PowerPoint Handouts in Grayscale

11/7/2009
Defibrillation Defibrillation Menu

1. Initial assessment 7. First Aid containers and contents Responsibilities Factors involved in an emergency 13. Defibrillation procedure 2. introductions 8. 9. 14. AED functions 3. Introduction to defibrillation 15. Defibrillation algorhithm
4.
Defibrillation in the workplace
10. Primary survey
16. Paediatric defibrillation
5.
The odds of survival
11. Heart attack and angina
17. Safety measures
Defibrillation Course
1
6 . The chain of survival
12. CPR - Recap
18. Final assessment
Welcome
Nuco Training Ltd November 2009
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Initial Assessment
Initial Assessment
CPR TEST
n/a
You will be assessed on your CPR skills It is imperative that you have the Basic Life Support skills in order to continue with this course. Your instructor will assess you individually - in private

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Designated waiting area Assessed on a 1:1 basis Designated waiting area after the assessment
Defibrillation
Introductions
n/a
Congratulations on passing the initial assessment!
Defibrillation
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Introduction to Defibrillation
CHD caused almost 33,000 premature deaths in the UK in 2005
%
Page 3
Deaths by cause for men in the UK (2005)

25 20 15 10 5 0
Coronary Heart Disease

25 20 15 10 5 0
Deaths by cause for women in the UK (2005)
Defibrillation
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More than 133,000 people die each year of Coronary Heart Disease
Contributory factors include:
Sudden Cardiac Arrest is unpredictable and can happen to anyone children included
Normal heart rhythm with an ECG reading
Smoking Overweight Poor Diet Lack of exercise Age

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Abnormal heart rhythm with an ECG reading Ventricular Fibrillation
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Death will occur in minutes if immediate treatment is not given Defibrillation is imperative!!
Defibrillation in the Workplace

Defibrillation in the workplace

First Aid in the workplace is governed by legislation There is no such legislation for defibrillators Guidelines are provided by the Resuscitation Council UK Developments over recent years have made the use of a defibrillator for the Layperson possible The Automated External Defibrillator (AED) is continually being developed More and more AEDs are being distributed to public places through a Government initiative AEDs will become a more common piece of equipment in many workplaces AEDs are safe to use given some basic training, including Basic Life Support training (CPR)
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Defibrillation
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The Odds of Survival
The Odds of Survival

For each minute that defibrillation is delayed the chances of your casualty recovering is reduced by 10%
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1
% S u c c e s s
100 90 80 70 60 50 40 30 20 10
1 2 3 4 5 6 7 8 9 10
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Defibrillation
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Time in minutes
The Chain of Survival

Early recognition and call for help
The Chain of Survival

Early CPR Early defibrillation Post-resuscitation care
Provide professional assistance in order to restore the quality of life
Page 8
Dial 999/112 when the casualty is not breathing normally
Start CPR to buy time until medical help arrives
Defibrillators give an electric shock to reorganise the rhythm of the heart
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Defibrillation
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The Chain of Survival Broken!

Early recognition and call for help
Dial 999/112 when the casualty is not breathing normally
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Post-resuscitation care
Provide professional assistance in order to restore the quality of life
First Aid Containers and Contents
Early CPR
Start CPR to buy time until medical help arrives
Early defibrillation
Defibrillators give an electric shock to reorganise the rhythm of the heart
Page 10
1. 2.
If you fail to call the emergency services, then there will be no post resuscitation care! If you dont start CPR, then it will probably be too late to save your casualtys life by the time the emergency services arrive If you have no AED, then it will be unlikely that CPR alone will be enough to save a life
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3.
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Defibrillation
11/7/2009
First Aid Kits
First Aid Kits

Minimum suggested contents
A guidance leaflet 20 adhesive dressings
Individually wrapped and assorted sizes
2 sterile eye pads 4 triangular bandages

Individually wrapped and sterile
6 medium sterile wound dressings

Individually wrapped and un-medicated
2 large sterile wound dressings

Individually wrapped and un-medicated
6 safety pins Disposable gloves If you have a defibrillator you will need to keep a disposable razor and towel close by
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Responsibilities
Responsibilities Arrival at the scene
Page 11
Assess the situation Make the area safe Ask questions about the incident Obtain help from others Send for help as soon as you have established the severity of the incident
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Defibrillation
Priorities of First Aid Treatment Protect yourself Think TRIAGE at all times Get help Treat in order of priority Clearing up
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999/112
Remember LIONEL L I O N E L
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Location Incident Other services Number of casualties Extent of injuries Repeat Location
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Factors Involved in an Emergency
STEP UP
Page 13
S T E P
Stop - Assess the situation Traffic Consider safety at all times Environment Consider your limitations Protection Yourself, your casualty and others
U Unknown hazards Gas, electricity, fire etc P Prioritise
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Defibrillation
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Primary Survey
Primary Survey
Page 14
Check for a response

A V P U
Alert Responds to Voice Responds to Pain or a stimulus Unresponsive
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Defibrillation
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Primary Survey
D R Danger
Make sure the area is safe before you approach
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Heart Attack and Angina
Response
Check to see if the casualty responds to verbal command or a pain stimulus Shout for help
Page 17
A B C
Airway
Open the airway by tilting the head back and lifting the chin with two fingers
Breathing
Look, listen and feel for normal breathing for up to ten seconds
CPR/Circulation
CPR if not breathing normally or Check for major bleeding and treat accordingly
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Defibrillation
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Heart Attack Recognition

Central chest pain Pain down left arm possibly Breathlessness A rapid or irregular pulse Rapid breathing and a shortness of breath Pale blue/grey, cold and clammy skin Nausea and vomiting
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Heart Attack - Treatment
Make the casualty comfortable and warm Position the casualty in the half-sitting position Monitor the casualtys breathing Call 999/112 Calm and reassure If the casualty becomes unresponsive carry out your procedure for Basic Life Support
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CPR - Recap
Principles of Resuscitation
Page 19
Start with chest compressions. This artificially circulates the oxygenated blood around the body and in particular, the vital organs After 30 chest compressions, give your casualty 2 ventilations or breaths. The recognised methods for this action are either by mouth to mouth or mouth to nose If you are unable to give 2 breaths, you must continue with chest compressions
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Defibrillation
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Basic Life Support 1

Check for DANGERS
Basic Life Support 2

Check for DANGERS
You are on your own

Shout for HELP Open the AIRWAY
When help is available
Check for RESPONSE
NO
Check for RESPONSE
NO
Shout for HELP
Open the AIRWAY
NO
Go for HELP yourself Call 999/112 Return to casualty Give 30 chest compressions
Check for normal BREATHING 10 seconds
YES
Check and treat injuries and place in the RECOVERY POSITION call 999/112
NO
Send bystander to Call 999/112
Check for normal BREATHING 10 seconds
YES
Check and treat injuries and place in the RECOVERY POSITION call 999/112 Give 2 effective rescue breaths. If they are not effective check the airway and remove any obstruction before your next attempt. Do NOT interrupt CPR
Give 2 effective rescue breaths. If they are not effective check the airway and remove any obstruction before your next attempt. Do NOT interrupt CPR
Give 30 chest compressions
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Continue CPR 30 COMPRESSIONS : 2 BREATHS Continue until the defibrillator arrives

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Continue CPR 30 COMPRESSIONS : 2 BREATHS Continue until the defibrillator arrives

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Defibrillation Procedure
Primary Survey
Page 24
10
Call the emergency services immediately you have identified that your casualty is not breathing normally Commence CPR immediately Ask for the defibrillator and First Aid equipment NB: If you are your own you must call the emergency services and get the defibrillator yourself.
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Defibrillation
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Remember the Chain of Survival

Waste no time in setting up the AED If you have trained help, then let them continue with CPR If you dont, then stop CPR and set the AED up yourself
It may be necessary to prepare the casualtys chest in order for the pads to adhere Do not waste valuable time shaving inappropriately
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40
Position the pads as shown on the manufacturers pads ensuring the chest is dry
Switch on the AED and follow the voice prompts It is imperative that no-one is touching the casualty, including yourself
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Remove any plasters or patches Remove any jewellery that may come into contact with the patches Ensure the pads are clear of any body piercing Be aware of any visible pacemaker
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If the AED voice prompts you to shock the casualty, then you must ensure everyone is clear of the casualty before pressing the shock button
Stand clear!
The AED may well prompt you to continue with CPR. If this is the case continue with CPR until the AED prompts you to stop. A further shock may be required. Continue to follow the voice prompts
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Continue to follow the prompts until the casualty recovers, or professional medical help tells you otherwise. Always ensure that no-one is touching the casualty throughout the procedure. Remember the Chain of Survival. Professional medical help should have been called from the onset.
Should your casualty recover, place them in the recovery position with the pads remained fixed to their chest and connected to the AED
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Monitoring the casualty to ensure they continue to breathe normally for themselves Be prepared to restart the process should they stop breathing normally again
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AED Functions
Page 28
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Defibrillation
11/7/2009
AED Functions
AED Functions
Some will be powered by a rechargeable lithium battery, others could be powered by disposable batteries Some will have a display window, allowing you to read the instructions, rather than listening to them Some will have a metronome to guide you with the speed of chest compressions Some will have a built-in recording facility, monitoring the whole process allowing you and the emergency services to download the information Ensure that the protocols embedded within your AED are up-to-date
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The positioning of the pads is vital. Most manufacturers will have a diagram on the pads showing you the correct positioning Some will have an on/off button, others may start when the lid is opened Some will have an analyse button, some will analyse automatically Some will have a shock button, some will shock automatically All will have a voice prompt
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You must familiarise yourself with your own AED

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Defibrillation Algorhithm
Defibrillation Algorhithm
Unresponsive Call for help Not breathing normally Send or go for AED Call 999 CPR 30:2 until AED is attached
Page 30
AED Assesses rhythm No shock advised Immediately resume CPR 30:2 for 2 minutes Continue until the casualty starts to breathe normally
Shock advised
1 Shock 150-360 J biphasic or 360 J monophasic Immediately resume CPR 30:2 for 2 minutes
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Defibrillation
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Paediatric Defibrillation
Paediatric Defibrillation Definitions
Page 37
Baby or Infant Child
0 1 year of age 1 onset of puberty
If your casualty appears to be that of a child, and has not reached puberty, then you must treat them as a child. If you are in doubt, you should adopt the adult protocols. Little harm will come to them should you identify the age of a child incorrectly.
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Carry out your normal Basic Life Support procedures
Most manufacturers will have special pads for both infants and children Only defibrillate an infant if you have special pads. These are not supplied by all manufacturers, so please check with your supplier. Follow the same procedure as you have been taught for adult defibrillation. However, please ensure you adopt the correct protocol for CPR
Check for dangers
Check for response Shout for help Open the airway
YES Assess injuries Treat unconscious casualty
Casualty breathing normally?
NO
Perform 1 minute of CPR before calling the Emergency Services. i.e. 5 initial breaths followed by 30 chest compressions and followed by 2 breaths (Approx 2 cycles) If you have help at hand send them to make the call and continue with CPR
Give 30 chest compressions followed by 2 breaths Repeat the sequence of 30 compressions:2 breaths until the defibrillator arrives
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Safety Measures
Stand back please
AED Safety
Know your AED controls, maintenance and battery Page 41
Only use it if you have been trained to use it Be aware of safety to you and others when shocking Do not use on infants unless the manufacturer provides the facility Only use on infants and children if you have appropriate pads Ensure the pads are the correct ones, undamaged and in-date Check battery at regular intervals Do not use near flammable gases
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Defibrillation
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Ensure there is no contact with water

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Final Assessment
Final Assessment
n/a
Practical test in the use of the AED
Knowledge test by answering 5 questions correctly from a bank of 10 Designated waiting area Assessed on a 1:1 basis Designated waiting area after the assessment Best of luck to you all
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Defibrillation
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11/7/2009
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without written permission from Nuco Training Ltd. This publication is supplied subject to the condition that it shall not, by any way of trade or otherwise, be lent, re-sold, hired out or otherwise circulated without the prior consent of Nuco Training Ltd.
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11/7/2009

Defibrillation Defibrillation Menu

Defibrillation in the workplace

10. Primary survey

16. Paediatric defibrillation

The odds of survival

11. Heart attack and angina

17. Safety measures

6 . The chain of survival

12. CPR - Recap

18. Final assessment

Nuco Training Ltd November 2009

Congratulations on passing the initial assessment!

Deaths by cause for men in the UK (2005)

Coronary Heart Disease

Deaths by cause for women in the UK (2005)

Smoking Overweight Poor Diet Lack of exercise Age

Abnormal heart rhythm with an ECG reading Ventricular Fibrillation

Defibrillation in the Workplace

Defibrillation in the workplace

The Odds of Survival

The Odds of Survival

The Chain of Survival

The Chain of Survival

Dial 999/112 when the casualty is not breathing normally

Start CPR to buy time until medical help arrives

Defibrillators give an electric shock to reorganise the rhythm of the heart

The Chain of Survival Broken!

First Aid Containers and Contents

Nuco Training Ltd November 2009

First Aid Kits

First Aid Kits

2 sterile eye pads 4 triangular bandages

6 medium sterile wound dressings

2 large sterile wound dressings

Responsibilities Arrival at the scene

Nuco Training Ltd November 2009

Factors Involved in an Emergency

U Unknown hazards Gas, electricity, fire etc P Prioritise

Check for a response

Heart Attack and Angina

Heart Attack Recognition

Heart Attack - Treatment

Basic Life Support 1

Basic Life Support 2

You are on your own

When help is available

Check for RESPONSE

Check for RESPONSE

Shout for HELP

Open the AIRWAY

Check for normal BREATHING 10 seconds

Check for normal BREATHING 10 seconds

Give 30 chest compressions

Continue CPR 30 COMPRESSIONS : 2 BREATHS Continue until the defibrillator arrives

Continue CPR 30 COMPRESSIONS : 2 BREATHS Continue until the defibrillator arrives

Remember the Chain of Survival

You must familiarise yourself with your own AED

Paediatric Defibrillation Definitions

Baby or Infant Child

0 1 year of age 1 onset of puberty

Check for response Shout for help Open the airway

YES Assess injuries Treat unconscious casualty