened
3. How many People are injured?
4. Are there bystanders who can help?
5. Identify Yourself as a Person Trained in First Aid

B. Do a Primary Survey of the Victim

The purpose of a primary survey is to check for life-threatening conditions and to give urgent first
aid care. Continue the primary survey by checking for an open airway, breathing, and circulation
(pulse and severe bleeding). This is known as checking the ABCs:

Airway:
Does the victim have an open airway? Immediately open an unconscious victims airway
using the head-tilt/chin-lift method

Breathing:
Is the person breathing? Look for the chest to rise and fall, listen for breathing, and feel for
air coming out of the victims nose and mouth.

Circulation:
1. Is the persons heart beating? To check to see if the victims heart is beating you will
Feel for a pulse at the side of the neck. This pulse is called the carotid pulse

2. Is the person bleeding severely? To check for bleeding, feel and look over the victims
body quickly for wet and blood-soaked clothing to determine if it is severe.

C. Phone the Emergency Medical Services (EMS) for Help

Be prepared to tell the dispatcher;
The location of the emergency (exact address, city or town, nearby intersections, landmarks, name
of building, floor, apartment or room number).
What happened.
The number of victims.
The victims conditions.
The help being given.

D. Do a Secondary Survey of the Victim

The purpose of a secondary survey is to check the victim carefully and in an orderly way for
injuries or other problems that are not an immediate threat to life but which could cause problems
if not corrected.

A secondary survey has three steps:

21
 1. Interview the victim and/or bystanders.
2. Check the victims vital signs.
3. Do a head-to-toe exam.

1. Interview the victim

Introduce yourself and get permission to give care, Say, Hi, my name is .
I know first aid and I can help you until an ambulance arrives; is that OK?

Ask the victims name.

Ask, What happened?
Ask, Do you have any pain or discomfort?
Ask, Do you have any allergies?
Ask, Are you taking any medications?

2. Check Vital Signs

a. Determine Radial or Carotid Pulse Rate. Tell victim you are going to take his or her pulse.
Count the number of beats in 30 seconds. Multiply by 2. This is the number of heartbeats per
minute.
Record pulse rate: ________________________

b. Determine Breathing Rate. Watch rise and fall of victims chest and abdomen.
Count number of breaths in 30 seconds. Multiply by 2. This is the number of breaths per
minute.
Record breathing rate: ____________________

c. Determine Skin Appearance.

Feel victims forehead with back of your hand.
Look at victims face and lips.
Record skin appearance:
Temperature ______________
Moisture _________________
Color ____________________

3. Do the Head-to-Toe Exam.

1. Start with the head. Look and feel for cuts, bruises, and other signs of injury.
2. Check and compare pupils of both eyes.
3. Check for fluid or blood in ears, nose, and mouth.
4. Gently feel the sides of the neck to check for pain and signs of injury. Look for cuts or bruises.
5. Check and compare both collarbones and both shoulders for signs of injury and pain.
6. Check the rib cage for pain or signs of injury by pressing firmly along sides of chest.
7. Check victims abdomen for tenderness by pressing lightly with flat part of your fingers. Check
for bruises if possible.
8. Check one arm at a time. Begin at the shoulder and move toward the fingers. Ask the victim to
wiggle his or her fingers, if not painful.
9. Press firmly on the hips. Look for signs of injury.
10. Check one leg at a time. Begin at the top of the leg and move toward the foot. Ask the victim to
wiggle toes or feet, if not painful.
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Record Your Findings _______________________________________

RESCUE BREATHING (RB)

You find a person lying on the ground, not moving. First survey the scene to see if it is safe, and to get
some idea of what has happened. Then do a primary survey by checking for unresponsiveness, an open
airway, breathing, and circulation.

23
 1. Check for unresponsiveness.
2. If no response, shout, Help!
3. Position the victim on his or her back.
4. Open the airway by using the head tilt and chin lift method
5. Check for breathlessness; Look, listen, and feel for breathing for 3 to 5 seconds
6. If the person is not breathing, give 2 full breaths.
7. Check the carotid pulse for 5 to 10 seconds
8. Have someone phone EMS for help.

Begin Rescue Breathing

Maintain open airway with head-tilt/chin-lift.

Pinch nose shut.
Open your mouth wide, take a deep breath, and
make a tight seal around outside of victims mouth
Give 1 breath every 5 seconds. Each breath should
last 1 to 1 seconds. Count aloud:
one one-thousand, two one-thousand, three
one-thousand, four one-thousand, take a breath
yourself, and then give a breath.
Look for the chest to rise and fall. Listen and feel
for escaping air and return of breathing. Continue
for 1 minute---about 12 breaths.

Recheck Carotid Pulse for 3 to 5 seconds.

Maintain head-tilt with one hand on victims forehead.

Say, Has pulse.

Recheck for breathing for 3 to 5 seconds.

Look, listen, and feel for breathing
Say, Has breathing.

Stop Rescue Breathing

CHOKING

You find a person lying on the ground, not moving. First survey the scene to see if it is safe, and to get
some idea of what has happened. Then do a primary survey by checking for unresponsiveness, an open
airway, breathing, and circulation.

24
 1. Check for unresponsiveness.
2. If no response, shout, Help!
3. Position the victim on his or her back.
4. Open the airway by using the head tilt and chin lift method
5. Check for breathlessness; Look, listen, and feel for breathing for 3 to 5 seconds
6. If the person is not breathing, give 2 full breaths.
7. If you are unable to breathe air into the victim, re-tilt the victims head and give 2 full breaths
again.
8. Have someone phone EMS for help.
9. Perform 6 to 10 abdominal thrusts.
10. Do finger sweep.
11. Give 2 full breaths.

Repeat the last three steps until the obstruction is cleared or help arrives.

CARDIOPULMONARY RESUSCITATION (CPR)

You find a person lying on the ground, not moving. First survey the scene to see if it is safe, and to get
some idea of what has happened. Then do a primary survey by checking for unresponsiveness, an open
airway, breathing, and circulation.

25
 1. Check for unresponsiveness.
2. If no response, shout, Help!
3. Position the victim on his or her back on a firm, flat surface.
4. Open the airway by using the head tilt and chin lift method
5. Check for breathlessness; Look, listen, and feel for breathing for 3 to 5 seconds
6. If the person is not breathing, give 2 full breaths.
7. Check the carotid pulse for 5 to 10 seconds
8. Have someone phone EMS for help.

* Victim has no breath and no pulse

Give 30 Compressions and 2 breaths

Give 30 compressions and 2 breaths at least 5 times in 2 minutes, compress breastbone 1 to 2

inches

Count aloud, One, two, three, four, five, six, seven,

Eight, nine, ten,. ., thirty.

Recheck Carotid Pulse for 3 to 5 seconds.

Maintain head-tilt with one hand on victims forehead.

Say, Has pulse.

Recheck for breathing for 3 to 5 seconds.

Look, listen, and feel for breathing
Say, Has breathing.

Stop CPR

Formula:
1. No pulse + No breaths = CPR
2. No pulse + Has breaths = Chest Compression (CC) / External Chest Compression (ECC)
3. Has pulse + No breaths = Rescue Breathing (RB) / Expired Air Resuscitation (EAR)
4. Has pulse + Has breaths = Monitor ABCs

BLS-1

RB

1. Why was the technique for opening the airway changed from the neck-lift to the chin-lift method?

2. Can a person be breathing and not have a pulse?

ANSWER
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 1. Lifting the chin instead of lifting from the back of the neck minimizes further injury to the
victim, especially if he or she is suffering from a neck or back injury.

2. No. When the heart stops beating, blood no longer circulates through the body, which deprives
the cells of oxygen. This causes the respiratory system to shut down and the person to stop
breathing.

CHOKING

1. Should I call EMS if the victim is conscious and the obstruction comes out easily and quickly?

2. What if the unconscious person is too large for me to straddle?

ANSWER

1. Yes. The object may cause tissues to swell and further complications might arise later.

2. The best position for correct delivery of abdominal thrusts is to straddle the victims
thighs. However, you can straddle one of the victims thighs instead of both, or you can
kneel close to one side, but the thrust will not be as effective.

CPR

1. Should I begin CPR if the victim has a very slow or very weak pulse?

2. Does the victims chest have to be bared to perform compressions? How much should be
uncovered?

3. Can or should you do CPR on someone who has a pacemaker?

4. How long should I continue CPR?

ANSWER

1. No. Performing chest compressions on a victim who has a pulse can result in serious
medical complications. If no breathing is present but there is a pulse, perform rescue
breathing and recheck the pulse frequently. If breathing and a pulse are present, maintain
an open airway and keep checking both the breathing and pulse frequently.

2. It is not necessary to bare the chest if the victims clothing does not interfere with finding
the proper location for chest compressions. If there are several layers of clothing, or if the
clothing interferes with the performance of CPR, part of the chest should be bared. If
possible, do not bare the entire chest, since a relatively small area is all that is needed for
hand placement to give chest compressions. Most importantly, do not waste time or delay
compressions.

3. If a persons heart has stopped beating (no carotid pulse), CPR is needed to maintain
blood circulation to the brain, heart, and other vital organs of the body. This is true
regardless of whether or not the person has a pacemaker. Because the pacemaker is placed
to the side of the heart and not directly below the breastbone, it will not get in the way of
chest compressions.
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 4. Continue CPR until one of the following things happens:

- The heart starts beating again

- A second rescuer rescuer trained in CPR takes over for you

- EMS personnel arrive and take over.

- You are too exhausted to continue

BLS-2

BLEEDING

1. Why arent we learning about using a tourniquet?

2. What is bleeding?

3. Mention the types of bleeding and explain!

4. What is external bleeding

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 5. Mention the types of open wounds!

6. What is the purpose of first aid for external bleeding?

7. How to control bleeding?

8. Mention the signs and symptoms of internal bleeding?

9. How to give first aid for internal bleeding?

ANSWER

1. Virtually all bleeding you might encounter can be controlled using direct pressure, elevation, and
pressure points. Even when limbs are amputated, they may not bleed heavily, since the force of
the injury causes blood vessels to collapse and close, limiting the bleeding. For many years
experts in first aid have cautioned that tourniquets should be used only as a last resort, when the
decision is made to sacrifice a limb in order to save a life. If you encounter a tourniquet put on by
someone else, do not release it. Only medical personnel should loosen tourniquets.

SHOCK

1. What is shock?

2. What are common causes of shock?

3. What are signs and symptoms of shock?

4. What is the first aid of shock?

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