1. Emergency Lifesaver Workshop
Objectives of First Aid
Preserve Life ・ Prevent Worsening ・ Pain Relief
Necessity of First Aid
Importance of the first 5 minutes
Necessity of independent aiders - the courage to help
In saving others, society saves us
Casualty (person injured or taken ill)
Responder ( passer-by)
2. The Chain of Survival
Early Access Early CPR Quick Emergency Early Medical
Calmly and quickly Perform CPR or Measures Care
call 102 / 108 and other first aid as Ambulance team Professional care at
explain the situation necessary until provides further medical institution
ambulance arrives expert care
3. Is Resuscitation Possible?
100
1 2 3
75
Death rate 50
25
0
2 3 5 10 15 30 1 hour
30s 1 min
time
① 50% die within 3min after circulatory arrest
② 50% die within 10min after pulmonary arrest
③ 50% die within 30min of major bleeding
* Average ambulance arrival assumed time is 10min from call
4. Emergency Aid
If unconscious Preserve airway
First Aid
If not breathing Artificially ventilate
If no heartbeat Chest compressions
If airway blocked Remove obstruction
If bleeding heavily Stop bleeding
Make comfortable.
Other Treat fractures, wounds, injuries,
Aid burns, drowning. Transportation.
5. Age Divisions for First Aid Treatment
• Life Saving
• CPR ( observation, airway, breathing, circulation)
• Bleeding
• Age Divisions
Adult 8 years or over
Child Between 1 and 8 years
Infant Between 1 month and 1 year
Newborn Less than 1 month old
6. Observation and First Aid
• Heavy bleeding? Stop bleeding
• Impaired consciousness? Preserve airway
• Breathing absent or impaired? Ventilate
• No signs of circulation? CPR
Is casualty breathing?
Watch response
When Signs of
ventilating Any coughing?
circulation
Give two breaths
Any movement?
7. Signs of Circulation: Checking the Pulse
Adults, children
( carotid artery )
Infants, newborns
( brachial or
femoral
artery )
8. No ①Conscious? Yes
②Get help
Insufficient ④Breathing?
③Open airway
Sufficient
④Breathing? Sufficient
Put in recovery
position and observe
⑤Ventilate (2 times)
Yes
⑥Circulation signs? If breathing still insufficient
(breathing, coughing, movement) continue ventilating (one breath
every 5 seconds)
⑦⑧ CPR (30 compressions: 2 breaths) Yes
for 5 cycles If breathing recovers or
casualty protests, stop
ventilating
⑥Circulation signs?
⑧ Continue CPR
(30 compressions: 2 breaths)
9. Observation: Consciousness
Call “Are you alright? Can you hear me?” into
casualty’s ear while tapping their shoulder. See if they
can talk or respond. If no response, get progressively
louder/harder (no more than 3 times!)
Judge whether casualty
Can you is conscious or
hear me? unconscious
Do not move or slide the
casualty
For infant/newborn
casualty, scrape the sole
of the foot
11. The Airway
The airway is the path taken by air through the mouth and nose
to the lungs.
( Consciousness problems/ not breathing/ airway obstruction )
12. Opening the Airway
Lift the chin forwards with the index and middle fingers of
one hand while pressing the forehead backwards with the
heel of the other hand.
Do not put pressure
on the soft parts of
the chin or throat.
Do not do this if
there is a risk of a
neck injury.
13. Opening the Airway (2): neck injuries
Grasp the jawbone with both hands and gently ease
upwards, applying pressure with all 4 fingers on both
sides.
14. Observe Breathing
Place your ear above the casualty’s mouth and nose. Look along the
chest and abdomen. If she is breathing you will hear and feel the
breath on your face and see movement.
Observe for no more
than 10 seconds to
judge whether or not
casualty is breathing.
Count “1 2 3 4 5 6”
“No breathing”
“Ventilate”
15. The Recovery Position
For the casualty who is breathing sufficiently but is not
fully conscious. Use the casualty’s own hand under
their jaw to keep the airway open.
16. Artificial Ventilation
Keeping the airway open, pinch the nostrils so that air
cannot escape through the nose but is forced into the lungs.
Mouth-to-
-Mouth
-Nose
-Mouth & nose
-Mask
-Tracheostomy
etc.
17. Breathe for the Casualty
Open your mouth wide, take a deep breath, and seal your lips around
the casualty’s mouth. Blow into the lungs, looking along the chest
until you see the chest rise slightly.
Blow about 10cc per kg of casualty’s weight. (e.g. 500-800cc)
Problems:
Open airway?
Nostrils?
Seal?
Airway obstructions?
18. Remove your mouth and watch the chest fall
Pros and cons of Mouth-to-Mouth Ventilation
Requires no special tools Risk of infection
Can be done by one person,
even a child Risk of secondary poisoning
May feel unpleasant
Easy to see if it’s working
19. Preventing Infection
A non-return valve resuscitation mask can be used.
If you’re worried about infection you can perform chest
compressions only.
20. Ventilating when circulation signs are present
1 2 1 2 1 2 3 4 5 6 7 8 9 10 1
“No breathing”
Breathe gently for two seconds
Breathe gently for two seconds
Breathe gently for two seconds
“Circulation Signs present”
Check signs for no more than
Ventilate
Ventilate
Ventilate
ten seconds.
Look for autonomous
breathing, coughing or
movement.
Breathing may still be
insufficient.
21. Breathing: Age groups
Frequency Amount Duration Method
Adult Every 3-5 sec. 500-800cc 2 sec.
( 10cc/kg ) Mouth-to-mouth
Child
Every 2-3 sec. 1 - 1.5 sec.
Infant
Until chest
Mouth-to-nose
rises gently.
Newborn
Every 1 - 2 sec. 1 sec. Mouth-to-mouth-
and-nose
22. Chest Compressions: Correct Hand Position
The heart is located within the ribcage, slightly to left of centre.
An incorrect hand position will make compressions less effective,
and break the casualty’s ribs.
Heart
Hand position
23. Hand position: lower half of the sternum (breastbone)
For adults and children, the first hand should be placed on the
sternum one finger-space from the lower end.
Hand
position Sternum
One finger-space
Lower limit for
compression
Xiphoid
process
24. Finding the correct hand position
Trace the underside of the ribs with your index and middle
fingers.
ribs
25. Place the middle finger in the sternal notch,
and the index finger on the sternum
Using two fingers, trace the underside of the ribs to the notch where the sides join in the middle.
Leaving your middle finger in the notch, rest the index finger next to it on top of the sternum.
Index finger on
the sternum
Middle finger in
the notch
26. Now rest the heel of the other hand on the sternum next to
the extended index finger. This is the correct hand position
for compressions.
27. Cardiac Compressions - Essential Points
① Sit level with the casualty’s chest
② Correct hand position, with the heel of the hand
③ Lock your elbows
④ Position your shoulders over the chest
⑤ Using your body weight, compress straight down towards the ground
Adult casualty:
Compress 3.5 〜 5cm
Rhythm of 100 per min.
28. Compression technique
Avoiding pressure on the casualty’s ribs, compress only
the narrow sternum. This maximises the safety and
effectiveness of the compressions.
Use this part (the heel of
the hand) to compress
the chest
29. Compress Vertically
With elbows straight, push straight down. Release pressure
promptly. Take care not to lose your position.
30. Cardiac Compressions
Compressing the heart between the sternum and spine
causes blood to circulate.
Compress 30 times at a rate of 100 compressions/minute.
heart sternum
spine
downstroke upstroke
31. How NOT to do it!
Don’t push at an angle Don’t bend your elbows
32. Cardio-pulmonary Resuscitation(CPR)
Repeat cycles of 15 compressions to two breaths (ratio 15:2)
After the first four cycles, check again for signs of circulation - for no more
than 10 seconds
30:2
33. 2 breaths
30 compressions : 2 breaths
One cycle
compressions
30 chest
“Starting CPR”
signs of life
10 second
check for
“No signs of life”
“Checking signs”
2 breaths “No breathing. Ventilate.”
34. Removing Obstructions (1)
Open the casualty’s mouth with the “crossed finger” technique.
Cross the thumb and index finger. Place the thumb on the upper teeth, the index
finger on the lower teeth, and twist to open the mouth.
Don’t move the head
when inspecting the
mouth.
Do you need to remove
dentures?
35. Removing Obstructions (2)
Turn casualty’s head to one side.
Wrap your finger with a handkerchief or cloth, and wipe out
any obstructions.
Make sure to clean away all blood or body fluids.
36. Back Slaps
Slap sharply and strongly 4 or 5 times between the
casualty’s shoulder blades using the heel of your hand.
37. Heimlich Maneuver (Sitting)
Only on conscious casualties aged > 8 years
Put the ball of the thumb against the upper stomach area
Put your chest against the casualty’s back.
Put both arms under the casualty’s armpits.
Squeeze inward and upward.
38. Heimlich Maneuver (Astride)
With the heel of one hand on the upper stomach area,
support with the other hand and push sharply upwards
and inwards.
39. Compression from Behind
With one knee raised, put open hands on the lower trunk
beneath the ribs on either side of the spine. Squeeze
strongly, inwards and upwards.
40. No ① Conscious? Yes
② Call for help
Not enough ④ Breathing?
③ Open airway
Enough
④ Breathing? Enough
Recovery position
(continue to monitor)
⑤ Two breaths
Yes
⑥ Check signs of life If breathing sufficient, continue
Breathing? Coughing? Moving? ventilations (1 every 2 to 3 sec.)
⑦⑧ Perform CPR (30:2) Yes
If breathing recovers or
casualty objects, stop
⑥ Check signs of life ventilations
⑧ Perform CPR (30:2)
41. CPR for Children, Babies and Newborns
Mouth-to-Mouth Mouth-to-Nose & Mouth
Two breaths. Two breaths.
1 ~ 1.5 seconds apart.
Chest should rise gently. Breathe for 1 sec.
Child Baby &
Newborn
42. Casualty Hand Position Technique Extent Rate
Child Lower half of Heel of one
(1-8 yrs) sternum hand 100/minute
About 1/3
Baby
depth of
(1-12 month) One finger Middle & At least 100/minute
chest
width below ring fingers
Newborn (less line joining the only
than 28 days) nipples About 120/minute
Child Baby &
Newborn
43. Removing Obstructions: Baby & Child
Back Slaps Thoracic Compressions
Turn over, facing Face upward.
downwards Compress lower sternum as
Support chin with fingers for CPR, 5 times.
Slap 5 times with heel of
hand
Cycle both techniques. If becomes unconscious start CPR!
44. Bleeding Control: Direct Pressure
Consider the cleanliness, thickness and position.
Apply direct pressure to the wound.
Use a plastic bag or rubber gloves to avoid infection.
Gauze pad
wound
bone
45. Bleeding Control: Tourniquet
Position between the wound and the heart.
Centered a few cm from the wound.
Using a wide (at least 3cm) triangular bandage or scarf.
Tighten using a stick.
Release pressure every 30 mins.
46. 1. Prepare the tourniquet.
4. Turn the stick until bleeding stops.
2. Tie loosely. Insert a pad. 5. Secure the stick so it won’t move.
3. Insert the stick. Steady the pad. 6. Record the time.
47. Legal Protection for First Aiders
INDIA : Good Samaritan Law. If emergency aid is given
with sincere spirit there will be no retribution even in the
event of a mistake.
“Regarding actions made in good faith, in the absence of
malice or negligence, there shall be no civil or legal
liability.”