https://www.procpr.org/training/adult-cpr-first-aid/video/musculoskeletal-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2053.mp4 Musculoskeletal Injuries The musculoskeletal system is actually the combination of two specific systems – the muscular system and the skeletal system, including each of your 206 bones. And let's not forget the ligaments, tendons, and joints that hold it all together. Breaks, strains, sprains, and soft tissue injuries are some of the most common types of injuries that you'll likely encounter, in everyone from the elderly to youth sports participants. How to Assess and Handle a Musculoskeletal Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "How much pain or discomfort are you in?" So long as the patient is conscious, alert, and breathing normally, activating EMS can likely wait while you investigate further, as calling 911 is often not required with these types of injuries. Pro Tip #1: The real question that needs answering is this: Does this injury require activating EMS, a visit to the ER, or is it something the patient can shake off? So, how do we answer that question? With musculoskeletal injuries, the patient will often times be self-splintering – instinctively holding the area in pain – when you find them. That injury will be obvious, so make sure you also look for those that aren't. "Do you hurt anywhere else?" Also begin to further assess the injured area. If clothing is in the way, cut around that area to expose the injury. Look for bruising, swelling, some kind of deformity or abnormal angulation, bone fragments, bleeding, etc. Do you see any signs of a serious injury? Or a developing condition? How is the victim's skin color? Are the nail beds bluish or pink and normal? Poor circulation can be serious and warrants an immediate 911 call. Ask the patient how he or she feels. People, especially adults, have a sense of whether or not an injury is serious. With children, you may have to read between the lines a bit and pay more attention to body language and whether they're becoming more concerned about the injury or less concerned. If the two of you are coming to the same conclusion – that maybe the injury isn't that bad, help them walk it off, so to speak. Assist them in whatever way they need – getting to their feet or by helping to support their body weight. If it's not bad, as you suspected, they'll be fine. However, if the inverse is obvious, that the patient is in pain and the injury is now causing more discomfort, help them back into a comfortable position, call 911, and help protect and stabilize the injured area as best as you can until help arrives. Pro Tip #2: If you can safely stabilize an injury, do so. But make sure stabilization won't cause secondary problems, increase the patient's discomfort, or aggravate the injury. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. A Word About the Musculoskeletal System Injuries to muscles, bones, and joints can be difficult to detect. Knowing the specific mechanisms of the injury will provide important clues about which body parts are likely injured. There are three basic mechanisms of injury: Direct force – when the injury is located at the point of impact Indirect force – when the injury is located some distance from the point of impact Twisting force – when the injury is caused by a rotating force There are four basic types of musculoskeletal injuries to keep in mind when assessing patients, each of which is caused by one of the mechanisms above. Fractures Fractures are bones that are broken or damaged – chipped, cracked, etc. Fractures can either be closed, meaning the skin over the injury is intact. Or they can be open, in that the injury is exposed, making it much more serious. Open fractures are more prone to infection. And they can include excessive bleeding that may be difficult to control. Dislocations Dislocations are the displacement of a bone. When a severe force causes a bone to move one joint away from its normal position, this is known as a dislocation. Dislocations also typically result in ligaments and tendons that have been stretched, torn, or displaced. Shoulders and fingers dislocate more easily than other areas of the body. Sprains Sprains occur when ligaments are torn or stretched. The greater the number of ligaments involved, the more severe the sprain. Strains Strains are similar to sprains but involve muscles and tendons instead of ligaments. And as tendons are stronger than muscles, making them more resistant to injury, when dealing with strains, they're more likely to involve a muscle than a tendon. https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/training/adult-cpr-first-aid/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/adult-cpr-first-aid/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/adult-cpr-first-aid/video/agonal-respiration-not-breathing-normally https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2022.mp4 Agonal Respiration (Not Breathing Normally) Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations. Agonal respiration is one sign of respiratory and cardiac arrest. Historically, this type of breathing has been difficult to identify and describe, especially for lay people, which can slow or hinder care and response times for cardiac arrest victims. A Word About Cardiac Arrest Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate blood to vital organs, including the brain. When heartbeats are weak, irregular, or uncoordinated, blood can't flow through the arteries to the rest of the body. If circulation is hampered or halted in any way, the body's organs cannot receive the oxygen they need to function normally. As a result, organ failure can occur. Brain damage sets in between 4-6 minutes, and after 8-10 minutes, this damage will likely be irreversible. Cardiovascular disease is the leading cause of death in the world and in the U.S., where it accounts for approximately 1 in 3 deaths. Cardiovascular disease is also the primary cause of cardiac arrest, but there are others, including: Drowning Choking Drug overdose Severe injury Brain damage Electrocution Warning: As more than 300,000 out-of-hospital cardiac arrests occur each year in the U.S., it's vital that lay rescuers and EMS professionals understand that early recognition – which is more difficult with agonal respiration – and quick action can have a tremendous impact on survival rates. Cardiac Chain of Survival To effectively respond to cardiac emergencies, it helps to understand the Cardiac Chain of Survival. Following the links in these chains – adult and pediatric – will give patients the best chance of survival. Warning: For each minute that CPR and/or defibrillation are delayed, the chance of survival is reduced by 7-10 percent. Adult Cardiac Chain of Survival Recognize the emergency and call 911 – the sooner medical personnel are called the sooner EMS can provide care for the patient. Early CPR – supplying blood and oxygen to vital organs can prevent brain damage and death. Early defibrillation – this electrical shock may restore an effective heart rhythm and increase the victim's chance of survival. Advanced life support – Medical personnel can help provide the proper equipment and medication needed to continue lifesaving care. Integrated post-cardiac arrest care – Integrated care can optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. Pediatric Cardiac Chain of Survival Injury prevention and safety – ways to prevent cardiac arrest in children. Early CPR Early Emergency Care – Rapid activation of the EMS system or response team to get help on the way quickly. Pediatric advanced life support Integrated post-cardiac arrest care Agonal Respiration Continued Agonal respiration is characterized by abnormal breathing attempts in which the patient appears to be gasping or gulping. (Think of a fish as it tries to breathe out of the water to get an idea of what agonal respiration looks like.) These respiratory attempts originate from the lower brain stem neurons as higher, more complex neurons become increasingly hypoxic – lacking in oxygen. Agonal Respiration occurs in around 40 percent of early cardiac arrest victims. Aggressive CPR attempts are often hindered or slowed due to misinterpretation or misunderstanding of this serious condition. Pro Tip #1: It's important to remember that, when it comes to agonal respiration, these attempts from the body to breathe are routinely misinterpreted as normal breathing. However, even though it may appear the victim is breathing, he or she is not exchanging air well and will require immediate assistance to increase his or her survival rate. While lay rescuers describe agonal respiration in a number of ways, the good news is that 911 dispatchers have become better equipped to recognize all the ways in which people describe it, leading to better assistance and improved response times. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/training/adult-cpr-first-aid/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/adult-cpr-first-aid/video/unconscious-adult-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2033.mp4 Unconscious Adult Choking In this lesson, we'll cover how to help an adult choking victim who is unconscious. In our fictional scenario, the adult victim went unconscious while you were trying to help them. The method of care will closely resemble performing CPR, which you recently learned, however, there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy. Help lower the victim to the ground or floor, so they don't fall and injure themselves. Pay extra attention to supporting their head and neck. Call 911 and activate EMS if you haven't already done so. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient. Lift the victim's chin and tilt his or her head back. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness. Pro Tip #3: Let's assume your compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compressions to two rescue breaths. Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. How You can Increase the Effectiveness of CPR It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. With that in mind, here are two lists (cheat sheets) to use when practicing CPR – one list of what to do and what of what NOT to do. What is High-Quality CPR? Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 (for adults) Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the victim's chest to rise What is Low-Quality CPR? Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/training/adult-cpr-first-aid/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/adult-cpr-first-aid/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/adult-cpr-first-aid/video/mechanism-of-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2050.mp4 Mechanism of Injury Physical injuries run the gamut from soft tissue injuries like bruises, cuts, and burns to those involving the musculoskeletal system and/or the head, neck, and back. While injuries can vary greatly, the tools of discovery you'll use to help you assess patients will not. When you arrive on the scene, you'll apply the mechanism of injury method to help you gain a greater understanding of what possible injuries the patient may have based, in large part, on how he or she may have sustained those injuries. How to Apply the Mechanism of Injury Method As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Warning: If the patient does begin showing signs of decreasing levels of consciousness or any problems involving breathing, airway, and/or circulation – numbness, tingling, inability to move limbs – call 911 immediately. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Pro Tip #1: Ask the victim open-ended questions when you're assessing them, rather than yes and no questions. So, instead of asking, does your head hurt?, ask, do you have pain anywhere? Asking yes and no questions can often lead them down the wrong road. During your assessment, involve family members and friends who are nearby and may have witnessed the accident. They'll also be able tell you if the victim is behaving normally or has any medical problems or allergic reactions to medications. This is even more important when dealing with injuries to children. Pro Tip #2: Don't be too myopic. Even though the injury may seem obvious, that doesn't mean another injury isn't also lurking. Keep this in mind as you perform a full head-to-toe examination of the patient. A Word About Soft Tissue Injuries Soft tissues include all the layers of skin, fat, and muscles in the human body. The largest organ is the skin, as it contains three layers of its own – epidermis (outer area that protects against bacteria), dermis (deep layer that protects the nerves), and hypodermis (the deepest layer that protects blood vessels). Soft tissue injuries are classified as closed wounds or open wounds. A closed wound is an injury that occurs beneath the surface of the skin, meaning that the outer layer of skin is still intact. There is usually internal bleeding, even if only minimally in the form of a bruise. An open soft tissue wound involves a break in the skin's outer layer, like a cut, and usually involves external bleeding – arterial, venous, or capillary. Burns deserve a special distinction as a soft tissue injury and are classified as superficial, partial thickness, and full thickness. Closed Wounds Closed wounds occur beneath the surface of the skin and are usually the result of blunt force. The contusion can be minor, like stubbing your toe, to more serious examples of blunt force trauma, like those sustained in motor vehicle accidents. Swelling and discoloration are normal in closed wounds as these are part of the healing process. Closed wounds become more serous when they affect the deeper layers, those that protect larger blood vessels and vital organs. Heavy internal bleeding can occur from a contusion or hematoma and when it affects those deeper layers, the signs may not be immediately noticeable. Opened Wounds Open wounds are those that affect the outer layer of the skin. There are six types of open wounds: Abrasions – scrapes, rug burns, road rashes, etc. – abrasions are more painful due to the presence of nerve endings nearby but don't involve much bleeding as the capillaries are mostly affected. Amputations – the loss of a limb – amputations are serious injuries that rely on controlling blood loss and shock. Avulsions – part of skin peeled away – avulsions can be very painful, and bleeding can be heavy. Crush injuries – extreme weight or force crushes a body part – crush injuries can cause great internal damage to blood vessels and vital organs. Punctures – gun shot wounds, stabbing wounds, etc. – punctures are smaller wounds that typically close around the wound, thereby limiting the amount of external bleeding. However, the puncture can also result in internal bleeding. Lacerations – cut from a sharp object – lacerations vary in severity depending on several factors, including the type of bleeding that the laceration has caused – arterial, venous, or capillary. https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/training/adult-cpr-first-aid/video/amputation https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2047.mp4 Amputation An amputation from trauma involves the loss of an extremity like a finger or toe but could also include an arm or a leg. It's important to not get too distracted looking for the amputated part and focus on the wellbeing of the victim. As amputation injuries often occur in machine accidents, the amputated part can get thrown quite a distance from the scene of the accident. It may also be covered in saw dust or shavings of some kind, which could make finding it more problematic. If there are other people on the scene, you may want to consider asking for help to locate the missing part. Amputation injuries are quite serious. It’s important to assess the patient beyond the amputation, including: Did the victim lose consciousness? If so, did they hit their head and are now suffering from a concussion? Is the victim showing signs of being in shock? How to Provide Care Clean-cut amputations bleed less than you might expect and often less than crushed extremities or partial amputations. The reason for this is that the arteries contract up into the stump and clamp down, which helps to control the bleeding for at least the first few minutes following the amputation. After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. If there is already a cloth or dressing pad covering the stump, don’t remove it, as this will pull off some of the clotting blood. Apply a second piece of gauze padding and, if necessary, subsequent pieces until bleeding is controlled and apply pressure. If the victim can't help apply pressure, you'll need to manage it yourself or ask someone to assist you. Pro Tip 1: With amputation injuries, there will sometimes be a protruding bone fragment. These can be very sharp and may cut you while you attend to the victim. Therefore, it's important to be careful when dressing the wound. If you're not, you could easily: Damage the bone further Cause more pain to the victim Introduce bacteria into the wound Once you've controlled the bleeding, meaning it is no longer leaking through the dressing pads, it's time to wrap the wound with a roller gauze bandage. Pro Tip 2: Your goal in wrapping the wound is to apply enough pressure to hold the dressing pads in place and control the bleeding. Be careful not to wrap so tight that you cut off circulation. Remember to use the pinch test on finger and toe nails if appropriate and you are able to. If blood begins to leak through while you're wrapping the wound, simply insert another dressing pad and continue wrapping. If you need extra pressure at that point, twist the bandage over the wound area. This will apply a bit more torque and should help control the bleeding. When you're done wrapping, tuck or tape the end of the bandage. By this point, the bleeding should be controlled, and the patient should be stable. Continue assessing the victim for signs of shock or other health concerns. How to Handle the Amputated Extremity If you or someone at the scene were able to find the amputated part, it’s important that you handle it properly using the following steps. Make sure it's clean. Wrap it in a sterile gauze pad, preferably an abdominal dressing pad if you have one. This will offer much more insulation than regular pads and help protect the part from cold damage. Place the part into a sealable plastic bag. Put the bag with the part between two cold packs or into a bag filled with ice water and seal that bag. Warning: The amputated part has no blood flowing through it, which makes it much more susceptible to frost bite and tissue damage. You want to keep it cold, not frozen. It's also important to keep it dry. When skin becomes water logged and gets pruney, this is actually the onset of that tissue breaking down and will make reattachment more difficult. Pro Tip 3: It's important to keep the amputated part with the victim and, if possible, out of sight from the victim. You don't want to encourage psychosomatic shock, but you want the surgeons at the hospital to have access to both victim and part immediately. As amputations are serious injuries, you should be continually assessing the victim for signs of shock or other life-threatening conditions. A Word About Early Signs of Shock We will be discussing shock in great detail in the next lesson, but it's important to know that it's a progressive condition. Symptoms may seem minor at first, but the situation can quickly get worse. Your rapid response is vital. Early symptoms of shock include: The victim expresses anxious or apprehensive feelings The victim's body temperature is lower than normal The victim's breathing is quicker than normal The victim's pulse has increased The victim's blood pressure has decreased The victim's skin appears pale or clammy If you suspect that the victim is in shock, it's important to call 911 immediately. It's impossible to know when an individual will go into shock, but with amputation injuries you may want to consider the threat more elevated. And knowing the warning signs and being able to spot them early on could make a big difference. https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/training/adult-cpr-first-aid/video/secondary-survey https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2051.mp4 Secondary Survey The secondary survey is simply a head-to-toe examination that you'll perform on injury victims who are awake and responsive. It's important to remember to not get too focused on one obvious symptom. If you come upon a patient with an obvious arterial bleeding wound, remain focused on other potential head-to-toe problems, as you help care for the more obvious injury. How to Conduct a Head-to-Toe Exam As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Pro Tip #1: Even though the patient is awake and responsive, symptoms can always worsen. And conditions that didn't seem life-threatening a minute ago, may seem so now. If at any point things do get worse, call 911 and activate EMS. Remember to ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Notice how much they are able to move. Are they nodding when you ask a question? Are they able to move their fingers and toes? "Can you wiggle your fingers?" Look for the early signs of shock. Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. Early signs of shock include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Pro Tip #2: A quick way to find out if a victim has a circulation problem, which could be a sign of shock, is to pinch a fingernail bed on the patient and count how long it takes to return to a normal pink color. Longer than 3-4 seconds could be a sign that something else is wrong. "Can you wiggle your toes?" Continue working your way down the victim, noticing any potential issues or conditions beyond the obvious. Also, make sure they're in a position of comfort, whether that's sitting, laying down, or getting to their feet and stretching out their legs. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? Warning: It's important to remember that this secondary survey is only for patients who are awake and responsive. If at any point, a once responsive patient goes unresponsive, call 911 immediately and activate EMS. A Word About Chest Injuries Chest injuries are one of the leading causes of trauma deaths in the U.S. each year. Chest injuries are most commonly the result of falls, vehicular accidents, workplace accidents, and direct blows or crushing incidents. Warning: The area around the chest, abdomen, and pelvis contain several vital organs. Therefore, any life-threatening injury in one of these areas can be particularly fatal if left untreated. There are several types of chest injuries: Blunt Trauma Any blow to the chest or abdomen that doesn't penetrate the skin would be considered a blunt trauma injury. Common symptoms include shortness of breath, chest pain, and rapid pulse. Traumatic Asphyxia Traumatic asphyxia occurs due to a severe lack of oxygen caused by a physical trauma, typically one in which the victim was crushed or pinned. Common symptoms include shock, distended neck veins, bluish discoloration, black eyes, broken blood vessels in the eyes, bleeding from the nose or ears, and coughing up blood. Fractured Ribs Fractured ribs, though painful, are rarely life-threatening. For victims, breathing will be labored for a while and deep breaths, in particular, will be very painful. Flail Chest Multiple rib fractures in multiple places results in flail chest. Flail chest is especially serious if it includes the presence of a loose section of ribs that could puncture a lung. Pneumothorax A pneumothorax is the collapse of a lung that results from too much air in the chest cavity. At the very least, breathing will be difficult. At the worst, it could lead to respiratory distress. Hemothorax A hemothorax is excessive lung pressure due to the accumulation of blood between the chest wall and lungs, which prevents the lungs from properly expanding. https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/training/adult-cpr-first-aid/video/hemostatic-agents https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2049.mp4 Hemostatic Agents A hemostatic dressing is any dressing treated with an agent or chemical that assists with the formation of blood clots. Much like tourniquets, hemostatic dressings are used with direct pressure to help control severe, life-threatening bleeding. Hemostatic dressings are usually only considered an option if: The bleeding is life-threatening The standard procedure of direct pressure failed The injury is located where a tourniquet wouldn't work, such as the torso, abdomen, groin, and neck A tourniquet was unavailable or ineffective How to Provide Care After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. Once you determine that direct pressure alone isn't working, and you've decided against using a tourniquet, apply a hemostatic agent or dressing to the wound followed by more direct pressure. Pro Tip 1: Hemostatic agents come in powders and dressing pads of numerous sizes. For large open wounds, you can pour the powder into the wound which will help speed up blood coagulation and clotting. If you're using hemostatic dressing with a large open wound, make sure you pack the dressing deep into the wound and apply continuous pressure until the bleeding is controlled. Hemostatic agents are an ideal option when EMS services are delayed or unavailable, perhaps in a wilderness setting, or when normal bleeding control options are ineffective. And like tourniquets, when it comes to hemostatic agents, you're just trying to buy some time before getting the victim to a surgical center for proper care. A Word About Internal Bleeding Internal bleeding is the blood loss from veins, arteries, and capillaries into spaces inside the body. This can be caused by injuries like blunt force trauma and fractures, but also due to certain medical conditions. Internal bleeding can also include external bleeding from the same incident. Consider how a knife wound could cause both internal and external bleeding simultaneously. Common signs of internal bleeding include: Discoloration of the skin Bruising and tenderness Nausea, vomiting, or coughing up blood Discolored, painful, tender, swollen, or firm tissue Victim protectively guarding the injury area Rapid pulse or breathing Moist, cool skin Pale or bluish skin Drop in blood pressure If you suspect that someone is bleeding internally, call 911 immediately and help keep the victim as still and calm as possible to reduce the heart's blood output. Also keep an eye on the victim for any signs of shock. Pro Tip 2: When internal bleeding is from the capillary blood vessels, the result is bruising around the wound area and is not serious. To reduce discomfort for the victim, you can apply an ice pack to the area. Like internal bleeding, injuries requiring a hemostatic dressing should be considered serious. And as with all bleeding injuries, you simply want to find the bleeding and stop the bleeding, by any means necessary. https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/training/adult-cpr-first-aid/video/when-cpr-doesnt-work https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2041.mp4 When CPR Doesn't Work This is the last lesson in the cardiac arrest section, and a difficult topic to tackle for most. Whether you're a licensed paramedic, family member, neighbor, or stranger, the question remains the same for many people: Why didn't CPR work? That's a fair question. Even when you do everything perfectly, the desired outcome often isn't what you expected or hoped for. However, some of that hope and desire can be rooted in a misunderstanding of what CPR really is, which is the point of this lesson. CPR was designed to buy time, and nothing more. During cardiac arrest the heart is either in a fibrillatory state, meaning it's wiggling around in a disordered fashion, or it's completely asystolic, meaning it's not contracting at all. When a heart is healthy and operating as it should, it beats from top to bottom in a very organized way utilizing one-way valves. It works perfectly to circulate oxygenated blood throughout the entire body, and it does so efficiently. However, during cardiac arrest, regardless of what caused it, the heart is unable to circulate blood and oxygen and the body begins to die. The patient isn't breathing. There's no pulse. At this point, that person is clinically dead. Now, it doesn't mean that person will remain that way, as there is a difference between clinical death and biological death. What CPR aims to do, specifically the compressions, is to make up for the circulation that isn't happening naturally. The reality, though, is that even when CPR is performed perfectly, it's delivering only a small percentage of what the body needs to survive. It wasn't designed to be equal to artificial life support. Remember, it's simply a way to buy time. People have this idea that if they perform chest compressions on an unresponsive person, the body will remain alive. And he or she will remain alive so long as the chest compressions continue. But this isn't the case. CPR doesn't stop the dying process. It slows down biological death a little. But that's all it does. The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives – an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. – and the underlying cause of the cardiac arrest can be addressed. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival. CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology. The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are. If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact – by performing high quality CPR, you gave the patient the best possible chance of survival. Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way. That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. Now, you may be asking yourself, if CPR rarely works, is it even worth trying? EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying. And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember – we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them. The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough (even strangers) to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live. Isn't that the greatest gift we can give to another? This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. If you've ever performed CPR on a cardiac arrest victim, but the patient still remained dead, hopefully this greater understanding of what CPR really is has brought some peace to you, as the pain, agony, and guilt can be immense. Go forth and rescue confidently! And be at peace with yourself when you do. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/training/adult-cpr-first-aid/video/tourniquets https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2048.mp4 Tourniquets Tourniquets are tight, wide bands placed around an arm or a leg to constrict blood vessels in order to stop blood flow to a wound. Generally, tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. Other reasons to consider using a tourniquet include: If bleeding cannot be controlled by direct pressure If the injury is in a location where direct pressure isn't possible If multiple people need help with life-threatening injuries and help is limited If the scene is unsafe or becoming unsafe Warning: Tourniquets can be extremely painful. Therefore, it's best to warn the victim beforehand. And tell them why they'll be wearing a tourniquet. How to Provide Care If you have a commercial tourniquet, great. If not, anything that you can wrap around an injured limb will work – a piece of rope, an insulated wire. Tie that into a knot and then insert a screwdriver, stick, or pen and begin twisting to tighten. Your goal in using a tourniquet is to control bleeding before hypovolemic shock sets in due to blood loss. Pro Tip 1: What may seem like a wound that won't stop bleeding, may just be due to pressure that's not being applied directly over the wound. Bandages can slip. Victims could be in shock and not applying as much pressure as it appears. Make certain that direct pressure truly fails before considering a tourniquet. We will assume that you've already made sure the scene is safe, and you're wearing latex-free gloves or have thoroughly washed your hands and have determined that the victim is currently not in shock. Apply the tourniquet over the extremity where the injury as occurred and a couple inches above the wound to limit tissue damage. Avoid wrapping around joints and follow the manufacturer's instructions. Secure the tourniquet as tightly in place as possible. Slowly tighten the tourniquet handle until bleeding stops. Fasten the handle to the tourniquet. Test the victim's toenail or fingernail to make sure you get a delayed capillary response, so you know the tourniquet is working as it should. Write down on the victim's dressing what time the tourniquet was applied and give that information to EMS. The ABCs of Bleeding Regardless of the bleeding incident, it's important to understand these simplified steps to trauma care response: A – Alert! Call 911.B – Bleeding. Find the bleeding injury.C – Compress. Apply pressure and stop the bleeding by: Applying direct pressure with a clean cloth or dressing pads. Using a tourniquet. Packing or stuffing the wound and then applying pressure. A Word About Perfusion Perfusion is how your body's circulatory system delivers oxygen and nutrients to your organs, all of which require varying amounts of perfusion. Your heart, for instance, requires constant perfusion to continue working. Your brain can last four-to-six minutes without perfusion, before damage begins to set in. Your kidneys can last 45 minutes and your skeletal system about two hours. What does this have to do with tourniquets? Pro Tip 2: It's important to keep in mind that limiting perfusion is a bad thing. But when we apply a tourniquet to a victim, that's exactly what we're doing. We're voluntarily cutting off the supply of oxygen and nutrients to a part of someone's body. So, it bears repeating: Tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/training/adult-cpr-first-aid/video/snake-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2059.mp4 Snake Bites In this lesson, you'll learn how to treat a patient who has been bitten by a venomous snake. When dealing with snake bite victims, there is one special point to take note of: If you have the snake, DO NOT bring it to the hospital, just take a picture from a safe distance or remember key features of the snake so the venom can be identified. Just don't get bit yourself trying to look at or take a picture of the snake. How to Treat a Patient who has been Bitten by a Snake As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Call 911 and activate EMS. Give them as much information as possible so that the patient gets routed to a hospital that has the correct antivenom. Get the patient into a comfortable position – seated or laying down – where they can be as calm as possible. They could become dizzy, and you don't want them falling and injuring themselves. Reassure the patient – tell him or her that they're in good hands, that EMS is on the way, and that they'll be taken good care of. You don't want them to get excited, nervous, or agitated, as the patient's heart rate will increase and circulate the venom faster. Warning: What you don't want to do – You don't want to use a cold pack; these have been widely ruled out now. And you certainly don't want to suck out the venom, unless you have a special fondness for urban myths. Keep the patient's snake-bitten limb or area level with the heart, if possible.  Raising or lowering of the extremity may both be correct, but that would depend on the species of snake and the condition of the patient.  Get the patient into the ambulance with as little movement as possible. Is there a golf cart around? How about a stretcher? How close can the ambulance get? You don't want them walking, or moving, any more than is absolutely necessary. Get the patient to the correct hospital with the correct antivenom and the life-saving treatment they may need. A Word About Venomous Snakes Snakebites kill few people in the United States. Of the estimated 7000 to 8000 people reportedly bitten each year, fewer than five die. And most of those deaths occur because the person has an allergic reaction, is in poor health, or because too much time passes before the person receives medical care. When it comes to the biggest threat, rattlesnakes account for most snakebites and nearly all of the deaths from snakebites. Venomous snakebite signs and symptoms include: One or two distinct puncture wounds, which may or may not bleed. The exception is the coral snake, whose teeth leave a semicircular mark Severe pain and burning at the wound site immediately after or within four hours of the bite Swelling and discoloration at the site of the bite immediately after or within four hours of the incident If the bite is from a venomous snake such as a rattlesnake, copperhead, cottonmouth, or coral snake, call 911 and activate EMS for more advanced medical personnel. To give care until help arrives, simply follow the steps outlined above. And if you're interested in more of what not to do, we have a list for that, too: Do not apply ice Do not cut the wound Do not apply suction Do not apply a tourniquet Do not use electric shock, like from a car battery https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/training/adult-cpr-first-aid/video/allergic-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2060.mp4 Allergic Reactions While there are only around 1500 deaths each year in the U.S. from severe allergic reactions, it is nonetheless frightening how quickly these allergic reactions can occur. Around 50 million Americans suffer from an allergy, and this is a number that's apparently on the rise. One theory as to why has to do with our too-sterile modern life. One that includes: Antibacterial soap Hand sanitizer Air-tight homes An increase in environmental pollutants It seems our body's immune systems aren't developing as effectively to fight germs and other foreign invaders like they were in the past. The most common causes of all allergic reactions are from foods (number one) and insects (number two). Children are most affected when it comes to food allergies. And while most kids outgrow their food allergies, according to the CDC, the number of children with food allergies rose by 18 percent in a 10-year span from 1997 to 2007. Pro Tip #1: While most kids outgrow most food allergies, there is one that cannot be outgrown – the peanut. Sadly, peanut allergies are for life. What Causes an Allergy? The job of your immune system is to protect your body from foreign invaders – various bacteria, germs, and viruses. A healthy immune system protects the body even in the presence of these invaders. However, when there is an allergy present, the immune system will mistakenly target and overreact to a threat that doesn't really exist. This results in your immune system attacking a harmless substance that has recently been eaten, inhaled, injected, or come into contact with the skin. And that substance is called an allergen. An allergen can be introduced to the body a number of times with no trouble. Then, for seemingly no reason, the body one day decides to flag that allergen as a foreign invader, which triggers the body to attack the allergen. And to further complicate matters, the body will remember the allergen and produce specific antibodies that will attack the allergen even more fiercely next time it's introduced into the body. Pro Tip #2: This is why allergic reactions are often more severe the second or third time – the build-up of antibodies and larger battles. When the immune system attacks the allergen, high quantities of histamine and other chemicals are released into the surrounding tissues. Depending on the part of the body affected, symptoms can include: Itching Hives and rash Sneezing Wheezing Swelling of the face Runny nose Nausea There is one particular kind of allergic reaction that can be especially life-threatening – anaphylaxis. Anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Warning: Anaphylaxis can cause the body's blood vessels to suddenly dilate – as in opening all the way up, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen-starved. Anaphylactic shock will cause death if not treated. One common and basic treatment for anaphylactic shock is epinephrine (or an epi-pen), as it constricts blood vessels and opens the airway, thereby reducing the effects of the allergen. The most common causes of anaphylaxis are bees and other stinging insects, latex, medications and the following foods: Nuts Fish Shellfish Eggs Milk The most common cause of severe, life-threatening allergic reactions is by far the peanut. How to Treat for Allergic Reactions As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first things you'll want to look for are the signs and symptoms of allergic reactions and anaphylactic shock: Trouble breathing Wheezing Tightness in the throat Itchiness on the tongue Swelling of the face Hives Pale skin Rapid heart rate Low blood pressure Nausea Vomiting Diarrhea Dizziness How children typically describe an allergic reaction may better help understand some of the signs: It feels like there's hair on your tongue You experience tingling Your mouth itches It feels like something is stuck in your throat Your lips feel tight Your body feels weird all over Warning: The key element with allergic reactions is time. Don't wait. Call 911 immediately. If available, use an epi-pen. But don't wait for symptoms to get better. The three steps to providing care for allergic reactions are: Recognize the signs early Call EMS or a code if in a healthcare setting Assist the patient with an epi-pen if needed Pro Tip #3: Keep the patient calm. Sit them down. Make sure they're comfortable. To make breathing easier, have the patient sit straight up and lean forward. If the patient is feeling faint or is losing consciousness, lie them down, elevate their legs, and keep them warm. Talk to them, reassure them, but be prepared to begin CPR if they suddenly stop breathing or become completely unresponsive. Warning: There is the possibility of a secondary reaction after the first. Which is why the patient should be monitored for four to six hours after the initial allergic reaction. A Word About how to Know if it's Anaphylaxis? Depending on the situation, there may be different things to watch out for as you put the puzzle pieces together. Here's a cheat sheet that may help. Situation #1: You know that the patient has been exposed to an allergen. What to Look For: Trouble breathing OR Signs and symptoms of shock Situation #2: You think the patient may have been exposed to an allergen. What to Look For: Any TWO of the following: A skin reaction Swelling of the face, neck, tongue, or lips Trouble breathing Signs and symptoms of shock Nausea, vomiting, cramping, or diarrhea Situation #3: You do not know if the patient has been exposed to an allergen. What to Look For: A skin reaction (such as hives, itchiness, or flushing) OR Swelling of the face, neck, tongue, or lips PLUS Trouble breathing OR Signs and symptoms of shock https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/training/adult-cpr-first-aid/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/adult-cpr-first-aid/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/adult-cpr-first-aid/video/recovery-position https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2063.mp4 Recovery Position In this lesson, you'll learn how to safely use the recovery position, for those times when you encounter a patient who is breathing but unconscious. The recovery position is used in the following scenario: The patient is unresponsive The patient is breathing normally The patient has good skin color, good circulation It's not an immediate CPR situation How to Put a Patient into the Recovery Position As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. In this situation the patient is unresponsive to your taps and shouts, which elicits an immediate 911 call and finding and/or preparing an AED for use, as you begin to assess the scene for clues of what happened. The patient could have ended up unconscious for a number of reasons: Passed out or fainted Suffering from low blood sugar Seizure Electrocution Warning: If you suspect electrocution, take extra measures to make sure the scene is safe. Is the power source still active? Is it still touching the patient? To help keep the patient's airway open and clear, put them into the recovery position using the following steps: Warning: Only use the recovery position if you don't suspect fractures, or serious neck and back injuries. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #1: The purpose of the recovery position is to expel any foods or liquids that come up. What comes up needs to come out. If it doesn't, it could find its way into the patient's lungs. The recovery position is also a great way for the patient to lay safely while waiting for EMS. Using the patient's leg as a kickstand allows his or her body to use gravity without the threat of them rolling completely over. Pro Tip #2: You want gravity working with you as you wait for EMS to arrive. It's important to eliminate the risks of the patient choking or an obstructed airway. Having the patient facing downward will help negate those risks. Warning: If the patient loses their pulse or stops breathing, immediately roll them onto their back and start CPR. Continue to reassess the patient while you wait for EMS to respond, particularly for signs of shock, responsiveness, airway, breathing, and circulation. And treat accordingly should the situation change. A Word About the Signs of Inadequate Breathing Inadequate breathing requires careful monitoring. You may not notice all of the signs and symptoms at once, and some can be hard to spot. If you see any of them, be prepared to give assisted ventilation. When the patient has to expend too much effort to breathe and their breathing has become inadequate, you'll notice the following signs: Muscles between the ribs pull in when the patient breathes in. As the patient enhales, you may notice the muscles pulling inward between the ribs, above the collarbone, around the muscles of the neck and below the rib cage. Pursed lips breathing. The patient exhales through pursed lips, like a whistling motion. This maneuver helps control the patient's breathing pattern. Flaring out of the nostrils on inhalation can be a sign of inadequate breathing in children and infants. Apparent signs of fatigue are also an indication of labored breathing. Excessive use of abdominal muscles to breathe, as in when the patient is using the abdominal muscles to force air out of the lungs. Sweating and anxiousness are also signs of severe respiratory distress. A patient who is sitting upright and leaning forward with hands on knees could be doing so because they're struggling to breathe. Abnormal breathing sounds are also a great sign of inadequate breathing. Listen for abnormal sounds such as wheezing or crackling. Wheezing or whistling sounds indicate restricted air flow and are common with conditions such as asthma, allergic reactions, and emphysema. If the patient has a fine cracking sound on inhalation, that may indicate fluid in the lungs. https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/training/adult-cpr-first-aid/video/asthma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2062.mp4 Asthma Anyone who has experienced an asthma attack will tell you what a frightening situation it can be, as your airways tighten and no matter what you do, you simply cannot get enough oxygen into your lungs. Pro Tip #1: Want to know what it feels like to have an asthma attack? Imagine only being able to breathe using a thin, plastic coffee stir straw. That would approximate how a severe asthmatic attack would feel. In this lesson we'll discuss one of the best medications for acute and chronic asthma attacks (Albuterol) and how to use it correctly. How to Treat a Patient with Asthma As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: Albuterol comes in a small aerosol container with an actuator. Whether the patient's asthma is exercise induced or persistent, the effect should be the same regardless. In this lesson, we're going to include the use of a spacer with the Albuterol dispenser. Spacers are really expensive, which probably contributes to many people not using one, and sort of resembles a small plastic sippy cup. The spacer goes between the patient's mouth and the Albuterol dispenser. Warning: When not using a spacer, much of the medication, instead of going into the patient's lungs and bronchials where it should go, winds up sitting at the back of the throat and on the tongue. This obviously decreases the dosage and the effectiveness of that dose. How to Administer Albuterol Using a Spacer Pro Tip #3: Before using your Albuterol device, make sure it has actuations remaining. To find this information, look on the back of the dispenser. Most devices have a number there inside a little window that corresponds with the number of actuations remaining. And don't forget to check the expiration date! Shake the Albuterol container just prior to using it. You don't have to shake for long. A few seconds will do the trick. Insert the Albuterol mouthpiece into the end of the spacer where it fits. (It will be obvious.) Place the other end of the spacer into the patients mouth. Make sure he or she completely exhales first. Push down on the Albuterol dispenser one time and instruct the patient to hold his or her breath for 10 seconds. Instruct the patient to exhale. Pro Tip #4: A normal dosage of Albuterol for most adults is two inhalations and children may be one or two doses. So we need to always ask the patient about their specific dosage. Repeat – patient exhales out all air, puts spacer into their mouth, dispense Albuterol, hold for 10 seconds, and exhale. If the patient doesn't get relief from two injections, ask them what their prescribed amount of time is between injections and doses. If the patient is still having trouble breathing, call 911 and activate EMS. They could be suffering from a persistent asthma attack that cannot be stopped with a simple rescue inhaler of Albuterol. Get help on the way immediately, in case the patient begins having a true respiratory emergency. It's important to avoid assumptions that the patient will get better after administering a dosage of Albuterol. Always be prepared for anything. A Word About Asthma Triggers Asthma is an illness in which the airways swell. An asthma attack happens when an asthma trigger, such as exercise, cold air, allergens, or other irritants, causes the airways to suddenly swell and narrow. This makes breathing difficult, which can be very frightening. The Centers for Disease Control and Prevention (CDC) estimates that approximately 24 million Americans are diagnosed with asthma in their lifetimes. Asthma is more common in children and young adults than in older adults, but its frequency and severity are increasing in all age groups. You can often tell when a person is having an asthma attack by the hoarse, whistling sound the person makes while inhaling and/or exhaling. This sound, known as wheezing, occurs because air becomes trapped in the lungs. But what exactly triggers an asthma attack? A trigger is simply anything that sets off an attack. And they can be very different for different people. Common asthma triggers include: Dust, smoke, and air pollution Exercise Plants Molds Perfume Medications Animal dander Temperature extremes and changes in the weather Strong emotions, such as anger, fear, or anxiety Infections, such as colds or other respiratory infections Usually, people diagnosed with asthma control their attacks by controlling environmental variables (exposure to those triggers) and through medication and other forms of treatment. https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/training/adult-cpr-first-aid/video/seizure https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2101.mp4 Seizure In this lesson, you'll learn how to treat an adult patient who goes into a seizure or has just come out of one. A person can go into a seizure for too many reasons to mention. As you are concerned, why it happened isn't important. Being able to recognize that it did happen is the key. For you to know if a seizure took place, ideally you or someone else saw the patient go into a tonic state that exhibited the following signs: Hands are gripped and pointed inward The patient is actively seizing The patient ends the seizure in the postictal state (relaxed recovery) How to Treat a Patient who is Actively Seizing There are a few important things that you can do when a person is suffering from a seizure to help protect them from further harm. First, is there anything around the patient that could injure them, such as sharp objects? If there is, remove the threat from the scene or move the patient to a safer area. If the patient is having a zootomic clonic seizure – in which they are fluctuating between contracting and relaxing – they could bang their head on the ground. To protect their head, simply cup your hands together and place them underneath the patient's head. Warning: Never hold down a seizing patient or try to stop the seizure in any way. Just support and protect the patient during the seizure. Then, once the seizure is over, assess for more serious situations like cardiac arrest. How to Treat a Patient after a Seizure Pro Tip #1: There are several things to do post-seizure, but the most important is calling 911 and activating EMS if it hasn't already been done. As soon as you determined that the patient had a seizure, and you don't know if the patient is an ongoing epileptic, call 911 immediately. After EMS has been activated, begin to assess the patient for a couple of things. Is the patient moving and breathing normally again? Are they beginning to return to consciousness? If the patient isn't moving or breathing normally, and isn't responsive to your taps and shouts, go right into CPR and retrieve or find an AED. If the patient is beginning to breathe normally again, does the breathing appear to be agonal respirations or more corrective breathing? To help keep the patient's airway open and clear, put them into the following recovery position. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #2: A person who has just experienced a seizure – essentially an electrical storm in the brain – will be low on oxygen. As a result, they may be confused or combative and this will likely last a few minutes. While waiting for EMS to arrive, continue to assess the patient for breathing and recovery signs, like talking. Any signs that the patient is becoming more responsive are good signs. If the patient begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive. A Word About Pediatric Seizures A seizure is a disorder in the brain's electrical system, which is sometimes marked by loss of consciousness and often by uncontrollable muscle movement, also referred to as convulsions. In children, febrile seizures are the most common type of seizure. These seizures occur with a rapidly-rising or excessively-high fever, typically higher than 102° F. Children with febrile seizures may exhibit some or all of the following signs and symptoms: Sudden rise in body temperature Jerking of the head and limbs Loss of bladder or bowel control Confusion Drowsiness Crying out Becoming rigid Holding the breath Rolling the eyes upward To assess what type of seizure the child has had and why, it's important to ask good questions: Has the child ever had seizures before? If so, is the child on medications for them? If not, is there a family history of seizures? Does the child have diabetes? If so, what type of insulin/medication is being used and when was the last time it was given? Has the child started taking any new medications lately? If the child takes medications, is it possible there may have been an overdose? Could the child have taken someone else's medication by accident? Could the child have ingested anything poisonous? Has the child had a recent injury, particularly a head trauma? Has the child seemed sick or had a high fever, stiff neck, or headaches? What did the seizure look like? Did it involve the child's whole body, or only one half of the body? Did it start in one area and progress to the rest? Did the child fall when the seizure began and if so, was it possible the child's head struck an object or the floor? These are just some of the questions you can use to help decipher what type of seizure the child had and why. https://d3imrogdy81qei.cloudfront.net/video_images/3761/seizure-2015.jpg Yes 246 https://www.procpr.org/training/adult-cpr-first-aid/video/heat-cold-emergencies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2064.mp4 Heat-Related Emergencies As you know, the human body runs at an internal temperature of 98.6 degrees Fahrenheit, or 37 degrees Celsius. The control center responsible for regulating this internal temperature is located in the brain, and more specifically, the hypothalamus. The hypothalamus receives information and adjusts body functions to maintain this optimal temperature. The temperature range – that which allows cells to stay alive and healthy – is actually quite narrow, at between 97.8 degrees and 99 degrees. Let's quickly look at the process of how the body cools down on its own. The hypothalamus detects a rise in blood temperature. Blood vessels close to the surface of the skin begin to dilate. This brings more blood to the surface and allows heat to escape. At the end of this lesson, we'll get into the five general ways in which the body can be cooled externally, along with several types of heat-related conditions to watch out for. How to Treat for a Heat-Related Emergency Heat-related emergencies typically occur in hot environments and when the patient hasn't been rehydrating enough to compensate for water loss. Common symptoms of a heat-related emergency include: Profuse sweating Dizziness Extreme thirst Cramping, usually in arms or legs Warning: Losing fluids can be very serious. In the absence of proper medical treatment, if the condition cannot be reversed, it will likely progress to the next level which is heatstroke. Pro Tip #1: If the patient suddenly goes from wet to dry and stops sweating, it's because the patient's body doesn't have enough fluids to lose. This is a good indication that the warning above is now likely a reality, making the situation that much more serious. Your number one goal when dealing with a heat-related emergency is to cool the patient down any way you can. Ideally, the patient is able to get some fluids down. But if for some reason they aren't able to drink or swallow or can't hold fluids down, you'll need to cool them off externally. Find a water source and some containers or a hose and begin pouring water over the victim, including their clothing, to help bring their core temperature down to a safe level. Another great aid in these situations is the cold pack. If you have some available, try placing them under the patient's armpits, the back of the neck, or forehead. Pro Tip #2: The key to successfully treating someone who is having a heat-related emergency begins by recognizing that emergency. Time is crucial. Once you've diagnosed the problem, the next step is reversing the condition by cooling them down. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally, call 911 immediately and activate EMS. Then begin CPR. A Word About Heat-Related Emergencies There are several types of heat-related conditions to be aware of, but let's first look at the general ways in which the body can be cooled. Radiation Radiation involves the transfer of heat from one object to another, though without physical contact. The human body also loses heat due to radiation, mostly through the head, feet, and hands. Convection Convection occurs when cold air moves over the skin and carries heat away. The faster the flow of air, the faster the body will be cooled. Convection is why warm skin feels cooler in a breeze. Convection also assists in the evaporation process. Conduction Conduction occurs when the body is in direct contact with something that is cooler than the body's temperature. Conduction allows the body's heat to transfer to the cooler object. Think about swimming in a cold lake or leaning against a cool slab of stone. Evaporation Evaporation is the process by which a liquid or solid becomes a vapor. When body heat causes one to perspire and the perspiration evaporates, the heat that was absorbed into the sweat dissipates into the air which cools off the skin. Respiration The last way in which the body can cool itself is through respiration. Before air is exhaled, it's warmed by the lungs and airway. Respiration accounts for around 10 to 20 percent of heat loss. There are several types of heat-related illnesses (hyperthermia) to be aware of, including dehydration, exercise-associated muscle cramps, exertional heat exhaustion, and heatstroke. Dehydration Dehydration occurs when there is an inadequate supply of water in the body's tissues. Dehydration can be serious and life-threatening, particularly for the very young and very old. Symptoms, which include fatigue, headaches, irritability, nausea, and dizziness, will worsen as the body continues to lose water. Exercise-Associated Muscle Cramps Muscle cramps are thought to occur due to a combination of fluid and electrolyte loss through sweating. Muscle cramps typically come on quickly and after rigorous work or exercise and are particularly more common in warmer environments. Exertional Heat Exhaustion Exertional Heat Exhaustion occurs when the body loses more fluids than are replenished. As this happens, the body will divert blood from the surface of the body to vital organs like the heart and brain. This type of heat-related illness is usually the result of intense physical activities and often in hot and humid climates – athletes, firefighters, construction workers, etc. Heatstroke Heatstroke is the most serious type of heat-related illness and can be life-threatening if quick action isn't taken. As there is a progressive nature to these conditions, ignoring the warning signs of exertional heat exhaustion can quickly lead to a body that will become overwhelmed by heat and begin to stop functioning. https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/training/adult-cpr-first-aid/video/intro-to-profirst-aid-basic https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2105.mp4 ProFirstAid Basic Introduction Welcome to ProFirstAid Basic. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. And at the end, we'll give you a little information on why learning CPR is so important. Your instructor for the duration of your ProFirstAid Basic course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and also a co-founder of ProCPR and ProFirstAid. In other words, you're in good hands. We created ProFirstAid Basic with you in mind. In our busy modern world, it's hard to imagine fitting anything else into our already jam-packed schedules and especially several hours' worth of CPR and first aid training. Since your schedule is already hectic, we created ProFirstAid Basic to be available whenever you are, 24 hours a day, seven days a week. You can squeeze in a quick lesson whenever you have a few minutes to spare, whether it's day or night, weekend or workday. It's there when you need it. Regardless of your occupation, you'll be getting the best training available for adult CPR and first aid; important skills you can use in the workplace and also at home. The list of occupations that can benefit from the ProFirstAid course is long and includes: Construction Workers Manufacturing Forestry Transportation Workplace Emergency Response Team Electricians Security Personnel Adult Foster Care Restaurant Staff Home Health Care Aids Hotel Staff CNAs High School Teachers High School Coaches Others who require Adult CPR (does not work with children or infants) and First Aid to meet OSHA requirements The total course time includes 3 hours and 21 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual here: Student Manual. What You Will Learn in this Course Your ProFirstAid course curriculum is extremely substantial. Some of the important things you'll be learning are: Introductory First Aid Training• The Five Fears of CPR Rescue Heart Attack and Stroke• Stroke• Heart Attacks Cardiac Arrest Training• Adult CPR• Adult AED• Hands-Only CPR Choking Training• Conscious Adult Choking• Unconscious Adult Choking Bleeding Control• Capillary, Venous, Arterial Bleeding Shock Control• Shock• Fainting Ongoing Assessment for Injury and Illness• Mechanism of Injury• Secondary Survey• Musculoskeletal Injuries• Amputation• Head, Neck, and Back Injuries• Seizure• Eye Injuries• Allergic Reactions• Snake Bites• Diabetes Heat and Cold EmergenciesSnow Safety - Prevention, Hypothermia, Frostbite• Heat and Cold Emergencies• Burns Prevention• Car Backing• Child Proofing the Home• Poison Control• Pool Safety• Child Abuse and Neglect Bloodborne Pathogens• Reducing Your Risk• Exposure Incident ProFirstAid Basic is CPR and First aid certification that meets OSHA guidelines for the general workplace. If you are looking to certify in all ages CPR, then a better option would be our ProFirstAid course that cover CPR & First Aid for all ages. If you are currently certified with Red Cross, AHA, National Safety Council, ASHI or Medic First Aid, you are welcome to utilize ProFirstAid.com and receive a new, two-year ProFirstAid Basic certificate. Those of you old enough to remember may recall that McDonald's signs used to include a running total of the number of hamburgers sold until that number outgrew the sign. Nearly 52,000 satisfied professionals just like yourself have completed this ProFirstAid Basic course. And although our numbers aren't growing as quickly as McDonald's, we do sincerely hope that you'll be the next person who has a satisfying experience. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Why Learning High-Quality CPR is Important ProFirstAid Basic is different from the typical CPR and first aid courses. We believe that high-quality CPR training is something everyone should be able to access, for free. So, rather than paying simply to learn CPR, the payment is at the very end, only for those who need a certification card for work. We also believe that the problem with CPR isn't that everyone is doing CPR incorrectly. The bigger problem is that people aren't doing CPR at all. That's why we start with the "why." Why are people afraid to rescue? What happens when CPR doesn't work? These are just a few of the parts of the training that will make even the most seasoned professional walk away from the course learning something new or thinking about CPR differently. Gaining confidence in your skills is a big part of performing high-quality CPR and administering vital first aid. Remembering that as you progress through each lesson will serve you well. Welcome again to ProFirstAid Basic. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3769/intro-to-profirst-aid-basic-2015.jpg Yes 53 https://www.procpr.org/training/adult-cpr-first-aid/video/adult-aed-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2107.mp4 Adult AED If the patient is a witnessed cardiac arrest, first check to assure the scene is safe. Check for patient responsiveness, contact emergency services. Turn on the AED if the patient is not breathing. Attach the AED pads to the patient, and do not touch the patient while the AED analyzes. After a shock is delivered, begin CPR for about 5 cycles or two minutes. The AED will interrupt after two minutes and reanalyze the patient. Continue to follow the AED's instructions until advanced life support arrives. https://d3imrogdy81qei.cloudfront.net/video_images/3773/adult-aed-profa-2015.jpg Yes 214 https://www.procpr.org/training/adult-cpr-first-aid/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/adult-cpr-first-aid/video/unconscious-adult-choking-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2118.mp4 Practice: Unconscious Adult Choking Learn how to give CPR to an adult who is unconscious and choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/training/adult-cpr-first-aid/video/adult-aed-workplace-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2138.mp4 Practice: Adult AED Learn how to give CPR with an AED to an adult who is unconscious and not breathing by watching the procedure performed on a manikin. https://d3imrogdy81qei.cloudfront.net/video_images/3835/adult-aed-workplace-practice-2015.jpg Yes 276 https://www.procpr.org/training/adult-cpr-first-aid/video/adult-cpr-workplace-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2139.mp4 Practice: Adult CPR Learn how to give CPR to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3837/adult-cpr-workplace-practice-2015.jpg Yes 96 https://www.procpr.org/training/adult-cpr-first-aid/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/adult-cpr-first-aid/video/animal-and-human-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2370.mp4 Animal and Human Bites In this lesson, you'll learn what to do when you come across patients who've been bitten by animals and/or humans. There are a few considerations that differentiate animal and human bites. However, for the most part, general first aid care will be the same for both. How to Treat for Animal and Human Bites As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Let's quickly differentiate between minor wounds and serious wounds. A minor wound is defined as bites that caused teeth marks, bruising, or scratching. When you encounter minor wounds, simply wash the area thoroughly with soap and water. For scratches, apply an antibiotic ointment to prevent infection, then cover the area with a clean bandage. A serious bite wound is one in which the skin has been punctured or torn and is bleeding. A victim with an open bite wound must seek advanced treatment from a physician due to the high risk of infection. A serious bite wound can include severe bleeding. Unless the wound is still oozing or spurting blood, wash the area with soap and water, apply sterile dressing, and seek advanced medical treatment. If the wound is still bleeding, apply direct pressure with a clean dry cloth or sterile gauze pad and first stop the bleeding. Apply a bandage once the bleeding has been controlled. If your serious bite wound does include arterial or severe bleeding, apply direct pressure, call 911, and watch for signs of shock. A severe bleeding incident is one in which the wound is spurting or pulsating blood and the bleeding is difficult to control. Special Considerations for Human Bites The most common type of human bite occurs among young children who are curious, angry, or frustrated. Children at day care centers are most at risk for human bite wounds. Most human bite wounds among children are harmless, as more serious child bite wounds are very unusual. The biggest threat when it comes to human bites is infection, as human saliva contains hundreds of species of bacteria. In fact, a bite wound is more likely to become infected if it came from a human versus an animal. Pro Tip #1: For any human bite wounds that break the skin, the patient will need to seek advanced medical care due to the risk of infection. And while highly unlikely, bloodborne pathogens like HIV and hepatitis B or C can be transmitted by human bites. Special Considerations for Animal Bites Most animal bites come from domestic pets like cats and dogs and typically involve young children. The biggest threat with animal bites, even domesticated animals, is the risk of rabies. If the animal bite included the skin being punctured by a non-immunized animal, or from an animal whose immunization status is unknown, the patient will need to be treated by a physician immediately. Pro Tip #2: Most rabies cases involve wild animals, like foxes, raccoons, skunks, and the most common rabies carrier of them all – bats. If you suspect that a patient was bitten by one of the above, keep in mind the need to seek swift medical treatment for rabies. Warning: Tetanus can be a concern in both animal and human bites. If a patient suffered a deep bite wound and he or she hasn't had a tetanus shot in more than five years, a booster shot should be encouraged. When it comes to animal and human bites, just following the general first aid guidelines, particularly for bleeding control and infection control, will encompass the majority of the treatment you provide. A Word About Animal Bites Dog bites are the most common among all types of wild and domestic animals. It's important that when a person is bitten, that they are quickly removed from the situation if possible. It's equally important to do so in a way in which you're not endangering yourself or others. Clean minor wounds with soap and clean water and do your best to control bleeding with major wounds. If the patient is bleeding severely, apply pressure and control it as best you can until advanced medical personnel arrive. Tetanus and rabies immunizations may be necessary, so it's vital that bites from any wild or unknown domestic animals be reported to the local health department or another agency according to local protocols. If the animal is still loose, follow local protocols regarding contacting animal control to capture the animal. Try to obtain and provide a description of the animal and the area in which the animal was last seen. https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/training/adult-cpr-first-aid/video/penetrating-trauma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6490.mp4 Penetrating Trauma In this lesson, we'll go over the treatment options for penetrating injuries like gunshot wounds, knife stabbings, or any other type of similar penetrating trauma. Penetrating injuries can often be life-threatening and will usually require immediate treatment. Knowing how to assess and provide first aid for these injuries can make a critical difference in the outcome of the victim.  In this lesson, we will guide you through the assessment phase and initial treatment of penetrating injuries. Pro Tip #1: Before we begin, it's essential to remember that first aid is not a substitute for professional medical care. In the case of penetrating injuries, it is vital to call emergency services immediately. Your main goal is to provide initial care and support until professional medical help arrives. First Aid Steps for Penetrating Trauma Injuries As always, the first thing you want to do is ensure that the scene is safe. Carefully assess the scene for any ongoing danger and ensure your safety and the safety of others before approaching the injured person. If there is an active threat, prioritize your safety and seek a safe location before providing aid. Your safety and the safety of others is always the most important step. Once you have determined that the scene is safe, follow the steps below. Step 1: Call 911 for help. If you cannot call emergency services yourself, ask someone else at the scene to do this, providing others are in the vicinity, as you may have your hands full with the victim. Step 2: Provide accurate details to emergency services about the situation, including your location and the nature of the injury. Calling for professional medical help is crucial for the injured person's survival. Also, remaining calm, if possible, will help to ensure the proper communication of vital information Step 3: Control the bleeding by applying direct pressure to the wound using a clean cloth, a sterile dressing, or even your gloved hand. Pro Tip #2: It is always recommended that you utilize universal precautions. Use personal protective equipment (PPE) at all times. Protecting yourself should not be overlooked. Step 4: Maintain pressure until medical professionals take over. If the object causing the penetration is still in the wound, don't remove it, as it may be acting as a plug to control the bleeding. If you believe there is a possibility that the penetrating item such as a bullet, knife, or other item may have gone through the body, check to see if there is a wound where the object came out. With bullets especially, the exit wound is usually larger than the entry wound. Pro Tip #3: Controlling the bleeding is of the utmost importance. Apply firm and continuous pressure to the wound. Treating the wound with a dressing and bandage will help the clot to form and stop the bleeding. Step 5: Once the bleeding has been controlled, help the victim get into a comfortable position, preferably lying flat on the ground if possible. Then, cover the injured person with a blanket or any available material to help maintain their body heat. This can reduce the risk of hypothermia, help with the clotting process, and provide comfort to the victim. Step 6: Lastly, provide reassurance. Keep the injured person calm and reassure them that help is on the way. It's important not to lie to them or give them false hope. Minimizing their movement to avoid exacerbating the injury, keeping them calm, and reassuring them that you are taking good care of them can all aid in their recovery. Pro Tip #4: Do not probe or irrigate the wound. Inserting objects into the wound or attempting to clean the wound extensively may cause further damage or introduce infection. It's important to resist the urge to probe or irrigate the wound. Your focus should be on controlling bleeding, keeping them warm, providing comfort and reassurance, and waiting for professional medical help to arrive. Remember, in most cases, maintaining the victim’s airway, breathing, and circulation will be the most important steps in a critical penetrating trauma emergency, as cardiac arrest may become an additional threat. These are the basic steps for providing the initial care for a penetrating injury. Once emergency medical services arrive, they'll take over and provide the appropriate medical treatment. A Word About Cardiac Arrests Associated with Penetrating Traumas According to the American Heart Association, basic and advanced life support for the trauma patient are fundamentally the same as that for the patient with a primary cardiac arrest, with a focus on support of the airway, breathing, and circulation. Cardiopulmonary deterioration associated with trauma has several possible causes including: Hypoxia secondary to respiratory arrest, airway obstruction, large open pneumothorax, tracheobronchial injury, or thoracoabdominal injury Injury to vital structures, such as the heart, aorta, or pulmonary arteries Severe head injury with secondary cardiovascular collapse Underlying medical problems or other conditions that led to the injury, such as sudden cardiac arrest Diminished cardiac output or pulseless arrest from tension pneumothorax or pericardial tamponade Extreme blood loss leading to hypovolemia and diminished delivery of oxygen Even with a rapid and effective out-of-hospital response, victims with out-of-hospital cardiac arrest due to trauma rarely survive. Those patients with the best outcome from trauma arrest generally are young, have treatable penetrating injuries, have received early endotracheal intubation, and undergo prompt transport to a trauma care facility. Remembering your CPR training during a penetrating trauma injury could be vital for whomever you're administering first aid to should they fall victim to a cardiac arrest. It pays to be prepared. https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/training/adult-cpr-first-aid/video/spider-bites-tick-bites-and-scorpion-stings https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6491.mp4 Spider Bites, Tick Bites and Scorpion Stings This first aid lesson is for the treatment of spider bites, tick bites, and scorpion stings. While these encounters can be alarming and sometimes painful, knowing the proper first aid steps can help ensure a swift and effective response and recovery. It's important to keep in mind that millions of people are bitten or stung by spiders, ticks, and scorpions every year in the United States alone, and most of these are harmless. However, in this lesson, we’re going to focus on generalized treatment and what to watch for in more severe cases. Remember that the priority is always safety. Once you and the victim are out of harm's way, see if there is a way to identify what bit or stung you, as this can help identify appropriate treatment if needed. But only do this if it can be done safely. Since all of these bites or stings will have punctured the skin, gently washing with soap and water is always the recommended first step. If you notice any concerning reactions or symptoms, seek medical help immediately. In that case, watch for skin discoloration or blistering, nausea, abdominal pain, difficulty breathing, change in responsiveness, or significant pain. If there are no immediate health concerns, here are the steps to handle these bites or stings. First Aid Steps for Spider Bites If you're in a geographical area where there are venomous spiders, remove yourself from the vicinity to avoid further bites.> It's important to identify the spider responsible for the bite whenever safe and possible. Wash the bite area with mild soap and water. Elevate the bitten extremity and apply a cold compress or an ice pack wrapped in a thin cloth to the bite site. Elevating the bitten extremity will help reduce pain and swelling. Leave the compress or ice pack on the bite site for about 10-15 minutes each hour. Symptoms Associated with Spider Bites Symptoms associated with spider bites can vary from minor to severe. Although extremely rare, death can occur in the most severe cases. Possible symptoms resulting from a spider bite include the following: Itching or rash Pain radiating from the site of the bite Muscle pain or cramping Reddish to purplish color or blister Increased sweating Difficulty breathing Headache Nausea and vomiting Fever Chills Anxiety or restlessness High blood pressure Pro Tip #1: For suspected or confirmed bites from venomous spiders, such as black widows or brown recluse spiders, it's crucial to seek immediate medical attention. Call emergency services or visit the nearest hospital. First Aid Steps for Tick Bites The important thing to remember with tick bites is that the longer the tick is attached, the more likely it is to transmit diseases. So acting quickly is definitely in the victim's best interest. Remove the tick promptly using a pair of fine-tipped tweezers. Grasp the tick as close to the skin's surface as possible. Pull the tick away from the skin steadily and slowly with firmness, and try to avoid twisting or crushing the tick during this process. The skin will tent, and the tick will eventually let go. Clean the area with mild soap and water. Pro Tip #2: If you're concerned about tick-borne diseases, you can preserve the tick in a sealed container or a plastic bag. This may assist healthcare professionals in identifying the tick and determining the risk of disease transmission. Please note that if the head comes off and stays embedded in the skin, call emergency services or visit the nearest hospital. A Word of Caution Avoid folklore such as painting the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible – not waiting for it to detach. If you develop a rash or fever within several days to weeks after removing a tick, see your doctor. Tick Bite Bot: An Interactive Tool for Dealing with Tick Bites The CDC has an interactive tool that can assist you in the removal of attached ticks and also advise you on when to seek medical attention. This online mobile-friendly tool asks a series of questions covering topics such as tick attachment time and symptoms. Based on the user's responses, the tool will then provide information on first-aid treatment options. First Aid Steps for Scorpion Stings Like with spider bites, remember to first remove yourself from the area to prevent further stings. Clean the sting site with mild soap and water. Apply a cold compress or an ice pack wrapped in a cloth to the sting site to help with the pain. Pro Tip #3: While most scorpion stings are harmless, seeking medical attention is essential to be safe, as venomous species can be fatal to humans. Call emergency services or visit the nearest hospital immediately. When it comes to scorpions, prevention is key. Be proactive and take precautions by checking your clothing and inside your shoes before putting them on wherever these creatures are common. And remember that if you are stung, stay calm and follow the steps above. And as always, seek professional medical help whenever necessary. Symptoms Associated with Scorpion Stings Symptoms usually subside within 48 hours, although stings from a bark scorpion can be life-threatening. Symptoms of a scorpion sting may include: A stinging or burning sensation at the injection site Extreme pain when the sting site is tapped with a finger Restlessness Convulsions Roving eyes Staggering gait Thick tongue sensation Slurred speech Drooling Muscle twitches Abdominal pain and cramps Respiratory depression https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/training/adult-cpr-first-aid/video/treating-ear-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6488.mp4 Ear Injuries In this lesson, we'll take a look at both external and internal ear injuries and how to apply first-aid treatment for both. Ear injuries can occur due to various causes, such as trauma, loud noises, or foreign objects that have been accidentally or purposely inserted into the ear. Knowing how to assess and provide initial first aid treatment for any ear injury is essential to minimize discomfort and prevent further complications. This lesson will guide you through the assessment and first aid treatment options for some of the more common ear injuries. Pro Tip #1: Before we begin, it's important to note that ear injuries can range from minor to severe. In cases of severe ear injury or if the injury involves hearing loss, it's crucial to seek medical assistance. Therefore, assessment of the ear injury is vital. Having said that, even in the event of a severe ear injury, you should still provide first aid to alleviate discomfort. Now let's take a look at how to assess and provide first-aid treatment for an ear injury. First Aid Treatment for External Ear Injuries Inspect the external ear for any visible injuries, cuts, or bleeding. If there is bleeding, apply gentle pressure with a clean cloth or sterile gauze to control it. Maintain pressure until the bleeding stops. Do not insert any objects into the ear canal, and do not attempt to clean the ear extensively. If there are signs of infection, such as redness, swelling, or discharge, seek medical attention. First Aid Treatment for Foreign Objects in the Ear If a foreign object - such as a small toy or insect – is visible and can be easily removed without pushing it in further, use clean tweezers or your fingers to fish it out. However, remember to use EXTREME caution and try to remove it gently. Avoid using sharp objects or excessive force, as this may cause injury or push the object deeper into the ear potentially causing permanent hearing loss. If the object cannot be easily removed, or if moving the object causes pain, discomfort, or bleeding, be sure to stop and seek medical attention. First Aid Treatment for Bleeding from in the Ear Foreign bodies or significant head trauma can lead to bleeding from the ear canal. For this type of bleeding injury, it is best to quickly seek medical attention. As for the bleeding, loosely apply a dressing or other clean materials to the outside of the ear and track how much blood came out, such as how many gauze pads or towels were used. Pro Tip #2: If you try to apply direct pressure, this could cause a build-up of pressure in the ear and cause an increase in pain or lead to other complications. Monitoring the victim and asking how they are doing will help determine if the pain is suddenly getting worse. If it is, it might be caused by this direct pressure. Remember, while these first aid measures can provide initial relief, seeking professional medical care for significant ear injuries, severe pain, changes in hearing, or especially head trauma that causes bleeding from the ear is essential. A Word About Basilar Skull Fractures Basilar skull fractures are fractures that occur in the base of the skull, which is the area at the bottom of the skull that supports the brain. Symptoms related to the ear that can occur with basilar skull fractures include: Battle's Sign: This refers to bruising behind the ear and is a common sign of basilar skull fracture. It typically appears a few days after the injury and is due to bleeding beneath the skin. Hearing Loss: Basilar skull fractures can affect the structures of the middle and inner ear, leading to conductive or sensorineural hearing loss. Conductive hearing loss occurs when sound waves cannot reach the inner ear due to damage to the ear canal, eardrum, or middle ear bones. Sensorineural hearing loss occurs due to damage to the inner ear or auditory nerve. Tinnitus: Ringing or buzzing in the ear (tinnitus) can occur as a result of the injury to the inner ear structures. Ear Bleeding: Bleeding from the ear canal (otorrhagia) can occur if the fracture involves damage to the temporal bone or surrounding structures. Dizziness and Vertigo: Damage to the inner ear or vestibular system can cause dizziness, vertigo (the sensation of spinning), and imbalance. Facial Nerve Dysfunction: Fractures involving the temporal bone can affect the facial nerve (cranial nerve VII), leading to facial weakness or paralysis on the affected side. CSF Leak: In severe cases of basilar skull fracture, cerebrospinal fluid (CSF) can leak from the nose or ear (otorrhea). This can be a serious complication requiring medical attention. https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/training/adult-cpr-first-aid/video/diabetes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2100.mp4 Diabetes In this lesson, you'll learn how to treat a patient with a blood sugar emergency. Some things to keep in mind about blood sugar problems: Signs and symptoms are the same for low blood sugar and high blood sugar Blood sugar issues will get worse without treatment Without treatment, a patient could become unresponsive and die The three most common signs and symptoms of someone experiencing a blood sugar issue are: Confusion Coordination issues Talking nonsense A person with a blood sugar issue might also randomly fidget with something and appear quite out of it. Pro Tip #1: Even though the signs of high blood sugar are the same as those for low blood sugar, in patients suffering from high blood sugar, those symptoms will come on much more slowly and will likely be less intense. How to Treat a Blood Sugar Event As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: When a patient has high blood sugar, the body will try to rid itself of it through urination, and failing that, through hyperventilation. Which is why, in patients with high blood sugar, you'll often notice a hint of fruit or cheap wine on their breath. The reason for this is called ketoacidosis – a byproduct of unused sugars in the body that become toxic. Pro Tip #3: If a patient is showing signs of a blood sugar issue, rule it out using sugar – either over-the-counter products like soda or professional glucose products specifically for diabetic events. Follow the pro tip above as long as the patient is coherent enough to follow commands and isn't getting agitated or aggressive. Then begin encouraging the consumption of sugar or glucose. Warning: A patient can only consume a glucose or sugar product if they are able to swallow safely. If their sugar event has escalated to the point where they cannot control their swallow reflex, it's too late. Sugar will need to be administered through an IV or by intermuscular injection. If the patient did have low blood sugar, you should notice improvements in 10 to 15 minutes. If the symptoms aren't improving after 15 minutes, there could be something else going on; call 911 and activate EMS. Professional glucose products like tabs and gels are your best bet, as they're designed for quick absorption. They're also encased in more stable packaging, meaning they can withstand freezing temperatures and other environmental threats. If you don't have any glucose products available, a full-sugar soda is your best option. Candy bars aren't a bad option either. However, more fibrous snacks will take too long to be absorbed by the body. Pro Tip #4: Most patients with sugar problems will know the dosage of sugar or glucose they need in emergencies like this. Read labels on the packaging and multiply or divide as needed to get the proper dosage. Keep in mind that high fructose corn syrup burns much more quickly compared to the longer-acting dextrose you'll find in many glucose products. If this was the patient's first sugar event, follow up with EMS to make sure they get the help they need moving forward. If this wasn't the patient's first sugar event, and they can explain what likely caused it, help them get back on their plan to avoid it happening again. And encourage them to check-in with their physician to make sure everything is all right. A Word About Diabetic Emergencies Diabetes mellitus is one of the leading causes of death and disability in the U.S. In 2016, 29 million Americans had diabetes, while another 86 million had prediabetes – a condition that increases your risk for developing type 2 diabetes and other chronic diseases like kidney disease, heart disease, gum disease, stroke, and amputations. The Two Types of Diabetes Type 1 Diabetes – Also known as juvenile diabetes or insulin-dependent diabetes, this condition results in a body that produces little to no insulin. Which is why most people who have type 1 diabetes inject themselves with insulin daily. Type 2 Diabetes – More common than type 1 diabetes, type 2 is characterized by a body that produces insulin, but either the cells can't use it effectively or not enough is being produced. People with type 2 diabetes can often improve their symptoms and regulate their blood glucose levels with dietary changes and sometimes medications. High Blood Glucose High blood glucose, or hyperglycemia, is when the body's insulin level is too low, and the sugar level is too high. However, the body cannot transport that sugar into the cells without insulin. Which results in a body that's about to have an energy crisis. The body then attempts to meet its need for energy by using other stored food and energy sources, such as fats. However, converting fat to energy is less efficient, produces waste products, and increases the acidity level in the blood, causing a condition known as diabetic ketoacidosis (DKA), which could ultimately result in a diabetic coma. Low Blood Glucose The exact inverse of the above – Low blood glucose, or hypoglycemia, occurs when the body's insulin level is too high, and the sugar level is too low. This can happen for a number of reasons, including when the patient: Takes too much insulin Fails to eat adequately Over-exercises and burns off sugar faster than normal Experiences great emotional stress Regardless of whether you're dealing with a patient who has type 1 diabetes or type 2 diabetes, the signs and symptoms are the same: Dizziness, drowsiness, or confusion Irregular breathing Abnormally weak or rapid pulse Feeling and looking ill Abnormal skin characteristics https://d3imrogdy81qei.cloudfront.net/video_images/3759/diabetes-2015.jpg Yes 500 https://www.procpr.org/training/adult-cpr-first-aid/video/bleeding-control-venous-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2095.mp4 Venous Bleeding Uncontrolled bleeding is the number one cause of preventable deaths due to a trauma. While venous bleeding is usually less serious than arterial bleeding, it still can pose a serious health risk to the victim. Venous bleeding can be the result of external trauma, as in something cutting or puncturing a vein, or internal trauma, due to a broken bone or organ damage. Venous bleeding involves blood that is returning to the heart, so there won't be as much pressure as arterial bleeding. However, the blood loss can still be severe. Venous bleeding distinctions are: The blood is dark red, not bright like arterial bleeding The blood flow is steady but not spurting; it can still be quick, though The pressure is lower than arterial bleeding so it's usually easier to control How to Provide Care A person who is the victim of venous bleeding will likely be applying pressure to the wound or cut by the time you arrive to help. Some things to keep in mind with venous bleeding are: It will often stop on its own in 4-6 minutes It's usually easy to control with direct pressure What may seem like a lot of blood is likely to just be smeared, dripping blood which often looks like more than it really is As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. Find the source of the bleeding and ask the victim if he or she is cut anywhere else to make sure you're not missing another wound. Place a dressing pad or cloth over the wound. Apply pressure. At this point, the one dressing pad will usually be enough to control venous bleeding. However, you may also want to consider assessing the severity of the cut. Pro Tip 1: When you remove pressure, do the folds of skin around the cut begin to come apart, or does the skin appear to be staying together. If the skin is coming apart, stitches are likely necessary. If not, the wound will probably heal on its own and stitches can be avoided. As can a trip to the emergency room. If a trip to the emergency room is warranted but EMS services are not, it's still a good idea to have someone else drive the victim. There may be a chance that the victim has difficulty seeing his or her own blood, which could cause psychogenic shock. It's always better if the victim is a passenger rather than the driver. Before you wrap the wound, make sure it's properly cleaned using a bacterial ointment if you have one. This will combat any bacteria that may have gotten into the cut and reduce the chances of infection. Pro Tip 2: Consider the chances of tetanus. If the victim was cut by something dirty and hasn't had a tetanus shot in the last 10 years, a trip to the emergency room is a necessity regardless of the severity of the wound. After cleaning the wound, reapply a dressing pad that completely covers the area. Wait and see if the bleeding stops or if it leaks through. Most venous cuts will stop after applying the first pad. Warning: There are reasons why venous bleeding cannot be easily controlled and these include: the victim has a bleeding disorder or is on blood thinners. Make sure to ask the victim if it appears that the bleeding is difficult to stop. It's now time to wrap the wound, and taping the pad is usually sufficient. Just be aware to maintain constant pressure while you tape. And as before with arterial bleeding, pinch the finger or toe nails if the extremities are involved and see if blood returns to the nails. You don't want to cut off blood supply. Your goals in tapping or bandaging the wound are: Maintain pressure and control bleeding Cover completely so dirt and debris cannot get inside the cut At this point it's always a good idea to make sure the patient is stable and not in shock. If their skin has good color and isn't cold or clammy, and if they haven't lost consciousness, EMS probably will not be needed. A Word About Disease Transmission To reduce your risk of disease transmission, there are a few guidelines to keep in mind: Avoid contact with the victim's blood by wearing latex-free gloves and protective eyewear if you have them. Avoid touching your mouth, nose, and eyes while providing care, and don't drink or eat anything before washing your hands. Wash your hands thoroughly after providing care, even if you wore gloves. Always dispose of the gloves or change gloves before helping someone else. As venous bleeding is often not a severe injury, it's still important to remember that it still has the potential to become a serious situation, especially if bleeding cannot be controlled or the victim goes into shock. When in doubt, it's best to call 911 and let the EMS professionals handle the situation. https://d3imrogdy81qei.cloudfront.net/video_images/3749/bleeding-control-venous-bleeding-2015.jpg Yes 214 https://www.procpr.org/training/adult-cpr-first-aid/video/adult-cpr-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2106.mp4 Adult CPR Adult CPR is performed by first contacting emergency services. Next, if the patient is not breathing, begin chest compressions followed by two rescue breaths. Perform 30 compressions at a rate of 100-120 per minute and a depth of 2-2.4 inches in the center of the chest. These 30 compressions should be followed by two rescue breaths, and repeat the cycle until an AED or emergency services arrives. https://d3imrogdy81qei.cloudfront.net/video_images/3771/adult-cpr-profa-2015.jpg Yes 158 https://www.procpr.org/training/adult-cpr-first-aid/video/concussion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2038.mp4 Concussion This lesson is for those times when a head injury may have led to one of the more common and serious injuries – concussions. Pro Tip #1: Concussions occur as the brain moves abruptly from side to side inside the skull, essentially bouncing off the walls that protect it. In serious concussion cases, the brain can shut down immediately, causing the victim to lose consciousness. Even in situations that don't involve a loss of consciousness, a person who exhibits other concussion signs and symptoms are at least mildly concussed. Part of your job is to determine if the victim is concussed and how severe it is by reading the signs and asking open-ended questions. Warning: The most important thing to keep in mind as you deal with someone who has sustained a head injury, as soon as it appears to be a concussion, that deserves an immediate 911 call. Even if the patient begins to recover, concussions are too traumatic and can develop into something more life-threatening. How to Assess and Treat a Concussion As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "Do you know if you hit your head?" If you suspect a head injury, ask questions about headaches, blurred vision, nausea, while also looking over the victim for concussion symptoms including: Eye-tracking – can they follow your finger Blurred vision, which indicates swelling in the brain Dizziness, loss of balance Nausea, vomiting Loss of memory Dazed and confused If the victim exhibits any of these symptoms, it's best to call 911 immediately. If they don't, continue assessing them. "Do you know what day it is?" "Do you know what year it is?" If the victim answers those two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. Which as you know by now, deserves a 911 call. Pro Tip #2: When it comes to head injuries, it's better to be safe than sorry. Get the patient to the ER whenever in any doubt and get them properly examined. Always err on the side of patient welfare. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. In concussion cases, the patient will likely require a 24-hour observation period to make sure that symptoms and swelling in the brain are reduced, which is the norm. However, these issues and symptoms can also worsen. A Word About Injuries to the Head The problem is that the head lacks the padding often present in other areas of the body. Which means it can easily be injured. And that injury can easily be considered serious. There are two main types of head injuries – open and closed. An open head injury is one that breaks or penetrates the skull. Excessive bleeding can occur and controlling that bleeding will be vital for a positive outcome. The other type is a closed head injury. Closed head injuries occur when the brain strikes against the inside of the skull and when the skull remains intact. These injuries are much more difficult to detect as there is a decided lack of visible clues. The four subtypes of head injuries are: Concussion Skull fractures Penetrating wounds Scalp injuries Let's take a deeper look into the physical, emotional, and behavioral signs and symptoms of a concussion. Physical symptoms include: Headache Blurry vision Nausea or vomiting Dizziness Sensitivity to noise or light Balance problems Feeling sluggish Emotional symptoms include: Irritability Sadness Heightened emotions Nervousness or anxiety Behavioral symptoms include: Sleeping more or less than usual Difficulty falling asleep Changes in playing habits for kids Changes in eating habits Thinking and remembering skills may also be impacted and include the following symptoms: Difficulty thinking clearly Difficulty remembering events that occurred just prior to the incident and just after the incident Difficulty remembering new information Difficulty concentrating Feeling mentally foggy Difficulty processing information https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/training/adult-cpr-first-aid/video/nosebleeds https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6487.mp4 Nosebleeds In this lesson, we're going to cover nosebleeds and how to apply first aid in the event you or someone you know gets one. Nosebleeds, also known medically as epistaxis, can catch us off guard and happen when we least expect them. However, they’re often quite harmless and can usually be managed easily. Each year, around 60 million people get nosebleeds in the United States alone. They are most likely to occur in the winter when cold weather and indoor heating dry the nasal passages. Most nosebleeds are minor and the bleeding will often stop on its own, but some people may require medical attention. This lesson will teach you the proper way to handle them. But before we proceed, bear in mind that while most nosebleeds are benign, there are exceptions. Pro Tip #1: If a nosebleed is intense, continues for over 20 minutes, or pairs with other symptoms, one should seek immediate medical help. It's important to note that if someone is on prescription blood thinners, their risk of a continued hemorrhage increases significantly, as these medications can intensify bleeding and challenge the standard control techniques. It's important and recommended that these patients seek further medical attention. First Aid Steps for Nosebleeds While nosebleeds are usually nothing to worry about, the presence of blood can make people feel anxious or queasy, particularly if it is their own blood. Reassure the affected person and urge them to stay calm. Ask the nosebleed victim to sit down and lean forward slightly, as this helps keep the blood from trickling down the back of the throat. Once you have your safety gloves on, or if the individual can do it themselves, pinch the soft section of the affected person's nostrils just past the nasal bone. Hold this pinch for about 10-15 minutes without releasing any of the pressure. This simple act applies pressure on the blood vessels of the nose and helps facilitate clotting. If the victim has any blood pooling in their mouth or throat, instruct them to carefully spit it out rather than swallow it. It is important to contain the blood spray or splatter through this process, which can be associated with sneezing, coughing, spitting, or speaking. Pro Tip #2: A backward tilt could lead to potential complications like aspiration or ingestion and vomiting. So step two is more vital than it may sound. Eye protection along with a face shield may be necessary - in addition to gloves – to fully protect the care provider appropriately. If no PPE (Personal Protective Equipment) is available, be sure to stand next to the patient, rather than in front of their face, as this may help protect you. Pro Tip #3: It's important to note that while a cold compress can help constrict blood vessels, cold blood does not clot swiftly. If you choose to use an ice pack, it is suggested to be placed on the bridge of the nose or the rear of the neck. Once the victim's nose stops bleeding, encourage the patient to resist the urge to blow their nose, as this can dislodge the clot and cause the nose to begin bleeding again. One common misconception is to pack the nose with gauze or tissue. This should be avoided in a first-aid scenario. And remember, only a physician should decide on medical nose packing. Also, for those patients who may be on blood thinners, the pressure might need to be maintained longer, and a physician's intervention may be required. Utilizing these first-aid methods, most nosebleeds can be managed easily. But remember, persistent bleeding, recurring episodes, or additional symptoms or complications may warrant prompt medical attention via a 911 emergency services phone call. A Word About Applying Pressure to a Stubborn Nosebleed The two most important factors when successfully controlling a nosebleed are: The amount of pressure applied. The amount of time the pressure is maintained. Remember that the pressure must be firm, and it must be maintained for a long time. Methods of applying pressure include pinching the nose with your fingers or using gauze or cloth placed over the nose and then pinching. If bleeding continues, try adjusting where you are pinching the nose or adjusting the pressure with which you are pinching the nose. About Hereditary Hemorrhagic Telangiectasia HHT is a genetic disorder in which blood vessels do not develop normally leading to bleeding that can be serious or life-threatening. A person with HHT may form abnormal capillaries or abnormal capillary connections between the arteries and veins. Capillaries are tiny blood vessels that pass blood from arteries to veins. The abnormal blood vessels formed in HHT are often fragile and can burst, which then causes bleeding. Men, women, and children from all racial and ethnic groups can be affected by HHT and experience the problems associated with this disorder, some of which are serious and potentially life-threatening. Nosebleeds are the most common sign of HHT, resulting from small abnormal blood vessels within the inside layer of the nose. While rare, it's important to understand that sometimes a nosebleed is a sign of a greater underlying problem. https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/training/adult-cpr-first-aid/video/fainting https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2056.mp4 Fainting This lesson focuses on what to do when you come upon a patient who has just fainted. Fainting is defined as a temporary loss of consciousness that's usually related to temporary insufficient blood flow to the brain. Fainting is also referred to as syncope, blacking out, or passing out. There are a number of reasons why a person would pass out and many of those are not at all life-threatening. In fact, when someone faints, the biggest concern is usually the victim's inability to protect themselves as they're falling, which can lead to a number of things going wrong – broken bones, head or face injuries, etc. In many fainting situations, there is no one around who witnessed the accident. Which means you may need to put on your detective hat to properly discover potential injuries. How to Assess and Treat a Patient who Faints As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #1: The first thing you'll want to do is to assess for life-threatening conditions, including head and neck injuries. After ruling out more serious conditions, begin to see if the patient has a simple problem, like low blood sugar or dehydration that contributed to his or her passing out. When you come upon a fainting victim, as long as there is nothing more serious going on, they will likely be awake and responsive. They may be sitting up already or are ready to sit up with your help. At this point you'll want to interview the patient to see what's going on. "Can you tell me what happened here today?" "Do you hurt anywhere?" It's common for fainting victims to be weak and dizzy afterward. The important thing is that the patient is awake and responsive enough to answer your questions. However, continue to monitor for: Airway issues Breathing problems Weak or rapid pulse Pale, clammy skin Pale and clammy skin are signs of shock. If you determine the patient to be in shock, that warrants an immediate 911 call and activation of EMS. As always, err on the side of patient welfare. Pro Tip #2: Just because the situation doesn't appear serious doesn't mean it can't suddenly become serious. If you don't have an AED already, it's a good idea to send someone at the scene to go find one. If, for instance, the fainting was caused by a serious heart dysrhythmia, an AED could be lifesaving. It's typical for fainting victims to begin to recover under their own powers. As they are coming around, gauge their mental alertness, ask again about the presence of pain, and of course, continue to assess for signs of something more serious: Decreased level of consciousness Airway, breathing, or circulation problems Signs of shock Long-bone fractures Varying degrees of responsiveness If you, at any point, notice any of the above, call 911 and activate EMS or call in a code if you're in a healthcare setting. Then treat the patient accordingly. A Word About Syncope and Presyncope Syncope, or fainting, is caused due to a temporary reduction in blood flow to the brain. Depriving the brain of its normal blood flow can cause it to momentarily shut down. When this happens, it triggers a fainting episode or syncope. But what specifically triggers fainting? There are a number of things that trigger it, including: Emotional shock Pain Certain medical conditions Overexertion In pregnant women and older people – getting up from a seated or lying position Syncope can occur without warning. Or there could be some early signs, such as dizziness, the feeling of being lightheaded, or feeling like your about to faint. Together, these symptoms have a name – presyncope. How to Prevent Someone in Presyncope from Fainting Help the patient lay down. Continue to monitor the patient's breathing and level of consciousness. Instruct and help the patient perform physical counter-pressure maneuvers (PCM). Three Examples of Physical Counter-Pressure Maneuvers Have the patient grip one hand at the fingers with the other and try to pull them apart without letting go. They should hold the grip for as long as they can or until their symptoms disappear. Have the patient hold a rubber ball or similar object in their dominant hand and then squeeze the object for as long as they can or until their symptoms disappear. Have the patient cross one leg over the other and squeeze them together tightly. Have them hold this position for as long as they can or until their symptoms disappear. Physical counter-pressure maneuvers help raise the patient's blood pressure through skeletal muscle contraction and, in many cases, will resolve symptoms of faintness. Let the patient know to avoid holding their breath while performing the maneuvers. An easy way to avoid this is to engage the patient and keep him or her talking. https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/training/adult-cpr-first-aid/video/dental-and-oral-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6489.mp4 Dental and Oral Injuries In this lesson, we'll take a look at dental and oral injuries and how you can apply first aid to treat them. Dental and oral injuries, such as tooth, tongue, or lip injuries, can occur unexpectedly and may require immediate first aid. Knowing how to assess and provide initial treatment can help alleviate pain and prevent further complications. This lesson will guide you through the assessment phase and first aid treatment options for some of the more common dental and oral injuries. Pro Tip: Before we begin, it is really important to remember that dental and oral injuries can vary in severity. For more severe injuries, seeking prompt dental or medical assistance is crucial. However, in minor cases, you can provide initial first aid to alleviate discomfort and help the healing process. First Aid Treatment for Tooth, Tongue, and Lip Injuries If a permanent tooth is lost, follow the first aid steps below. Try to locate the tooth and handle it only by the crown. Avoid contact with the root – the part that is hidden in the gums - as touching this could damage the tooth. If the tooth is dirty, gently and quickly rinse the tooth with water. Do not scrub or remove any tissue fragments. Gently reposition the tooth back into its socket and have the patient bite on a clean cloth, such as a piece of gauze, to hold it in place. If the first option is not possible, place it in a suitable storage medium, such as milk, saliva, or a tooth preservation kit, and seek dental care immediately, as the chance of saving a knocked-out tooth decreases with time. Additionally, according to the latest guidelines of the International Association of Dental Traumatology, it is not recommended to replant a primary tooth. It is still advisable to place the tooth in a storage medium and seek further evaluation by a dentist. There are many other dental injuries that could occur, but there is very little we can do about these. The best recommendation is not to move or irritate the area and seek immediate dental care. If there's bleeding from the tongue or lip, have the person rinse their mouth with water to clear any blood. You can gently clean the injured area with a damp cloth or gauze pad to remove debris. This will allow you to assess the extent of the injury. Apply direct pressure to the wound with a clean cloth or sterile gauze to control bleeding. If there is significant bleeding or the wound is deep, seek immediate medical attention since this may lead to breathing problems as blood can make breathing increasingly difficult. It may also cause the patient to swallow blood which can quickly lead to nausea and vomiting, further compromising the airway. Encourage the person to avoid hot or spicy foods and to maintain good oral hygiene. Remember, while these first aid measures can provide relief, seeking professional dental or medical care is always essential. A Word About Dental Avulsion Injuries A dental avulsion injury - also known as a knocked-out tooth - can damage both the tooth and the supporting soft tissue and bone, resulting in the permanent loss of the tooth. Dental avulsion is relatively uncommon compared to other dental injuries but can occur in various age groups, particularly among children and young adults involved in sports or accidents. It most commonly affects children and adolescents, often due to falls or sports-related injuries. The peak incidence is seen in the 7-14 age group. Studies suggest that dental avulsion accounts for approximately 0.5 to 3 percent of all dental injuries. It tends to affect males more frequently than females, possibly due to higher participation rates in contact sports. Participation in contact sports (e.g., football, hockey, and basketball), inadequate use of mouthguards during sports activities, and accidents (falls and collisions) are significant risk factors. Immediate reimplantation of an avulsed tooth is believed to result in the greatest chance of tooth survival. The longer a tooth is out, the more likely it will be permanently lost. In situations that do not allow for immediate reimplantation of an avulsed tooth, it is beneficial to temporarily store it in a variety of solutions that are shown to prolong the viability of dental cells. If available, place the avulsed tooth in Hanks' Balanced Salt Solution or in another oral rehydration salt solution, or wrap the tooth in cling film to prevent dehydration and improve the likelihood of successful replantation by a dental professional. This should always be done as quickly as possible. If an avulsed permanent tooth cannot be immediately replanted in either Hanks’ Balanced Salt Solution, oral rehydration salt solutions, or cling film, store the tooth in cow’s milk or saliva, as these are your best secondary options. Keeping the tooth "safe" in the saliva inside the person's mouth is also not suggested as the patient will often keep moving the tooth around which can further damage to the roots of the tooth. An avulsed tooth should never be stored in tap water.  The viability of an avulsed tooth stored in any of the above solutions is limited. And reimplantation of the tooth within an hour after avulsion provides the best chance for tooth survival. Following the loss of a permanent tooth, it is essential to seek rapid medical assistance for reimplantation. The long-term success of replantation depends on various factors, including the extra-alveolar time (time the tooth is out of its socket), the storage medium used for transporting the tooth, and the condition of the tooth and surrounding tissues. Complications may include pulp necrosis (death of the tooth's inner tissue), infection, root resorption (breakdown of the tooth root), and periodontal issues. Prevention is often a key to avoiding oral injuries while playing contact sports. The proper use of mouthguards is highly recommended. https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/training/adult-cpr-first-aid/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/adult-cpr-first-aid/video/how-to-use-an-epipen https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2102.mp4 How to Use an EpiPen Epinephrine is the first line of defense when it comes to treating anaphylaxis. And the sooner it's administered, the less severe the allergic reaction. Remember, anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Anaphylaxis can cause the body's blood vessels to suddenly dilate, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen starved. Anaphylactic shock will cause death if not treated. People with a history of allergic reactions should always carry an epinephrine pen. Pens are single dose, pre-filled, automatic injection devices, also known as epi pens. The following instructions are specifically for Epi Pen brand. If you're using a different brand of epi pen, be sure to follow the manufacturer's instructions. How to Use an Epi Pen Pro Tip #1: Any time an epi pen is used, be sure to call 911 and activate EMS. The person, even if feeling better, must seek further medical attention after a severe allergic reaction. Remove the pen's safety cap. Grip the pen in your hand with the tip pointing down. Warning: Never put your thumb, fingers, or hand over the tip of the pen; you may accidentally inject yourself while treating the patient. Firmly push the tip of the pen into the patient's outer thigh at a 90-degree angle and until you hear the pen click. Needles can penetrate clothing. Keep the auto injector firmly pressed against the patient's thigh; hold for 3 seconds. Pull the epi pen straight out. Warning: Make sure you don't pull the pen out at an angle. This can cause a lot of pain and bleeding. And if blood comes out of the leg, there's a good chance the effectiveness of the shot will be reduced. Rub the area for 10 seconds, as this will increase absorption of the epinephrine within the leg muscle. Pro Tip #2: A second epi pen may be used if symptoms persist or recur and if EMS has been delayed for more than 5 to 10 minutes. Usually the patient will notice some airway relief pretty quickly, as the tightness in the throat begins to dissipate. There are, however, some unfortunate side effects that some patient's may experience, including: Rapid heartbeat Shakiness Feelings of anxiety Dizziness Headache Pro Tip #3: Once you administer an epinephrine injection, make note of the time it was delivered and tell EMS when they arrive. A Word About Epinephrine Epinephrine is a drug that slows or stops the effects of anaphylaxis. If a patient is known to have an allergy that could lead to anaphylaxis, they may carry an epinephrine auto-injector (an epi pen) that can deliver a single dose of the drug. Epinephrine devices are available in different doses, as the dose of epinephrine is based on weight – 0.15 mg for children weighing between 33 and 66 pounds, and 0.3 mg for children and adults weighing more than 66 pounds. People with a known history of anaphylaxis would be wise to carry an anaphylaxis kit containing at least two doses of epinephrine with them at all times. Why a second dose? Because more than one dose may be needed to stop a strong anaphylactic reaction. It's important to remember that a second dose is administered only if emergency medical responders are delayed and the patient is still having signs and symptoms of anaphylaxis 5 to 10 minutes after administering the first dose. It's important to act fast when a patient is having an anaphylactic reaction, as difficulty breathing and shock are both life-threatening conditions that could suddenly erupt. If the patient is unable to self-administer the medication, you may need to help them with the epi pen. Only assist if/when: The patient has a previous diagnosis of anaphylaxis and has been prescribed an epinephrine auto-injector The patient is having signs and symptoms of anaphylaxis The patient requests your help using an auto-injector Your state laws permit giving assistance https://d3imrogdy81qei.cloudfront.net/video_images/3763/how-to-use-an-epipen-2015.jpg Yes 140 https://www.procpr.org/training/adult-cpr-first-aid/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/adult-cpr-first-aid/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/adult-cpr-first-aid/video/burns https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7187.mp4 Burns Burns are a complex injury, as there are varying degrees of burns, different sizes, and different locations that can present unique challenges. And there are also different types of burns – thermal, chemical, and electrical. In this lesson, when we talk overall about burns, then how to treat them, starting with thermal burns. Then, we'll discuss some information on chemical and electrical burns. How to Assess and Treat a Burn Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first thing you want to do is assess how bad the burn is. To determine the degree of burn, look for the following signs: 1st degree (superficial) – usually presents itself as a pink outer ring; characterized by redness and pain 2nd degree (partial-thickness) – will present itself with blistering skin and is usually very painful 3rd degree (full-thickness) – dark, charred areas; can include life-threatening complications Warning:  The following burns should be seen immediately at a hospital for treatment: Large 2nd burns that involve the face, hands, feet, or genitalia All 3rd degree burns Any burn that has concern for inhalation injury (soot around the nose or mouth, difficulty breathing)  The concerning part about burns is that you may not see the full extent or concern of the injury until hours later. After the burning process has ended, the injured skin starts the healing process. This involves the moving of fluid to the injured area causing swelling, pain, dehydration/shock and other potentially life threatening conditions. Minor seeming injuries may be far more serious if not evaluated or treated by professionals. Sequence of Treatment for Burn Victims Remove the body from the burn. This can mean a few different things – like the presence of smoldering clothing or a victim who's laying in burning embers. Cool the burn. Pour cool clean water over the burn for five to 20 minutes. Your goal is to remove residual heat from the burned tissue. This will stop the burning process. Even room temperature water is appropriate as that is still over 20 degrees cooler than normal body temperature and can remove heat from the skin. Apply loose, dry, sterile dressing over the wound. Begin wrapping above the burn and wrap particularly lightly over the burn. During 3rd degree burns, the nerve endings become damaged, so there is less pain. However, 1st and 2nd degree burns can be quite painful. Pro Tip #1:Observe the patient for signs of shock or dizziness. If they are losing their balance, help them into a seated or lying position, whichever is more comfortable. At the first sign of shock, call 911 and activate EMS immediately. Look for inhalation burns. Is the victim wheezing? Is there some swelling or burns around the face? Have the eyebrows been burned? Is there soot on the inside of the victim's mouth or nose? All of these could signal possible future complications in the form of respiratory issues. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock Pro Tip #2: Skin is the major organ that controls your body temperature. If we damage it from a burn, then pour cold or cool water over the body (burned area), the victim could become cold and start to shiver, hypothermia has now set in. Once the burn is cooled, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. Chemical Burns You're likely going to encounter two types of chemical burns – those from dry chemicals and those from wet. When you're dealing with dry chemicals, you first want to brush off as much of the loose, dry chemical as you safely can. Safety is key. You don't want to become the next victim. After brushing off the loose chemical, rinse the burn for a minimum of 15 minutes, again using cool clean water. When dealing with wet chemicals, go right into rinsing them off using cool, clean water. Pro Tip #3: Dilution is the solution to pollution. When dealing with chemical burns, rinsing them off with cool, clean water will have a weakening effect, as the chemicals are diluted again and again with every dousing of clean water. Electrical Burns Electrical burn situations require an extra level of safety. Before anything, make sure the energy source has been removed before coming into contact with the patient. This could mean removing the patient from the energy source, cutting the power, or something else. You cannot risk becoming another patient at the scene. Pro Tip #4: There is a significant difference between electrical entry burn wounds and electrical exit burn wounds. Entry wounds look like typical thermal burns. But exit wounds may look more like shotgun exit wounds – huge, explosive, and damaging. Manage the entry wound the same as you would a thermal burn. Manage the exit wound as the situation requires, which will likely include treatment options for tissue damage and excessive bleeding. Warning: As electricity travels through the body it can affect the conductivity of the heart, which could potentially damage the conduction points in the heart and contribute to secondary cardiac issues. With electrical burns, monitoring for heart dysrhythmias for 24 to 72 hours in hospital might be necessary. A Word About Burn Victim Pediatric Considerations It's important to note that children have greater surface areas relative to their weights than adults. This can become a major factor when it comes to staying warm and hydrated. Victims with severe burns tend to lose a lot of water through evaporation and leaking from the burned area. This increases our concerns as it can lead to hypothermia and shock. Monitor the victim for signs of dehyration, shock or hypothermia. Immediately seek advanced medical intervention if any of these are seen. After Burn Care If the burn is minor, and the burning has been completely stopped, at-home treatment might be appropriate. The 2024 ECC Guidelines suggest petrolatum (with or without topical antibiotics such as polymyxin), honey, and aloe have been shown to improve healing time in certain burns. Over the counter pain medications may help with pain when used correctly. All treatment should be under the direction of your physician. https://d3imrogdy81qei.cloudfront.net/video_images/13034/burns-bls-2025.jpg Yes 345 https://www.procpr.org/training/adult-cpr-first-aid/video/cold-related-emergncies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7188.mp4 Cold-Related Emergencies Cold-related emergencies are typically the result of cold temperatures combined with a lack of insulation or protective clothing to deal with those temperatures. How We Lose Heat   Radiation is the most significant and it involves the emission of infrared waves from the skin to cooler surroundings, similar to heat radiating from a stove. Convection contributes the next most heat loss and occurs when warm air or water around the body is replaced by cooler air or water, carrying heat away.  Think of how nice a strong breeze is on a hot day. Conduction is when there is direct contact with other objects. This is often a smaller concern, however, if your skin is in contact with a surface that absorbs heat easily like water, metal or cemet, conduction becomes a much larger concern.  Evaporation is responsible for another large portion of heat loss under normal conditions and becomes the only effective cooling mechanism when the environment is warmer than the skin.  It includes sweat evaporation and moisture loss from the lungs during breathing.    Pro Tip #1:> Protecting yourself from as many of the methods of heat loss as possible will ensure you stay as warm as you can.   Hypothermia begins to set in around the time the patient begins to shiver. And once the core body temperature drops below 95 degrees Fahrenheit, serious side effects ensue, including: Dizziness Delirium/confusion Lethargy Fatigue and weakness Loss of consciousness How to Treat for a Cold-Related Emergency If at any point someone starts showing signs of hypothermia or frostbite, call 911 immediately to activate EMS. Attempt to find warm shelter to keep the patient as comfortable and as warm as possible until help arrives. Monitor for airway, breathing, and circulation issues. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally. Then begin CPR. Treatment for hypothermia is a simple concept of just keeping them warm. It can become difficult in different situations though. This following list includes our priorities, but the order of when we conduct them may change based on the circumstances. Insulate the patient's body as best you can until help arrives. Move the patient to a warmer environment if possible. Remove any wet clothing and cover with blankets. Pro Tip #2: One of your best tools for helping you achieve number one above is a mylar blanket. They're common in first aid and emergency kits, and for good reason. They work by reflecting the heat of the patient and are big enough to cover most adults from head to toe. Warning: Wrapping a patient in a mylar blanket should be done gently using the steps below. You want to make sure not to agitate any frost-bitten extremities. Plus, cardiac arrest is also a concern. Aggressive movements can put the heart into a fatal rhythm. Using a Mylar Blanket Unwrap the blanket and tuck it around the patient as much as possible as this can help with both convection and radiation heat losses. For smaller patients, blankets could be placed under the mylar so long as the blanket is dry and the mylar fits completely over the victim and blankets. Pro Tip #3: The patient may be in a fetal position to try and stay warm. This can help decrease heat loss from radiation, convection and conduction. Leave them in this position if they are comfortable and you can continue to assist them in staying warm such as covering them with blankets. Seal the blanket as best you can, but leave room for the patient to breathe, as mylar isn't breathable material. Put another blanket or coat over the patient. Cover the feet and tuck it in around the patient as best you can, including the top of the head. Pro Tip #4: We lose a ton of heat through our feet, hands, and head, so make sure these areas are covered. Top and sides of head, not the face. Warning: Don't forget to protect yourself. When dealing with cold-related emergencies, you're likely putting yourself in the same environment that felled the patient. And since you're likely kneeling on cold pavement, in snow, and may be working with your gloves off for reasons of manual dexterity, pay extra care that you don't also become a victim.> Rewarming Body Parts in the Field A clinical setting is the preferred location for rewarming, so don't worry about it, especially considering that frozen parts that have been warmed could re-freeze causing additional injury. However, it pays to know that you should only rewarm using water between 99 and 104 degrees Fahrenheit. Higher temperatures could burn the patient, not to mention the pain involved. Rewarming is very painful, as the nerve endings begin to come back and the patient begins feeling again. Which is why a setting that can offer analgesics is the best option. Also, rubbing or massaging the frostbitten portion could cause further injury, so it is best to let the body part warm up on its own. Recognizing Frost Nip and Frost Bite The most common body parts to freeze first are the nose, cheeks, ears, feet, hands, and especially the ends of fingers and toes. When frost bitten, these parts will appear white, hard to the touch, and numb or nearly numb to the patient. A Word About Cold-Related Contributing Factors When it comes to cold-related emergencies, there are several contributing factors to be aware of, including the environment and the age of the patient. Anyone can develop hypothermia; however, the risk factors below could put people at higher risk. A cold environment. Though, even if the ambient temperature isn't that low, it can quickly be made worse if the patient isn't properly protected from the cold, including the use of inappropriate clothing. A wet environment. The presence of moisture – perspiration, rain, snow, etc. – will increase the speed at which body heat is lost. Wind. Wind makes the environment a lot colder than the temperature indicates. The higher the wind chill effect, the lower the actual temperature. Age. The very young and very old usually have a harder time staying warm in cold conditions. Body mass, or lack thereof, is one concern, as is their ability to think clearly when it comes to removing themselves from that environment or better protecting themselves with proper clothing. And in older adults, impaired circulation may also be a concern. Medical conditions. People with certain medical conditions, such as hypoglycemia, shock, and head injury, may be at higher risk of developing hypothermia. Drugs and alcohol. Alcohol and certain types of drugs can reduce a person's ability to feel the cold, or can impair judgment and impede rational thought, preventing the patient from taking proper precautions to stay warm. Trauma. If a person is injured and they are facing issues with hypothermia, both conditions may worsen much quicker. Injured victims must be kept as warm as possible. https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/training/adult-cpr-first-aid/video/eye-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7189.mp4 Eye Injuries Injuries to the eye can involve the eyeball, the bone, and the soft tissue surrounding the eye. Blunt objects, like a fist or a baseball, can injure the eye and/or the surrounding area. Or a smaller object could penetrate the eyeball. Care for open and closed wounds around the eye as you would for any other soft tissue injury. In this lesson, when we talk about treating an eye injury, assume we're referring to treating an injury from an object. Near the end we'll present some information on the other type of eye injury – chemical injuries.> How to Assess and Treat Eye Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Once you've ensured that the patient isn't suffering with airway, breathing, or circulation issues, the first thing you want to do is assess what type of eye injury you're dealing with – object or chemical? Both are serious! Pro Tip #1: Eye injuries are serious and always warrant a trip to the ER, whether by calling 911 and activating EMS or by private vehicle. Therefore, the job of the responder is to stabilize the wound, stop the damage, and ready the patient for safe transport. Sequence of Treatment for Eye Injuries Sit the patient down and facing you if possible. Place a small cup over the injured eye to eliminate any more damage or pressure. Ask the victim to hold the cup in place. Pro Tip #2: If you don't have a medical grade cup, a Dixie cup is a suitable alternative. And smaller is better as you'll have tape over it. Using a gauze bandage, begin wrapping over the cup and injured eye, while asking the patient to let go of the cup.  Cover the victim's head two to three times. Tuck or tape the end of the gauze to hold it in place. Pro Tip #3: The injured person has impaired eye sight with one eye covered. Be sure to be extra communicative and always talk to them as you're helping them. Having an eye covered can be disorienting. Make sure the victim's good eye is free and clear of the bandage to prevent even further impairement. Perform a secondary survey as you do the above. Assess the patient for secondary issues, from head to toe. And as always, continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. A Word About Chemical Eye Injuries This section will mirror the last lesson on the importance of, and strategies for, diluting chemical burns. Only with the eyes, and particularly the mucous membrane, damage can occur very quickly. Meaning your quick actions are essential. There are two types of chemical eye injuries – dry or wet. If you're dealing with dry chemicals, brush as much off the eye as you can before beginning to flush with a solution. If you're dealing with a wet chemical, go right into flushing the eye. Pro Tip #4: Ideally, you'll have a balanced pH solution for moments like this. Otherwise, use what you have access to – tap water, bottled water, etc. Flush the injured eye for at least 20 minutes. Your goal here is to stop the damage from the chemical. Warning: Always rinse from the inside of the eye to the outside of the eye. Flushing the eye the other way – from the outside in – could lead to cross-contamination of the other eye. While readying the patient for transport, and during your secondary survey, make sure the victim didn't get any chemicals into their mouth, nose, ears, etc. if they did, treat accordingly. Prevent Eye Injuries The single most effective measure for both chemical and foreign object injuries is wearing appropriate protective eyewear — ANSI-approved safety glasses or goggles have been shown to reduce workplace eye injuries by up to 90%. For environments involving chemicals, the CDC and OSHA recommend using sealed, indirect-vent goggles rather than standard safety glasses, since chemical splashes can travel around unprotected frames; additionally, knowing the location of the nearest eyewash station and flushing affected eyes with clean water for a minimum of 15–20 minutes is critical to minimizing damage after exposure. https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/training/adult-cpr-first-aid/video/poison-control https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7190.mp4 Poison Control Some of the most dangerous areas of any home, especially for young, curious children, are the places where poisons are stored, such as cleaning products and medications. Limiting access to these areas will always be key to preventing catastrophe. Luckily, there are numerous procedures and products that can easily help secure cupboards, drawers, and cabinets that house these dangers. A couple simple ways to better secure household poisons include: Store all medications and dangerous chemicals up high, so they're out of reach for small children Purchase commercial made locks at the hardware store Warning: It's important to understand how a colorful liquid chemical looks to a child. Those bright colors probably look like Kool-Aid, fruit punch, or the latest soda, and appear more delicious than dangerous. Chemicals don't have to be in liquid form to be tempting to children. Another common threat lately are the dishwasher and laundry cleaning pods that children routinely mistake as candy. However, children consuming poisons is just part of the problem. Kids also don't know the difference between consuming a medication that will help them feel better when they're sick and over-consuming that same medication – something that could hurt them or even kill them. Then add to this the fact that these medications are often flavored to taste good so that children will take them. Which is why medicine cabinets deserve the same amount of precaution as those cabinets where poisons are stored. How to Treat for Poisoning Is you suspect poisoning, the first thing to do is look for clues to corroborate that suspicion, such as: Are there pills scattered about? Are there empty pill bottles or packages around? Does the victim have burns or redness around the lips and mouth? Does the victim have unusual stains or odors, particularly breath that smells like gasoline or paint thinner? Is the victim exhibiting signs of drowsiness or mental confusion? Is the victim having difficulty breathing? Has the victim vomited? Pro Tip #1: First aid treatments for poisoning have changed a lot over the years. Which is why if you suspect poisoning you should call the Poison Control Hotline at 1-800-222-1222. Keep this phone number in a prominent location for quick and easy access. Poison Control will work with you to first help identify the poison in question. And then will guide you in providing treatment for that poison. Pro Tip #2: You may have heard to induce vomiting for poisonings. This is rarely true. One more reason to call poison control and get the proper treatment advice based on the poison that was ingested. Warning: If at any point, the patient goes unconscious or stops showing signs of life (moving, breathing normally, etc.), call 911 immediately and activate EMS. A Word About How Poison Enters the Body There are four categories of poisons based on how they enter the body – ingestion, inhalation, absorption, and injection. Ingestion This category is for all the poisons that can be swallowed – common food poisoning culprits like mushrooms and shellfish, recreational drugs, medications, alcohol, and household items like cleaning supplies. Young children are most at risk, as everything they see looks like it should go into their mouths immediately and often does. Older adults are also more at risk, mostly due to medication errors. Inhalation Inhaled poisons are those gases and fumes that are poisonous. The most common inhaled poison is carbon monoxide, as it's odorless, colorless, and tasteless. To further complicate matters, exposure can lead to death in mere minutes. Carbon monoxide comes from car exhaust, tobacco smoke, fires, and defective gas cooking and heating equipment, like furnaces and hot water heaters. Other less common culprits in this category include carbon dioxide, chlorine gas, ammonia, sulfur dioxide, nitrous oxide, chloroform, dry cleaning solvents, fire extinguisher gases, industrial gases, and hydrogen sulfide. Absorption Absorbed poisons can enter the body through the skin or mucous membranes in the eyes, nose, and mouth. Plants are the biggest offenders when it comes to absorbed poisons, and most of us have probably had a run-in with poison ivy once or twice. Chemicals in fertilizers and pesticides are also commonly absorbed poisons, as are topically applied medications. Injection Injected poisons do include those administered by hypodermic needle, such as recreational and medicinal drugs. But more times than not, instances of poisoning by injection are perpetrated through bites and stings. Poisonous snakes, insects, spiders, and marine life are abundant in certain countries, like Australia, while others like their neighbor New Zealand, can boast a total of zero poisonous animals. https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/training/adult-cpr-first-aid/video/bleeding-control-arterial-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2094.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care A person who is the victim of arterial bleeding will instinctively grab and cover the wound to reduce the amount of blood flow, if that person is conscious and able to. To best assist in treating the wound, you should: Make sure the scene is safe. Put on latex-free gloves if available. If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer. Find the source of the bleeding; you may have to remove clothing over the wound. Make the switch from the victim's hand to a dressing pad or a clean cloth. Apply pressure. The wound will be pulsating, and it will likely take several dressing pads to control the bleeding. If the victim is conscious and can assist, this will help. Ask the victim to maintain pressure over the dressing pad or cloth. The blood will probably soak through, so apply a second pad on top of the first, rather than removing it. Continue to apply firm, direct pressure over the wound. If the victim is becoming light-headed from the blood loss, have them sit or lie down. The goal is to control the bleeding to the point where the wound is not leaking through each new dressing pad. If blood continues to leak through, continue to apply another pad or piece of cloth until it stops. Consider using a tourniquet if – you cannot control the bleeding with dressing pads and the blood loss is extreme. This is a life-threatening situation and last resort. In most cases, even arterial bleeding can be controlled using pressure plus dressing and bandages. Once you have the bleeding controlled, it's time to wrap the wound. Using an ACE roller bandage like you find in most first aid kits, start from the end of the extremity where the injury is located. If the wound is on the wrist, began wrapping from the hand. Pro Tip #1: it's important to extend the bandage several inches beyond the wound on both sides. This will help keep the wound clean and limit the chances of infection. When wrapping the wound, if extra pressure is required, twist the bandage once over the wound and continue wrapping. Repeat as often as necessary. To finish, tuck the end of the bandage into the wrap to hold it in place. Pro Tip #2: While pressure is important to control the bleeding, you don't want to cut off circulation to the extremity on which the wound occurred. Pinch a nail and the fleshy underside between two of your fingers (if the wound occurred on an arm or a leg). The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. At this point, you'll want to decide whether to call 911 for EMS services or transport the victim to the emergency room by private vehicle. Call 911 if: The victim has lost consciousness or is showing signs of losing consciousness The victim is exhibiting signs of shock – pale, cold, sweaty skin You cannot stop the bleeding A Word About Dressings and Bandages Dressings are sterile pads used to absorb blood and other fluids, help promote clotting, and prevent infection. Gauze pads are most common. Most dressing pads are porous, which allows air to circulate to the wound and promote healing. Common sizes range from 2-4-inch squares. Universal or trauma dressings are larger in size and used for larger wounds. Occlusive dressings are not porous, which means no air or fluids can pass through, and typically used for abdominal wounds. Bandages are strips of material used to hold the dressing in place, maintain pressure over the wound, control bleeding, and protect from dirt and infection. The most common type of bandage is the roller bandage that is usually made of gauze and comes in assorted widths and lengths. These are the type of bandages you find in most first aid kits. However, there are other types of bandages including: Pressure bandage – for more pressure and a snugger fit Bandage compress – thick gauze dressing attached to a gauze bandage Elastic bandage – type of roller bandage typically used for muscles, bones, and joints Triangular bandage – large bandage that can folded and used as a sling As arterial bleeding is the most severe type of bleeding, it's important to properly assess the situation quickly as a rapid response is vital for a positive outcome. If you feel like the situation is too serious to handle yourself, it's important that you or someone else at the scene call 911 immediately. https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/training/adult-cpr-first-aid/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/adult-cpr-first-aid/video/bleeding-control-capillary-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2096.mp4 Capillary Bleeding While you're probably familiar with veins and arteries, capillaries may warrant a quick definition. Capillaries are tiny blood vessels linking arteries and veins that transfer oxygen and other nutrients from the blood to all body cells and remove waste products. Capillary bleeding has the classic appearance of a road rash type of wound. Anyone who has fallen off a bike or while playing sports likely has some experience with this type of bleeding injury. Capillary bleeding distinctions are: The blood tends to ooze or bubble up on the surface of the wound The pressure is very low and will usually clot on its own or with minimal pressure The blood is mixed with serous fluid Serous fluid is a yellowish liquid that is made up of proteins and water. It's the same fluid that fills a burn blister and is the body's attempt to heal the wound. How to Provide Care Capillary bleeding is usually not a concern in healthy people. The blood vessels are quite small, and the pressure is minimal. Some things to keep in mind with capillary bleeding are: Because it affects the epidermal layer where the nerve endings are located, it can be more painful than other types of bleeding injuries Infection is likely to be the biggest area of concern Thoroughly cleaning the wound is the greatest weapon against infection, particularly if the victim fell on a dirty surface As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. Remove any visible debris from the wound – dirt, sand, pebbles, and shavings of glass or metal. Blot the area with a dressing pad and apply direct pressure if the bleeding hasn't stopped on its own. Thoroughly clean the wound with soap and water. Apply an over-the-counter triple antibiotic to the area using a clean dressing pad. Pro Tip 1: When cleaning off debris from the wound, if you notice that those things are embedded into the wound, the victim will need to make a trip to the ER, where the medical staff will probably need to numb the area before removing the debris. The nerve endings could be quite raw, and it's important to keep in mind that the victim may be in a good deal of pain. Once the wound is cleaned and the antibiotic has been applied, put a fresh dressing pad over the area. Make sure it's large enough to cover the wound completely with room to spare on all sides. Using medical grade tape, if you have it, hold the dressing pad in place with a couple strips of tape or however much is needed. Let the victim know that he or she can replace the pad with a large band aid after a day or two. Pro Tip 2: It's important to help the victim understand what the signs of infection are, as this is likely to be the biggest threat with capillary bleeding wounds. Signs of infection include: Puss oozing or draining from the wound The wound becomes puffy and more painful A wound that begins to turn red around the site Warning: Capillary bleeding is usually not a life-threatening injury, but infections could be. If the victim notices any of the above, it's important that he or she go to the ER or their doctor to avoid the chance of serious infection. However, keeping the wound area clean is often enough to avoid this complication. Also let the victim know what a healthy outcome of capillary bleeding looks like: The wound will begin to scab over after 48 – 72 hours After a couple of more weeks, it should be completely healed as the scab begins to fall off A Word About Life-Threatening Bleeding While capillary bleeding is often very easy to control, it's important to understand the concept of the Golden Hour – the critical first hour after a traumatic bleeding injury has occurred. During the Golden Hour: The risk of shock is at its highest Extensive blood loss can quickly result in death Quick action and proper intervention will result in the victim's best chance of survival As all bleeding injuries occur from arteries, veins, and capillaries, it's important to understand what a life-threatening bleeding incident looks like. Blood that is spurting out of a wound. Blood that won't stop coming out of a wound. Blood that is pooling on the ground. The victim's clothing is soaked with blood. Bandages that are soaked with blood. Loss of part, or all, of an arm or leg. Bleeding in a victim who is confused or unconscious. If you experience any of these situations while providing care, be aware that these can be life-threatening, and you should call 911 immediately and get EMS involved. Capillary bleeding is often the least severe type of bleeding injury, but don't get lulled into a false sense of security. Any bleeding situation can become serious. And it deserves repeating that with capillary bleeding, it's especially important to clean the wound well to reduce the chances of infection. https://d3imrogdy81qei.cloudfront.net/video_images/3751/bleeding-control-capillary-bleeding-2015.jpg Yes 235 https://www.procpr.org/training/adult-cpr-first-aid/video/head-neck-and-back-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2098.mp4 Head, Neck, and Back Injuries If you come upon a patient who appears to have taken a fall, or was injured in an accident, and there are no bystanders around who witnessed the accident, you'll need to figure out the mechanism of injury. Hopefully the victim will be able to help, who in this lesson, we are assuming is conscious, alert, and not exhibiting more serious issues involving airway, breathing, circulation, etc. The most important thing to keep in mind as you deal with someone who has sustained potential injuries to their head, neck, and/or back, is minimizing movement, as you inquire more into what happened and how the patient is feeling. Pro Tip #1: Part of your job is to figure out if EMS is required as you tend to them. It may be a situation where the victim is able to get up and has no significant injuries. Or it could be a situation that doesn't appear serious initially, but suddenly becomes serious. If at any point the situation warrants it, call 911 immediately. How to Handle a Patient with Head, Neck, and Back Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. When dealing with potential back and neck injuries, it's best not to touch the patient while you assess them. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions; try not to nod. Answer with yes or no. And try not to move other parts of your body." "Do you remember what just happened?" "Do you know if you hit your head?" "Do you know what day it is?" "Do you know what year it is?" If the victim answers the last two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. This altered mental state is enough of a concern to call 911 and activate EMS if you haven't already done so. The fact that you're able to talk with the patient is a good sign. It indicates that they're awake, breathing normally, and have a pulse, all of which indicate a lack of an immediate emergency. However, that doesn't mean the situation cannot suddenly change. As you're talking with the victim, you're also looking them over for injuries, beginning with their head. Is there blood in the ears? Is there blood in the nose? Does the patient have any broken teeth? Are the pupils equal size and responsive to light? Pro Tip #2: Put your hand over the victim's eyes for a second or two then remove it and see if their pupils react. If they do not, it could be due to a concussion and swelling in the brain. Determine how injured they are by seeing how much they can move and with open-ended questions. "Can you tell me what hurts?" "Can you wiggle your fingers?" "Can you wiggle your toes?" A victim in paralysis is prone to going into spinal shock. Remember, shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. Early signs of shock to look for include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Warning: Should you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. If at any point during your assessment, the patient goes unresponsive, appears to be having trouble breathing normally, or goes into full cardiac arrest, activate EMS and treat the patient accordingly until help arrives, an AED arrives, or the patient is responding positively. A Word About Injuries to the Neck and Spine Injuries to the neck and spine can damage soft tissue and bone, including the spinal cord. Unfortunately, assessing the level of this damage on the scene, and without proper diagnostic equipment, is very difficult. Which is why you should always proceed with caution. Some common situations in which serious neck and spine injuries tend to be seen include: Swimming pool diving accidents Vehicular accidents Accidents that include a broken hard hat or helmet Some common symptoms for serious neck injury are: Obvious lacerations or swelling Impaled object Excessive external bleeding Difficulty speaking Air escaping through the trachea and/or larynx An airway obstruction Some common symptoms for serious spine injury are: Back pain or pressure Pain with movement Numbness, weakness, tingling in limbs or extremities Loss of feeling in limbs or extremities Breathing problems Loss of bladder and bowel control https://d3imrogdy81qei.cloudfront.net/video_images/3755/head-neck-and-back-injuries-2015.jpg Yes 229 https://www.procpr.org/training/adult-cpr-first-aid/video/shock-lay-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7184.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. It is a serious and potentially life-threatening condition that requires immediate medical care as it is a multi-symptom and complex condition. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. There are several types of shock, including psychological shock – a psychological condition in which worry and concern send a person into shock, rather than a physical condition. While this shock lesson is in the bleeding control section, it's important to understand that any first aid emergency could send a person into shock. Pro Tip #1: The important thing to remember with shock is that the symptoms are the same regardless of what contributes to it. It's a serious condition that warrants rapid treatment and an immediate 911 call. Besides psychological shock, there are four main types. The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #2: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue mask with a one-way valve available if necessary. Warning: If at any point the victim stops breathing normally or becomes unresponsive, begin CPR (or rescue breathing) immediately and continue until medical professionals arrive. Pro Tip #3: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #4: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. A Few Common Shock Questions Are there any tests I can perform on the victim to better help identify shock? If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail bed. If it's more than a few seconds – or the time it takes to say capillary refill – your victim is likely in shock. How do I know when to call 911? It's always better to be safe than sorry, so call 911 any time it's an actual emergency or if you're unsure what to do or overwhelmed, and how exactly that's defined will vary from rescuer to rescuer. However, as it pertains to this lesson, always call 911 immediately as soon as you suspect shock or as soon as the victim loses consciousness or begins having breathing issues. In other words, err on the side of victim safety. https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/training/adult-cpr-first-aid/video/2025-guidelines-update-for-cpr-and-first-aid-adults https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7288.mp4 2025 Guidelines Update for CPR and First Aid for Adults In this lesson, we'll go over the most important updates from the 2025 American Heart Association Emergency Cardiovascular Care guidelines for lay rescuers — that means everyday people like you who may need to help in an emergency. The goal of these updates is simple: help more people survive cardiac arrest by acting fast. When someone's heart stops, every second counts. The 2025 guidelines focus on making CPR easier to do, reducing delays, and encouraging more people to step in and help. Starting CPR in Adults When an adult collapses and is unresponsive, the most important thing you can do is start CPR right away. If you know how to give rescue breaths, you should give both compressions and breaths. But if you're not comfortable giving breaths, don't let that stop you — hands-only CPR is still much better than doing nothing at all. Start CPR where the person is. Moving them wastes valuable time. Lay them on their back on a hard, flat surface — a firm surface helps your compressions work better. Try to kneel beside them so their chest is about level with your knees, as this helps you push down with the right amount of force. You can also try placing the hand closest to their head on the center of their chest first, as this may help improve the quality of your compressions. Pro Tip #1:Don't wait. Don't move them unless you absolutely have to. Just get down and start compressions as soon as possible. Using an AED on Female Patients An AED, or automated external defibrillator, is a device that can reset the heart with an electric shock. One barrier that has been identified is that people sometimes hesitate to use an AED on a woman because they feel uncomfortable exposing her chest. The 2025 guidelines want to clear this up: you do not need to fully remove clothing to use an AED. Simply move clothing or undergarments aside to place the pads directly on the skin. The pads don't have to be in the perfect spot to work. Getting the AED on quickly and delivering a shock is what matters most. Always prioritize speed while being respectful of the patient's dignity. Helping Someone Who Is Choking If an adult is conscious and choking — meaning something is stuck in their airway and they cannot breathe, cough, or speak — here is what to do. Give 5 firm back blows between the shoulder blades, then follow with 5 abdominal thrusts. Keep repeating this cycle until the object comes out or the person goes unconscious. Research shows that back blows can be more effective and safer than abdominal thrusts alone, which is why this combination approach is now recommended. If the person is pregnant or if abdominal thrusts are not possible for any reason, use chest thrusts instead. Cardiac Arrest After Drowning If someone has gone into cardiac arrest after drowning, start CPR with breaths before reaching for an AED. Drowning cuts off oxygen to the body, so getting air into the lungs is the first priority. An AED is less likely to help initially in these cases because the heart rhythm involved in drowning emergencies is usually not one that can be shocked back to normal. Eye Injuries with an Embedded Object If something is stuck in a person's eye, cover only the injured eye — not both. Covering both eyes can make the person feel panicked and disoriented. Keeping the uninjured eye uncovered helps them stay calm and aware of what's happening around them, while still preventing further injury to the injured eye. Caring for Someone in Shock If someone is showing signs of shock — such as pale or clammy skin, weakness, or dizziness — but is still awake and alert, have them lie flat on their back. If they seem drowsy, are vomiting, or you can't keep a close eye on them, roll them onto their side instead. This is called the recovery position, and it helps keep their airway clear. Pro Tip #2: If the person fainted or is dehydrated but has no injuries, some studies suggest that gently raising their feet 6 to 12 inches may help in the short term to improve blood flow. This is not always recommended, but it may be worth trying in the right situation. Just keep in mind that our priority should be keeping them warm, on the ground and making sure to keep their airway clear and monitor for CPR if needed. A Unified Chain of Survival The 2025 guidelines now use one Chain of Survival for everyone — infants, children, and adults. Think of it as a step-by-step path to survival: recognize the emergency, call for help, start CPR, use an AED, and keep going until professional help arrives. Each link in that chain matters, and you are one of those links. Closing Thoughts The message behind all of these updates is simple: act fast, do your best, and don't be afraid to help. You don't have to be a medical professional to save a life. CPR doesn't have to be perfect — it just has to happen. The more confident and informed you are, the more of a difference you can make. https://d3imrogdy81qei.cloudfront.net/video_images/13118/2025-guidelines-update-for-cpr.jpg Yes 356 https://www.procpr.org/es/training/adult-cpr-first-aid/video/lesiones-musculoesqueleticas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2053.mp4 Lesiones musculoesqueléticas https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/es/training/adult-cpr-first-aid/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/adult-cpr-first-aid/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/adult-cpr-first-aid/video/respiracion-agonica-no-respirar-normalmente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2022.mp4 Respiración agónica (no respirar normalmente) Un signo de parada cardiaca se describe como respiración agonal. Esto ocurre cuando una persona está haciendo un jadeo o tragarse el movimiento y no está respirando normalmente. La respiración agónica ocurre en el 40% de los paros cardiacos tempranos. Saber cuándo una persona es respiratoria agonal puede prevenir intentos agresivos de RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/es/training/adult-cpr-first-aid/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/adult-cpr-first-aid/video/asfixia-adulto-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2033.mp4 Asfixia en adulto inconsciente Una vez que una víctima de asfixia se convierte en inconsciente, asegúrese de que EMS se ha activado. Dar 30 compresiones torácicas. Compruebe el objeto en la boca del paciente y barrerlo si es posible. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Si todavía no entra aire, realice 30 compresiones torácicas, revise el objeto nuevamente y, si es posible, retírelo. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Continúe este proceso hasta que la vía aérea esté abierta y el aire entre en los pulmones. https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/es/training/adult-cpr-first-aid/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/adult-cpr-first-aid/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/adult-cpr-first-aid/video/mecanismo-lesion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2050.mp4 Mecanismo de lesión https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/es/training/adult-cpr-first-aid/video/amputacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2047.mp4 Amputación https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/es/training/adult-cpr-first-aid/video/valoracion-secundaria-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2051.mp4 Valoración secundaria https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/es/training/adult-cpr-first-aid/video/agentes-hemostaticos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2049.mp4 Agentes hemostáticos https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/es/training/adult-cpr-first-aid/video/cuando-rcp-no-funciona-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2041.mp4 Cuando la RCP no funciona La RCP es un intento de compensar la circulación en el corazón que no está sucediendo normalmente. La RCP no detiene el proceso de morir; Simplemente disminuye la muerte celular biológica. La esperanza es que este procedimiento puede comprar tiempo para que el ccsme llegue a probar otros métodos de restaurar la circulación apropiada de la sangre oxigenada por todo el cuerpo para comprar aún más tiempo de modo que la razón subyacente por la cual la persona entró en paro cardiaco en el primer lugar puede ser Explorado Si la RCP no funciona, recuerde que le dio a esa persona la mejor oportunidad de sobrevivir. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/es/training/adult-cpr-first-aid/video/torniquetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2048.mp4 Cómo aplicar un torniquete https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/es/training/adult-cpr-first-aid/video/mordeduras-serpiente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2059.mp4 Mordeduras de serpiente https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/es/training/adult-cpr-first-aid/video/reacciones-alergicas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2060.mp4 Reacciones alérgicas https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/es/training/adult-cpr-first-aid/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/adult-cpr-first-aid/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/adult-cpr-first-aid/video/posicion-lateral-seguridad-recuperacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2063.mp4 Posición lateral de seguridad https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/es/training/adult-cpr-first-aid/video/asma-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2062.mp4 Asma https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/es/training/adult-cpr-first-aid/video/convulsiones https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2101.mp4 Convulsiones https://d3imrogdy81qei.cloudfront.net/video_images/3761/seizure-2015.jpg Yes 246 https://www.procpr.org/es/training/adult-cpr-first-aid/video/emergencias-relacionadas-calor-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2064.mp4 Emergencias relacionadas con el calor https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/es/training/adult-cpr-first-aid/video/introduccion-pro-primeros-auxilios-basico https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2105.mp4 Introducción a primeros auxilios básicos Nosotros diseñamos ProFirstAid Básico para cubrir las áreas de RCP para adultos y Primeros Auxilios para profesionales ocupados como tú. Algunos de ustedes lo necesitan no solo para el trabajo, sino quizás también en el hogar. https://d3imrogdy81qei.cloudfront.net/video_images/3769/intro-to-profirst-aid-basic-2015.jpg Yes 53 https://www.procpr.org/es/training/adult-cpr-first-aid/video/dea-adultos-pro-primeros-auxilios https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2107.mp4 DEA en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3773/adult-aed-profa-2015.jpg Yes 214 https://www.procpr.org/es/training/adult-cpr-first-aid/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/adult-cpr-first-aid/video/asfixia-adulto-inconsciente-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2118.mp4 Práctica: Asfixia en adulto inconsciente Aprenda a dar RCP a un adulto que está inconsciente y ahogándose observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/es/training/adult-cpr-first-aid/video/dea-adulto-lugar-de-trabajo-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2138.mp4 Práctica: DEA en adulto https://d3imrogdy81qei.cloudfront.net/video_images/3835/adult-aed-workplace-practice-2015.jpg Yes 276 https://www.procpr.org/es/training/adult-cpr-first-aid/video/rcp-adulto-lugar-de-trabajo-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2139.mp4 Práctica: RCP en adulto https://d3imrogdy81qei.cloudfront.net/video_images/3837/adult-cpr-workplace-practice-2015.jpg Yes 96 https://www.procpr.org/es/training/adult-cpr-first-aid/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/adult-cpr-first-aid/video/mordeduras-animales-y-humanos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2370.mp4 Mordeduras de animales y humanos https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/es/training/adult-cpr-first-aid/video/traumatismos-penetrantes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6490.mp4 Traumatismos penetrantes https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/es/training/adult-cpr-first-aid/video/picaduras-de-escorpiones-garrapatas-y-aranas https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6491.mp4 Picaduras de escorpiones, garrapatas y arañas Ahora discutiremos el tratamiento de primeros auxilios para picaduras de arañas, picaduras de garrapatas y picaduras de escorpiones. Estos encuentros pueden ser alarmantes, pero conocer los pasos adecuados puede ayudar a garantizar una respuesta rápida y efectiva. Primero, sepa que millones de personas son mordidas o picadas cada año solo en los Estados Unidos. y la mayoría de estas son inofensivas. Queremos enfocarnos en el tratamiento generalizado y en qué observar en casos más graves. La prioridad siempre es la seguridad. Una vez que usted y la víctima estén a salvo, vea si hay una forma de identificar qué lo mordió o picó, ya que esto puede ayudar a identificar el tratamiento adecuado si es necesario. Dado que todas estas mordeduras o picaduras habrán perforado la piel, se recomienda siempre lavar suavemente con jabón y agua. Si se notan picaduras o signos o síntomas preocupantes, busque ayuda médica de inmediato. En ese caso, observe si hay decoloración o ampollas en la piel, náuseas, dolor abdominal, dificultad para respirar, cambio en la capacidad de respuesta, o dolor significativo. Si no hay preocupaciones inmediatas, aquí es cómo podemos manejar estos casos de manera independiente siempre y cuando no se noten síntomas preocupantes. Para las arañas: Si se encuentra en un área conocida por las arañas venenosas, aléjese del lugar para evitar más mordeduras. Es importante identificar la araña responsable de la mordedura. Luego, lávese con jabón suave y agua. Para reducir el dolor y la hinchazón, eleve la extremidad mordida y aplique una compresa fría o una bolsa de hielo envuelta en un paño delgado en el lugar de la mordedura. Déjelo actuar durante unos 10-15 minutos cada hora. Para mordeduras sospechosas o confirmadas de arañas venenosas como las viudas negras o las arañas reclusas pardas, es crucial buscar atención médica inmediata. Llame a los servicios de emergencia o diríjase al hospital más cercano. Ahora hablemos de las garrapatas. Si encuentra una garrapata adherida a su piel, retírela rápidamente ya que cuanto más tiempo estén adheridas, más probable es que transmitan enfermedades. Use unas pinzas de punta fina para agarrar la garrapata lo más cerca posible de la superficie de la piel. Tire de ella alejándola de la piel de manera constante y lenta con firmeza, evitando torcer o aplastar la garrapata. La piel se tensará y la garrapata finalmente se soltará. Limpie el área con agua y jabón suave. Si está preocupado por las enfermedades transmitidas por garrapatas, puede conservar la garrapata en un recipiente sellado o una bolsa de plástico. Esto puede ayudar a los profesionales de la salud a identificar la garrapata y determinar el riesgo de transmisión de enfermedades. Tenga en cuenta que si la cabeza se desprende y queda incrustada en la piel, esto es una llamada al profesional médico para pedir ayuda. Ahora hablemos de los escorpiones. Aléjese del área para prevenir más picaduras. Limpie el sitio de la picadura con jabón suave y agua, similar a las mordeduras de araña, y aplique una compresa fría o una bolsa de hielo envuelta en un paño en el sitio de la picadura para ayudar con el dolor. Aunque la mayoría de las picaduras de escorpión son inofensivas, buscar atención médica es esencial para estar seguro, ya que las especies venenosas pueden ser mortales para los humanos. Llame a los servicios de emergencia o diríjase el hospital más cercano inmediatamente. Recuerde, la prevención es clave, así que tome precauciones revisando su ropa y vistiendo la indumentaria adecuada siempre que estas criaturas sean comunes. Mantenga la calma y siga estos pasos si se encuentra con una mordedura o picadura. Y siempre busque ayuda médica profesional cuando sea necesario. https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/es/training/adult-cpr-first-aid/video/lesiones-del-oido https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6488.mp4 Lesiones del oído https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/es/training/adult-cpr-first-aid/video/diabetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2100.mp4 Diabetes https://d3imrogdy81qei.cloudfront.net/video_images/3759/diabetes-2015.jpg Yes 500 https://www.procpr.org/es/training/adult-cpr-first-aid/video/control-hemorragia-sangrado-venoso https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2095.mp4 Sangrado venoso https://d3imrogdy81qei.cloudfront.net/video_images/3749/bleeding-control-venous-bleeding-2015.jpg Yes 214 https://www.procpr.org/es/training/adult-cpr-first-aid/video/rcp-adultos-pro-primeros-auxilios https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2106.mp4 RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3771/adult-cpr-profa-2015.jpg Yes 158 https://www.procpr.org/es/training/adult-cpr-first-aid/video/conmocion-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2038.mp4 Conmoción cerebral https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/es/training/adult-cpr-first-aid/video/hemorragias-nasales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6487.mp4 Hemorragias nasales https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/es/training/adult-cpr-first-aid/video/desvanecimiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2056.mp4 Desvanecimiento https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/es/training/adult-cpr-first-aid/video/lesiones-dentales-y-bucales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6489.mp4 Lesiones dentales y bucales https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/es/training/adult-cpr-first-aid/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/adult-cpr-first-aid/video/como-usar-epipen https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2102.mp4 Cómo usar un Epipen https://d3imrogdy81qei.cloudfront.net/video_images/3763/how-to-use-an-epipen-2015.jpg Yes 140 https://www.procpr.org/es/training/adult-cpr-first-aid/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/adult-cpr-first-aid/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/adult-cpr-first-aid/video/quemaduras https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7187.mp4 Quemaduras https://d3imrogdy81qei.cloudfront.net/video_images/13034/burns-bls-2025.jpg Yes 345 https://www.procpr.org/es/training/adult-cpr-first-aid/video/emergencias-relacionadas-frio-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7188.mp4 Emergencias relacionadas con el frío https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/es/training/adult-cpr-first-aid/video/lesiones-oculares-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7189.mp4 Lesiones oculares https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/es/training/adult-cpr-first-aid/video/control-envenenamiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7190.mp4 Control de envenenamiento https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/es/training/adult-cpr-first-aid/video/es-control-hemorragia-sangrado-arterial https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2094.mp4 Sangrado arterial https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/es/training/adult-cpr-first-aid/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/adult-cpr-first-aid/video/es-control-hemorragia-sangrado-capilar https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2096.mp4 Sangrado capilar https://d3imrogdy81qei.cloudfront.net/video_images/3751/bleeding-control-capillary-bleeding-2015.jpg Yes 235 https://www.procpr.org/es/training/adult-cpr-first-aid/video/lesiones-cabeza-cuello-espalda https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2098.mp4 Lesiones de cabeza, cuello y espalda https://d3imrogdy81qei.cloudfront.net/video_images/3755/head-neck-and-back-injuries-2015.jpg Yes 229 https://www.procpr.org/es/training/adult-cpr-first-aid/video/conmocion-rescatista-lego-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7184.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/es/training/adult-cpr-first-aid/video/2025-guidelines-update-for-cpr-and-first-aid-adults-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7288.mp4 Actualizaciones de las Guías 2025: RCP en Adultos y Primeros Auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13118/2025-guidelines-update-for-cpr.jpg Yes 356 https://www.procpr.org/training/cpr-first-aid/video/nosebleeds https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6487.mp4 Nosebleeds In this lesson, we're going to cover nosebleeds and how to apply first aid in the event you or someone you know gets one. Nosebleeds, also known medically as epistaxis, can catch us off guard and happen when we least expect them. However, they’re often quite harmless and can usually be managed easily. Each year, around 60 million people get nosebleeds in the United States alone. They are most likely to occur in the winter when cold weather and indoor heating dry the nasal passages. Most nosebleeds are minor and the bleeding will often stop on its own, but some people may require medical attention. This lesson will teach you the proper way to handle them. But before we proceed, bear in mind that while most nosebleeds are benign, there are exceptions. Pro Tip #1: If a nosebleed is intense, continues for over 20 minutes, or pairs with other symptoms, one should seek immediate medical help. It's important to note that if someone is on prescription blood thinners, their risk of a continued hemorrhage increases significantly, as these medications can intensify bleeding and challenge the standard control techniques. It's important and recommended that these patients seek further medical attention. First Aid Steps for Nosebleeds While nosebleeds are usually nothing to worry about, the presence of blood can make people feel anxious or queasy, particularly if it is their own blood. Reassure the affected person and urge them to stay calm. Ask the nosebleed victim to sit down and lean forward slightly, as this helps keep the blood from trickling down the back of the throat. Once you have your safety gloves on, or if the individual can do it themselves, pinch the soft section of the affected person's nostrils just past the nasal bone. Hold this pinch for about 10-15 minutes without releasing any of the pressure. This simple act applies pressure on the blood vessels of the nose and helps facilitate clotting. If the victim has any blood pooling in their mouth or throat, instruct them to carefully spit it out rather than swallow it. It is important to contain the blood spray or splatter through this process, which can be associated with sneezing, coughing, spitting, or speaking. Pro Tip #2: A backward tilt could lead to potential complications like aspiration or ingestion and vomiting. So step two is more vital than it may sound. Eye protection along with a face shield may be necessary - in addition to gloves – to fully protect the care provider appropriately. If no PPE (Personal Protective Equipment) is available, be sure to stand next to the patient, rather than in front of their face, as this may help protect you. Pro Tip #3: It's important to note that while a cold compress can help constrict blood vessels, cold blood does not clot swiftly. If you choose to use an ice pack, it is suggested to be placed on the bridge of the nose or the rear of the neck. Once the victim's nose stops bleeding, encourage the patient to resist the urge to blow their nose, as this can dislodge the clot and cause the nose to begin bleeding again. One common misconception is to pack the nose with gauze or tissue. This should be avoided in a first-aid scenario. And remember, only a physician should decide on medical nose packing. Also, for those patients who may be on blood thinners, the pressure might need to be maintained longer, and a physician's intervention may be required. Utilizing these first-aid methods, most nosebleeds can be managed easily. But remember, persistent bleeding, recurring episodes, or additional symptoms or complications may warrant prompt medical attention via a 911 emergency services phone call. A Word About Applying Pressure to a Stubborn Nosebleed The two most important factors when successfully controlling a nosebleed are: The amount of pressure applied. The amount of time the pressure is maintained. Remember that the pressure must be firm, and it must be maintained for a long time. Methods of applying pressure include pinching the nose with your fingers or using gauze or cloth placed over the nose and then pinching. If bleeding continues, try adjusting where you are pinching the nose or adjusting the pressure with which you are pinching the nose. About Hereditary Hemorrhagic Telangiectasia HHT is a genetic disorder in which blood vessels do not develop normally leading to bleeding that can be serious or life-threatening. A person with HHT may form abnormal capillaries or abnormal capillary connections between the arteries and veins. Capillaries are tiny blood vessels that pass blood from arteries to veins. The abnormal blood vessels formed in HHT are often fragile and can burst, which then causes bleeding. Men, women, and children from all racial and ethnic groups can be affected by HHT and experience the problems associated with this disorder, some of which are serious and potentially life-threatening. Nosebleeds are the most common sign of HHT, resulting from small abnormal blood vessels within the inside layer of the nose. While rare, it's important to understand that sometimes a nosebleed is a sign of a greater underlying problem. https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/training/cpr-first-aid/video/penetrating-trauma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6490.mp4 Penetrating Trauma In this lesson, we'll go over the treatment options for penetrating injuries like gunshot wounds, knife stabbings, or any other type of similar penetrating trauma. Penetrating injuries can often be life-threatening and will usually require immediate treatment. Knowing how to assess and provide first aid for these injuries can make a critical difference in the outcome of the victim.  In this lesson, we will guide you through the assessment phase and initial treatment of penetrating injuries. Pro Tip #1: Before we begin, it's essential to remember that first aid is not a substitute for professional medical care. In the case of penetrating injuries, it is vital to call emergency services immediately. Your main goal is to provide initial care and support until professional medical help arrives. First Aid Steps for Penetrating Trauma Injuries As always, the first thing you want to do is ensure that the scene is safe. Carefully assess the scene for any ongoing danger and ensure your safety and the safety of others before approaching the injured person. If there is an active threat, prioritize your safety and seek a safe location before providing aid. Your safety and the safety of others is always the most important step. Once you have determined that the scene is safe, follow the steps below. Step 1: Call 911 for help. If you cannot call emergency services yourself, ask someone else at the scene to do this, providing others are in the vicinity, as you may have your hands full with the victim. Step 2: Provide accurate details to emergency services about the situation, including your location and the nature of the injury. Calling for professional medical help is crucial for the injured person's survival. Also, remaining calm, if possible, will help to ensure the proper communication of vital information Step 3: Control the bleeding by applying direct pressure to the wound using a clean cloth, a sterile dressing, or even your gloved hand. Pro Tip #2: It is always recommended that you utilize universal precautions. Use personal protective equipment (PPE) at all times. Protecting yourself should not be overlooked. Step 4: Maintain pressure until medical professionals take over. If the object causing the penetration is still in the wound, don't remove it, as it may be acting as a plug to control the bleeding. If you believe there is a possibility that the penetrating item such as a bullet, knife, or other item may have gone through the body, check to see if there is a wound where the object came out. With bullets especially, the exit wound is usually larger than the entry wound. Pro Tip #3: Controlling the bleeding is of the utmost importance. Apply firm and continuous pressure to the wound. Treating the wound with a dressing and bandage will help the clot to form and stop the bleeding. Step 5: Once the bleeding has been controlled, help the victim get into a comfortable position, preferably lying flat on the ground if possible. Then, cover the injured person with a blanket or any available material to help maintain their body heat. This can reduce the risk of hypothermia, help with the clotting process, and provide comfort to the victim. Step 6: Lastly, provide reassurance. Keep the injured person calm and reassure them that help is on the way. It's important not to lie to them or give them false hope. Minimizing their movement to avoid exacerbating the injury, keeping them calm, and reassuring them that you are taking good care of them can all aid in their recovery. Pro Tip #4: Do not probe or irrigate the wound. Inserting objects into the wound or attempting to clean the wound extensively may cause further damage or introduce infection. It's important to resist the urge to probe or irrigate the wound. Your focus should be on controlling bleeding, keeping them warm, providing comfort and reassurance, and waiting for professional medical help to arrive. Remember, in most cases, maintaining the victim’s airway, breathing, and circulation will be the most important steps in a critical penetrating trauma emergency, as cardiac arrest may become an additional threat. These are the basic steps for providing the initial care for a penetrating injury. Once emergency medical services arrive, they'll take over and provide the appropriate medical treatment. A Word About Cardiac Arrests Associated with Penetrating Traumas According to the American Heart Association, basic and advanced life support for the trauma patient are fundamentally the same as that for the patient with a primary cardiac arrest, with a focus on support of the airway, breathing, and circulation. Cardiopulmonary deterioration associated with trauma has several possible causes including: Hypoxia secondary to respiratory arrest, airway obstruction, large open pneumothorax, tracheobronchial injury, or thoracoabdominal injury Injury to vital structures, such as the heart, aorta, or pulmonary arteries Severe head injury with secondary cardiovascular collapse Underlying medical problems or other conditions that led to the injury, such as sudden cardiac arrest Diminished cardiac output or pulseless arrest from tension pneumothorax or pericardial tamponade Extreme blood loss leading to hypovolemia and diminished delivery of oxygen Even with a rapid and effective out-of-hospital response, victims with out-of-hospital cardiac arrest due to trauma rarely survive. Those patients with the best outcome from trauma arrest generally are young, have treatable penetrating injuries, have received early endotracheal intubation, and undergo prompt transport to a trauma care facility. Remembering your CPR training during a penetrating trauma injury could be vital for whomever you're administering first aid to should they fall victim to a cardiac arrest. It pays to be prepared. https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/training/cpr-first-aid/video/treating-ear-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6488.mp4 Ear Injuries In this lesson, we'll take a look at both external and internal ear injuries and how to apply first-aid treatment for both. Ear injuries can occur due to various causes, such as trauma, loud noises, or foreign objects that have been accidentally or purposely inserted into the ear. Knowing how to assess and provide initial first aid treatment for any ear injury is essential to minimize discomfort and prevent further complications. This lesson will guide you through the assessment and first aid treatment options for some of the more common ear injuries. Pro Tip #1: Before we begin, it's important to note that ear injuries can range from minor to severe. In cases of severe ear injury or if the injury involves hearing loss, it's crucial to seek medical assistance. Therefore, assessment of the ear injury is vital. Having said that, even in the event of a severe ear injury, you should still provide first aid to alleviate discomfort. Now let's take a look at how to assess and provide first-aid treatment for an ear injury. First Aid Treatment for External Ear Injuries Inspect the external ear for any visible injuries, cuts, or bleeding. If there is bleeding, apply gentle pressure with a clean cloth or sterile gauze to control it. Maintain pressure until the bleeding stops. Do not insert any objects into the ear canal, and do not attempt to clean the ear extensively. If there are signs of infection, such as redness, swelling, or discharge, seek medical attention. First Aid Treatment for Foreign Objects in the Ear If a foreign object - such as a small toy or insect – is visible and can be easily removed without pushing it in further, use clean tweezers or your fingers to fish it out. However, remember to use EXTREME caution and try to remove it gently. Avoid using sharp objects or excessive force, as this may cause injury or push the object deeper into the ear potentially causing permanent hearing loss. If the object cannot be easily removed, or if moving the object causes pain, discomfort, or bleeding, be sure to stop and seek medical attention. First Aid Treatment for Bleeding from in the Ear Foreign bodies or significant head trauma can lead to bleeding from the ear canal. For this type of bleeding injury, it is best to quickly seek medical attention. As for the bleeding, loosely apply a dressing or other clean materials to the outside of the ear and track how much blood came out, such as how many gauze pads or towels were used. Pro Tip #2: If you try to apply direct pressure, this could cause a build-up of pressure in the ear and cause an increase in pain or lead to other complications. Monitoring the victim and asking how they are doing will help determine if the pain is suddenly getting worse. If it is, it might be caused by this direct pressure. Remember, while these first aid measures can provide initial relief, seeking professional medical care for significant ear injuries, severe pain, changes in hearing, or especially head trauma that causes bleeding from the ear is essential. A Word About Basilar Skull Fractures Basilar skull fractures are fractures that occur in the base of the skull, which is the area at the bottom of the skull that supports the brain. Symptoms related to the ear that can occur with basilar skull fractures include: Battle's Sign: This refers to bruising behind the ear and is a common sign of basilar skull fracture. It typically appears a few days after the injury and is due to bleeding beneath the skin. Hearing Loss: Basilar skull fractures can affect the structures of the middle and inner ear, leading to conductive or sensorineural hearing loss. Conductive hearing loss occurs when sound waves cannot reach the inner ear due to damage to the ear canal, eardrum, or middle ear bones. Sensorineural hearing loss occurs due to damage to the inner ear or auditory nerve. Tinnitus: Ringing or buzzing in the ear (tinnitus) can occur as a result of the injury to the inner ear structures. Ear Bleeding: Bleeding from the ear canal (otorrhagia) can occur if the fracture involves damage to the temporal bone or surrounding structures. Dizziness and Vertigo: Damage to the inner ear or vestibular system can cause dizziness, vertigo (the sensation of spinning), and imbalance. Facial Nerve Dysfunction: Fractures involving the temporal bone can affect the facial nerve (cranial nerve VII), leading to facial weakness or paralysis on the affected side. CSF Leak: In severe cases of basilar skull fracture, cerebrospinal fluid (CSF) can leak from the nose or ear (otorrhea). This can be a serious complication requiring medical attention. https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/training/cpr-first-aid/video/dental-and-oral-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6489.mp4 Dental and Oral Injuries In this lesson, we'll take a look at dental and oral injuries and how you can apply first aid to treat them. Dental and oral injuries, such as tooth, tongue, or lip injuries, can occur unexpectedly and may require immediate first aid. Knowing how to assess and provide initial treatment can help alleviate pain and prevent further complications. This lesson will guide you through the assessment phase and first aid treatment options for some of the more common dental and oral injuries. Pro Tip: Before we begin, it is really important to remember that dental and oral injuries can vary in severity. For more severe injuries, seeking prompt dental or medical assistance is crucial. However, in minor cases, you can provide initial first aid to alleviate discomfort and help the healing process. First Aid Treatment for Tooth, Tongue, and Lip Injuries If a permanent tooth is lost, follow the first aid steps below. Try to locate the tooth and handle it only by the crown. Avoid contact with the root – the part that is hidden in the gums - as touching this could damage the tooth. If the tooth is dirty, gently and quickly rinse the tooth with water. Do not scrub or remove any tissue fragments. Gently reposition the tooth back into its socket and have the patient bite on a clean cloth, such as a piece of gauze, to hold it in place. If the first option is not possible, place it in a suitable storage medium, such as milk, saliva, or a tooth preservation kit, and seek dental care immediately, as the chance of saving a knocked-out tooth decreases with time. Additionally, according to the latest guidelines of the International Association of Dental Traumatology, it is not recommended to replant a primary tooth. It is still advisable to place the tooth in a storage medium and seek further evaluation by a dentist. There are many other dental injuries that could occur, but there is very little we can do about these. The best recommendation is not to move or irritate the area and seek immediate dental care. If there's bleeding from the tongue or lip, have the person rinse their mouth with water to clear any blood. You can gently clean the injured area with a damp cloth or gauze pad to remove debris. This will allow you to assess the extent of the injury. Apply direct pressure to the wound with a clean cloth or sterile gauze to control bleeding. If there is significant bleeding or the wound is deep, seek immediate medical attention since this may lead to breathing problems as blood can make breathing increasingly difficult. It may also cause the patient to swallow blood which can quickly lead to nausea and vomiting, further compromising the airway. Encourage the person to avoid hot or spicy foods and to maintain good oral hygiene. Remember, while these first aid measures can provide relief, seeking professional dental or medical care is always essential. A Word About Dental Avulsion Injuries A dental avulsion injury - also known as a knocked-out tooth - can damage both the tooth and the supporting soft tissue and bone, resulting in the permanent loss of the tooth. Dental avulsion is relatively uncommon compared to other dental injuries but can occur in various age groups, particularly among children and young adults involved in sports or accidents. It most commonly affects children and adolescents, often due to falls or sports-related injuries. The peak incidence is seen in the 7-14 age group. Studies suggest that dental avulsion accounts for approximately 0.5 to 3 percent of all dental injuries. It tends to affect males more frequently than females, possibly due to higher participation rates in contact sports. Participation in contact sports (e.g., football, hockey, and basketball), inadequate use of mouthguards during sports activities, and accidents (falls and collisions) are significant risk factors. Immediate reimplantation of an avulsed tooth is believed to result in the greatest chance of tooth survival. The longer a tooth is out, the more likely it will be permanently lost. In situations that do not allow for immediate reimplantation of an avulsed tooth, it is beneficial to temporarily store it in a variety of solutions that are shown to prolong the viability of dental cells. If available, place the avulsed tooth in Hanks' Balanced Salt Solution or in another oral rehydration salt solution, or wrap the tooth in cling film to prevent dehydration and improve the likelihood of successful replantation by a dental professional. This should always be done as quickly as possible. If an avulsed permanent tooth cannot be immediately replanted in either Hanks’ Balanced Salt Solution, oral rehydration salt solutions, or cling film, store the tooth in cow’s milk or saliva, as these are your best secondary options. Keeping the tooth "safe" in the saliva inside the person's mouth is also not suggested as the patient will often keep moving the tooth around which can further damage to the roots of the tooth. An avulsed tooth should never be stored in tap water.  The viability of an avulsed tooth stored in any of the above solutions is limited. And reimplantation of the tooth within an hour after avulsion provides the best chance for tooth survival. Following the loss of a permanent tooth, it is essential to seek rapid medical assistance for reimplantation. The long-term success of replantation depends on various factors, including the extra-alveolar time (time the tooth is out of its socket), the storage medium used for transporting the tooth, and the condition of the tooth and surrounding tissues. Complications may include pulp necrosis (death of the tooth's inner tissue), infection, root resorption (breakdown of the tooth root), and periodontal issues. Prevention is often a key to avoiding oral injuries while playing contact sports. The proper use of mouthguards is highly recommended. https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/training/cpr-first-aid/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/cpr-first-aid/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/cpr-first-aid/video/adult-cpr-lay-rescuer-community https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2023.mp4 Adult CPR In this lesson, we'll cover how to administer CPR on an adult victim. In situations where CPR is needed, you personally may have witnessed the victim exhibit symptoms and go unresponsive. Others may have witnessed the incident. Or no one was around to see what really happened. If someone was there to witness the incident, what they likely would have noticed is a victim who: Loses their balance Clutches their chest Collapses to the ground or floor If you arrive on the scene after this happens, in cardiac arrest emergencies, the victim will usually also be unresponsive and not breathing normally, if at all. Let's assume for this lesson that that's how you found the victim. And that CPR is required. CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped. Oxygen is vital for life and it's only a matter of minutes before the brain begins to be negatively impacted. How to Provide Care Warning: Don't let the repetition of this next paragraph lull you into overlooking or dismissing the importance of scene safety. What if you show up to the scene and there's a live electrical wire, or poisonous gases in the air, and this is why the victim collapsed? Don't make assumptions, and don't become another victim. Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue shield available and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Pro Tip #1: As long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation. If you've determined at this point that the victim is unresponsive and not breathing normally continue immediately with CPR, beginning with chest compressions. Pro Tip #2: Chest compression landmarks: Aim for the center of the chest, between the nipples and on the lower one-third of the sternum. Hand placement: Place your first palm on that landmark and interlock the fingers on your top hand over your first. Lean over the victim, position your hands as indicated above, and in the video, and lock your elbows. Use your upper body weight to supply the force needed for chest compressions and compress at a depth between 2 – 2.4 inches. Perform 30 chest compressions at a rate between 100 – 120 compressions per minute, which amounts to around two compression every second. Make sure you allow the victim's chest to come all the way back up before performing your next compression. Pro Tip #3: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Lift the victim's chin and tilt his or her head back. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver two breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Pro Tip #4: Don't forget to watch the victim's chest when providing breaths. If the chest doesn't rise, then you might be dealing with another problem and one that likely includes an obstructed airway. Go right back into 30 chest compressions followed again by two breaths. Continue to perform 30 chest compressions to two breaths until EMS arrives, an AED is located, someone equally trained can relieve you, or the victim becomes responsive and begins breathing normally again. A Few Common Questions About Adult CPR Why is it important to use your upper body weight when performing chest compressions? If you need to perform CPR for a longer period of time, using only your upper body strength will begin to fatigue you. As you become fatigued, your compression rate and depth may falter, as would the quality of CPR and the victim's chances of recovering. Can I stop doing CPR once I've started? Once you begin CPR, it's important not to stop. If you must stop, do so for no longer than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life and the patient breathing normally again, an AED being available and ready to use, or being too exhausted to continue. Is there anything else I can do to help a cardiac arrest victim? The best thing you can do in these situations is to provide high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. So, what constitutes high-quality CPR? High-Quality CPR Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise Pro Tip #5: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Low-Quality CPR Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force https://d3imrogdy81qei.cloudfront.net/video_images/3605/adult-cpr-lay-rescuer-community-2015.jpg Yes 216 https://www.procpr.org/training/cpr-first-aid/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/cpr-first-aid/video/adult-aed-lay-rescuer-community https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2026.mp4 Adult AED In this lesson, we'll cover how to use an AED on an adult victim. An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm. Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the rescuer, or someone else, that could result in electrocution? Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient. If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if it is a concern, you can disconnect it and remove it from the pathway to the heart. Necklaces should be moved to the side. Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads. Piercings shouldn't cause any problems. It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it. There are no special considerations for pregnant women. Pro Tip #2: It's OK to be just as aggressive with a pregnant woman as you would any other victim. The primary focus should be on the mother, as saving her will also help save the baby. The care you provide to the mother won't put the baby in any more jeopardy. How to Provide Care Let's assume a few things: The scene is safe, and your gloves are on You or a bystander called 911 You have an AED, whether you found one or had it with you The victim is unresponsive and not breathing normally CPR is already in progress Remember, as long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation. However, when it comes to AEDs, they supply their own instructions. Well, at least after the first step below. AED Technique for Adults Pro Tip #3: This is really the anti Pro Tip, as you don't need to be a pro to execute it. The AED will tell you what to do and what it's doing, like "remove clothing" or "analyzing rhythm." All you have to do is follow along. Turn on the AED. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. (AEDs will typically include a pair of scissors somewhere on the unit.) Attach the AED pads to the victim's chest. The pads should have a diagram on placement if you need help. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side of the victim's side, under the left breast. Make sure they adhere well. Plug the cable into the AED and be sure no one is touching the victim. The AED should now be charging and analyzing the rhythm of the victim's heart. If the scene is clear and no one is touching the victim, push the discharge button to deliver a shock. Then go right back into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Perform 30 chest compressions. Grab the rescue shield and place it over the victim's mouth and nose. Lift the victim's chin and tilt his or her head back. Deliver two rescue breaths. Continue with CPR until the AED interrupts you. At some point, it will reanalyze the victim's heart rhythm and again advise you on what to do next. If the AED advises a shock, do that. If it advises you to NOT shock the victim, continue with CPR only, again over the pads. (The AED will continue to reanalyze.) Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until EMS arrives, the patient is responsive and breathing normally, or someone who's equally trained or better can relieve you. A Couple Special AED Considerations There could be special situations that go beyond what you found in the list that opened this lesson. These include using an AED on a victim who's wearing an implantable device and a victim with an excessive amount of chest hair. Implantable Devices Implantable devices, like pacemakers, are sometimes located below one of the collarbones in the area where one of the AED pads should go. This can be problematic as the device could interfere with shock delivery. An ICD (Implantable Cardioverter-Defibrillator) is another common implantable device you may encounter. It's sort of like a mini version of an AED, as it detects abnormal heart rhythms and restores them to normal. If one of these devices is visible – a small lump can sometimes be seen or felt – or if you know the victim has one in a specific location, do not place the AED pad on top of it. Instead, adjust the placement of the pad to avoid the device. Excessive Chest Hair Chest hair rarely interferes with AED pad adhesion, but it is nonetheless a possibility. If the victim has excessive chest hair, press firmly on the pads when placing them on the victim's chest. If you get an error message, like check pads, or something similar, remove them and replace with new pads. Some of the victim's chest hair will likely come off with the old pads, which may solve the problem. However, if the AED still refuses to work, you'll have to shave the victim's chest (or cut some of the hair) before applying a third round of pads. https://d3imrogdy81qei.cloudfront.net/video_images/3611/adult-aed-lay-rescuer-community-2015.jpg Yes 244 https://www.procpr.org/training/cpr-first-aid/video/child-aed-fa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2027.mp4 Child AED AED pads come in an adult size and a pediatric size, for patients less than 8 years old or 55 pounds - roughly 25 kilograms. However, remember, if you do not have pediatric pads and the patient is less than 8 years old or less than 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. If placing the pads on the chest, pads cannot touch. If using adult size pads on a child, you may place them one on the center of the chest and the other on the center of the back to avoid touching, like you would for an infant. Also, remember that when using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? If for some reason the scene isn't safe enough to use an AED, move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. And one last reminder: It's OK if the victim or the victim's clothing is wet, as long as the area where pads will be placed is dry and you or the victim aren't submerged in water or connected by it. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? (With children, shouting their name may help.) If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS.. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. If you've determined at this point that the victim is unresponsive, not breathing normally, continue immediately with your AED. AED Technique for Children Turn on the AED. Remove the patient's clothing to reveal a bare chest. There are two pad placement options for children based on their size. The pads should have a diagram on placement if you need a reminder. Determining the size for pad location can be as simple as if the pads look like they will touch each other on the chest, then use the front and back locations. For small children, attach one AED pad to the center of the child’s chest, roll the child onto his or her side, and attach the second pad to the center of the back, between the shoulder blades.  For larger children placement is the same as an adult. One on the upper right chest, just below the collar bone. The other pad is placed on the lower left side of the chest, mid axillary line, below the breast. Plug the cable into the AED and be sure no one is touching the patient, including yourself. Some AEDs will have the cable already plugged into the device. The AED should now be analyzing the heart rhythm.  The AED will find one of two options, either a shockable rhythm or a non-shockable rhythm. For a shockable rhythm, the AED will charge itself to deliver the shock. If the scene is clear and no one is touching the patient, push the flashing shock button. Some AEDs will shock automatically, so be sure to listen to the directions of the AED. For a non-shockable rhythm or after the AED does shock, we immediately go right back into CPR starting with compressions. It's OK to perform CPR over the pads, so don't worry about moving them. Perform 30 compressions that go about 2 inches deep, or 1/3 the depth of the chest, and at a rate of between 100 and 120 compressions per minute, which amounts to almost two compressions per second. Grab the appropriately-sized rescue mask or face shield and seal it over the victim's face and nose and tilt back the head to open the airway. Breathe into the rescue mask or face shield and wait for the chest to rise and fall before administering the second breath. Continue with 30 compressions to 2 breaths. Every 2 minutes of CPR, the AED will analyze the heart again. Follow the directions and go right back into CPR. Continue this cycle until help arrives, the patient is responsive and breathing normally, the scene becomes unsafe for you, or the next level of care takes over. A Word About AED Precautions When using an AED, there are several precautions to keep in mind. Some of these may be obvious (and a repeat of what you've already learned in this course), while others may not be. Since alcohol is flammable, do not use anything with alcohol on it to wipe the patient's chest or back dry. While it's OK to use adult pads on a child, the reverse isn't entirely true, as pediatric pads may not deliver enough energy to defibrillate the adult patient. Do not touch the patient while the AED is conducting an analysis, as this may affect the analyzation process. Before delivering an AED shock, make sure no one is touching the patient or any of the resuscitation equipment. Do not use an AED if there are flammable or combustible materials or gases present. Do not operate an AED inside a moving vehicle, as the movement can affect the analysis and shock incorrectly. Do not use an AED if the victim is in contact with free-standing water or in the rain. Move the patient first. Do not place AED pads on top of any patches or implantable devices. Remove patches first and adjust the pads as necessary to avoid devices like a pacemaker.   https://d3imrogdy81qei.cloudfront.net/video_images/3613/child-aed-fa-2015.jpg Yes 250 https://www.procpr.org/training/cpr-first-aid/video/unconscious-adult-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2033.mp4 Unconscious Adult Choking In this lesson, we'll cover how to help an adult choking victim who is unconscious. In our fictional scenario, the adult victim went unconscious while you were trying to help them. The method of care will closely resemble performing CPR, which you recently learned, however, there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy. Help lower the victim to the ground or floor, so they don't fall and injure themselves. Pay extra attention to supporting their head and neck. Call 911 and activate EMS if you haven't already done so. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient. Lift the victim's chin and tilt his or her head back. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness. Pro Tip #3: Let's assume your compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compressions to two rescue breaths. Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. How You can Increase the Effectiveness of CPR It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. With that in mind, here are two lists (cheat sheets) to use when practicing CPR – one list of what to do and what of what NOT to do. What is High-Quality CPR? Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 (for adults) Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the victim's chest to rise What is Low-Quality CPR? Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/training/cpr-first-aid/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/cpr-first-aid/video/unconscious-child-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2034.mp4 Unconscious Child Choking In this lesson, you'll learn how to help a choking victim who is an unconscious child. Just as with our last fictional choking scenario, this victim went unconscious while you were trying to help them. Much of this lesson will look exactly like the unconscious adult choking lesson that you just finished. However, keep in mind that we learn through repetition and you can always expect a nugget or two (or seven) that wasn't in the last lesson. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy. Help lower the child to the ground or floor, so they don't sustain a trauma from a hard fall. Pay extra attention to supporting their head and neck. Call 911 and activate EMS if you haven't already done so. Enlist the help of a bystander if one is available. Locate the area over the heart to begin chest compressions. Pro Tip #1: While likely a refresher, it's important to remember your CPR compressions landmark – center of the chest on the lower third of the sternum. And don't forget, that to maximize cardiac output, position yourself directly over the victim's chest and not off to one side. If you're not directly over the heart, you may not adequately compress it. Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Remember, once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Lift the victim's chin and tilt his or her head back slightly. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness. Remember, we're assuming your chest compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compression to two rescue breaths. Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. A Few Common Random Questions that (may) Pertain to Choking Victims What are the differences between child CPR and adult CPR? There are three distinct differences to be aware of. Opening the Airway While the same head tilt maneuver is applied to children as it is for adults, make sure there is less hypertension in a child's neck compared to adults. To do that, simply tilt the head back only slightly past neutral. Your goal is a chin angle that's less pronounced and more perpendicular to the ground. Remember, with infants, that tilt is even less pronounced, as in neutral or slightly sniffing. With infants, it's more about distancing the chin from the chest, due to a neck that's still in the stubby stage. Performing Compressions The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. And in very small children, it's better to perform compressions using just one hand. But since human beings tend to come in many different sizes, stick to your 1/3 the depth of the chest and you'll never be wrong. Using AEDs As you recently learned, AEDs work the same regardless of age. However, the pads themselves, as well as pad placement, will vary based on the size of the victim. If your cardiac arrest victim weighs more than 55 pounds, continue using the adult AED pads. If the victim weighs less than 55 pounds, use pediatric AED pads if available. And yes, you'll have to guess when it comes to their weight. How well do compressions work for dislodging an obstruction? Just because your choking victim went unconscious, there's no reason to panic, as chest compressions work surprisingly well for removing airway obstructions. Performing those compression perfectly will also help. If the victim begins breathing again but it's not “normal breathing”, what are some signs I can look for? Just as there are many reasons why a person would experience respiratory or airway issues, there are also numerous signs and symptoms that can alert you to a problem, including: The person is unable to speak, can only speak a few words, or has a hoarse-sounding voice excessive use of abdominal muscles to breathe muscles between the ribs pull in on inhalation pursed lips breathing nasal flaring fatigue Adequate breathing means that respiratory rate – 12-20 for adults, 15-30 for children, 25-50 for infants – depth and effort are all normal. https://d3imrogdy81qei.cloudfront.net/video_images/3627/unconscious-child-choking-first-aid-2015.jpg Yes 190 https://www.procpr.org/training/cpr-first-aid/video/agonal-respiration-not-breathing-normally https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2022.mp4 Agonal Respiration (Not Breathing Normally) Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations. Agonal respiration is one sign of respiratory and cardiac arrest. Historically, this type of breathing has been difficult to identify and describe, especially for lay people, which can slow or hinder care and response times for cardiac arrest victims. A Word About Cardiac Arrest Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate blood to vital organs, including the brain. When heartbeats are weak, irregular, or uncoordinated, blood can't flow through the arteries to the rest of the body. If circulation is hampered or halted in any way, the body's organs cannot receive the oxygen they need to function normally. As a result, organ failure can occur. Brain damage sets in between 4-6 minutes, and after 8-10 minutes, this damage will likely be irreversible. Cardiovascular disease is the leading cause of death in the world and in the U.S., where it accounts for approximately 1 in 3 deaths. Cardiovascular disease is also the primary cause of cardiac arrest, but there are others, including: Drowning Choking Drug overdose Severe injury Brain damage Electrocution Warning: As more than 300,000 out-of-hospital cardiac arrests occur each year in the U.S., it's vital that lay rescuers and EMS professionals understand that early recognition – which is more difficult with agonal respiration – and quick action can have a tremendous impact on survival rates. Cardiac Chain of Survival To effectively respond to cardiac emergencies, it helps to understand the Cardiac Chain of Survival. Following the links in these chains – adult and pediatric – will give patients the best chance of survival. Warning: For each minute that CPR and/or defibrillation are delayed, the chance of survival is reduced by 7-10 percent. Adult Cardiac Chain of Survival Recognize the emergency and call 911 – the sooner medical personnel are called the sooner EMS can provide care for the patient. Early CPR – supplying blood and oxygen to vital organs can prevent brain damage and death. Early defibrillation – this electrical shock may restore an effective heart rhythm and increase the victim's chance of survival. Advanced life support – Medical personnel can help provide the proper equipment and medication needed to continue lifesaving care. Integrated post-cardiac arrest care – Integrated care can optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. Pediatric Cardiac Chain of Survival Injury prevention and safety – ways to prevent cardiac arrest in children. Early CPR Early Emergency Care – Rapid activation of the EMS system or response team to get help on the way quickly. Pediatric advanced life support Integrated post-cardiac arrest care Agonal Respiration Continued Agonal respiration is characterized by abnormal breathing attempts in which the patient appears to be gasping or gulping. (Think of a fish as it tries to breathe out of the water to get an idea of what agonal respiration looks like.) These respiratory attempts originate from the lower brain stem neurons as higher, more complex neurons become increasingly hypoxic – lacking in oxygen. Agonal Respiration occurs in around 40 percent of early cardiac arrest victims. Aggressive CPR attempts are often hindered or slowed due to misinterpretation or misunderstanding of this serious condition. Pro Tip #1: It's important to remember that, when it comes to agonal respiration, these attempts from the body to breathe are routinely misinterpreted as normal breathing. However, even though it may appear the victim is breathing, he or she is not exchanging air well and will require immediate assistance to increase his or her survival rate. While lay rescuers describe agonal respiration in a number of ways, the good news is that 911 dispatchers have become better equipped to recognize all the ways in which people describe it, leading to better assistance and improved response times. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/training/cpr-first-aid/video/tourniquets https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2048.mp4 Tourniquets Tourniquets are tight, wide bands placed around an arm or a leg to constrict blood vessels in order to stop blood flow to a wound. Generally, tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. Other reasons to consider using a tourniquet include: If bleeding cannot be controlled by direct pressure If the injury is in a location where direct pressure isn't possible If multiple people need help with life-threatening injuries and help is limited If the scene is unsafe or becoming unsafe Warning: Tourniquets can be extremely painful. Therefore, it's best to warn the victim beforehand. And tell them why they'll be wearing a tourniquet. How to Provide Care If you have a commercial tourniquet, great. If not, anything that you can wrap around an injured limb will work – a piece of rope, an insulated wire. Tie that into a knot and then insert a screwdriver, stick, or pen and begin twisting to tighten. Your goal in using a tourniquet is to control bleeding before hypovolemic shock sets in due to blood loss. Pro Tip 1: What may seem like a wound that won't stop bleeding, may just be due to pressure that's not being applied directly over the wound. Bandages can slip. Victims could be in shock and not applying as much pressure as it appears. Make certain that direct pressure truly fails before considering a tourniquet. We will assume that you've already made sure the scene is safe, and you're wearing latex-free gloves or have thoroughly washed your hands and have determined that the victim is currently not in shock. Apply the tourniquet over the extremity where the injury as occurred and a couple inches above the wound to limit tissue damage. Avoid wrapping around joints and follow the manufacturer's instructions. Secure the tourniquet as tightly in place as possible. Slowly tighten the tourniquet handle until bleeding stops. Fasten the handle to the tourniquet. Test the victim's toenail or fingernail to make sure you get a delayed capillary response, so you know the tourniquet is working as it should. Write down on the victim's dressing what time the tourniquet was applied and give that information to EMS. The ABCs of Bleeding Regardless of the bleeding incident, it's important to understand these simplified steps to trauma care response: A – Alert! Call 911.B – Bleeding. Find the bleeding injury.C – Compress. Apply pressure and stop the bleeding by: Applying direct pressure with a clean cloth or dressing pads. Using a tourniquet. Packing or stuffing the wound and then applying pressure. A Word About Perfusion Perfusion is how your body's circulatory system delivers oxygen and nutrients to your organs, all of which require varying amounts of perfusion. Your heart, for instance, requires constant perfusion to continue working. Your brain can last four-to-six minutes without perfusion, before damage begins to set in. Your kidneys can last 45 minutes and your skeletal system about two hours. What does this have to do with tourniquets? Pro Tip 2: It's important to keep in mind that limiting perfusion is a bad thing. But when we apply a tourniquet to a victim, that's exactly what we're doing. We're voluntarily cutting off the supply of oxygen and nutrients to a part of someone's body. So, it bears repeating: Tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/training/cpr-first-aid/video/amputation https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2047.mp4 Amputation An amputation from trauma involves the loss of an extremity like a finger or toe but could also include an arm or a leg. It's important to not get too distracted looking for the amputated part and focus on the wellbeing of the victim. As amputation injuries often occur in machine accidents, the amputated part can get thrown quite a distance from the scene of the accident. It may also be covered in saw dust or shavings of some kind, which could make finding it more problematic. If there are other people on the scene, you may want to consider asking for help to locate the missing part. Amputation injuries are quite serious. It’s important to assess the patient beyond the amputation, including: Did the victim lose consciousness? If so, did they hit their head and are now suffering from a concussion? Is the victim showing signs of being in shock? How to Provide Care Clean-cut amputations bleed less than you might expect and often less than crushed extremities or partial amputations. The reason for this is that the arteries contract up into the stump and clamp down, which helps to control the bleeding for at least the first few minutes following the amputation. After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. If there is already a cloth or dressing pad covering the stump, don’t remove it, as this will pull off some of the clotting blood. Apply a second piece of gauze padding and, if necessary, subsequent pieces until bleeding is controlled and apply pressure. If the victim can't help apply pressure, you'll need to manage it yourself or ask someone to assist you. Pro Tip 1: With amputation injuries, there will sometimes be a protruding bone fragment. These can be very sharp and may cut you while you attend to the victim. Therefore, it's important to be careful when dressing the wound. If you're not, you could easily: Damage the bone further Cause more pain to the victim Introduce bacteria into the wound Once you've controlled the bleeding, meaning it is no longer leaking through the dressing pads, it's time to wrap the wound with a roller gauze bandage. Pro Tip 2: Your goal in wrapping the wound is to apply enough pressure to hold the dressing pads in place and control the bleeding. Be careful not to wrap so tight that you cut off circulation. Remember to use the pinch test on finger and toe nails if appropriate and you are able to. If blood begins to leak through while you're wrapping the wound, simply insert another dressing pad and continue wrapping. If you need extra pressure at that point, twist the bandage over the wound area. This will apply a bit more torque and should help control the bleeding. When you're done wrapping, tuck or tape the end of the bandage. By this point, the bleeding should be controlled, and the patient should be stable. Continue assessing the victim for signs of shock or other health concerns. How to Handle the Amputated Extremity If you or someone at the scene were able to find the amputated part, it’s important that you handle it properly using the following steps. Make sure it's clean. Wrap it in a sterile gauze pad, preferably an abdominal dressing pad if you have one. This will offer much more insulation than regular pads and help protect the part from cold damage. Place the part into a sealable plastic bag. Put the bag with the part between two cold packs or into a bag filled with ice water and seal that bag. Warning: The amputated part has no blood flowing through it, which makes it much more susceptible to frost bite and tissue damage. You want to keep it cold, not frozen. It's also important to keep it dry. When skin becomes water logged and gets pruney, this is actually the onset of that tissue breaking down and will make reattachment more difficult. Pro Tip 3: It's important to keep the amputated part with the victim and, if possible, out of sight from the victim. You don't want to encourage psychosomatic shock, but you want the surgeons at the hospital to have access to both victim and part immediately. As amputations are serious injuries, you should be continually assessing the victim for signs of shock or other life-threatening conditions. A Word About Early Signs of Shock We will be discussing shock in great detail in the next lesson, but it's important to know that it's a progressive condition. Symptoms may seem minor at first, but the situation can quickly get worse. Your rapid response is vital. Early symptoms of shock include: The victim expresses anxious or apprehensive feelings The victim's body temperature is lower than normal The victim's breathing is quicker than normal The victim's pulse has increased The victim's blood pressure has decreased The victim's skin appears pale or clammy If you suspect that the victim is in shock, it's important to call 911 immediately. It's impossible to know when an individual will go into shock, but with amputation injuries you may want to consider the threat more elevated. And knowing the warning signs and being able to spot them early on could make a big difference. https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/training/cpr-first-aid/video/intro-to-profirst-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2043.mp4 ProFirstAid Introduction Welcome to ProFirstAid. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. And at the end, we'll give you a little information on why learning CPR is so important. Your instructor for the duration of your ProFirstAid course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and a co-founder of ProCPR and ProFirstAid. In other words, you're in good hands. We created ProFirstAid with you in mind. Regardless of your occupation, you'll be getting the best training available for infant, child, and adult CPR and first aid. Your schedule is probably hectic, which is why ProFirstAid is available whenever you are, 24 hours a day, seven days a week. You can squeeze in a quick lesson whenever you have a few minutes to spare, whether it's day or night, weekend or workday. It's there when you need it. The list of occupations that can benefit from the ProFirstAid course is long and includes: Daycare providers Elementary/Middle School Teachers Elementary/Middle School Coaches Foster parents Nannies / Babysitters Bus Drivers Tour Guides Others who require Pediatric CPR (adult, child, and infant) and First Aid to meet OSHA requirements The total course time includes 4 hours and 22 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual here: Student Manual. What You Will Learn in this Course Your ProFirstAid course curriculum is extremely substantial. Some of the important things you'll be learning are: Introductory CPR & First Aid Training• Latest Updates• The Five Fears of CPR Rescue• Accessing EMS with Technology Medical Emergencies• Stroke• Heart Attacks Universal Precautions Cardiac Arrest Training• Adult, Child, Infant CPR• AED Training• Hands-Only CPR Choking Training• Adult, Child, Infant Choking (Conscious)• Adult, Child, Infant Choking (Unconscious) Bleeding Control• Capillary, Venous, Arterial Bleeding• Amputation• Shock• Tourniquets• Hemostatic Agents• Animal & Human Bites Injuries• Mechanism of Injury• Secondary Survey• Musculoskeletal Injuries• Head, Neck, and Back Injuries• Concussion• Burns• Eye Injuries Sudden Illness• Fainting• Diabetes• Seizure• Snake Bites• Allergic Reactions & EpiPen• Asthma• Recovery Position Heat & Cold Emergencies Prevention• Car Backing• Child Proofing the Home• Poison Control• Pool Safety• Child Abuse and Neglect ProFirstAid is an adult, child and infant, pediatric CPR/AED, and First Aid 2-year certification. If you are currently certified with Red Cross, AHA, National Safety Council, ASHI, or Medic First Aid, you are welcome to utilize the ProFirstAid.com program and receive a new, two-year ProFirstAid certificate. Individuals are free to train, refresh, and test at no charge any time 24/7! ProFirstAid's class is nationally accredited and follows the latest American Heart Association, ECC/ILCOR guidelines. Those of you old enough to remember may recall that McDonald's signs used to include a running total of the number of hamburgers sold until that number outgrew the sign. More than 65,000 satisfied professionals just like yourself have completed this ProFirstAid course. And although our numbers aren't growing as quickly as McDonald's, we do sincerely hope that you'll be the next person who has a satisfying experience. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Why Learning High-Quality CPR is Important ProFirstAid is different from the typical CPR and first aid courses. We believe that high-quality CPR training is something everyone should be able to access, for free. So, rather than paying simply to learn CPR, the payment is at the very end, only for those who need a certification card for work. We also believe that the problem with CPR isn't that everyone is doing CPR incorrectly. The bigger problem is that people aren't doing CPR at all. That's why we start with the "why." Why are people afraid to rescue? What happens when CPR doesn't work? These are just a few of the parts of the training that will make even the most seasoned professional walk away from the course learning something new or thinking about CPR differently. Gaining confidence in your skills is a big part of performing high-quality CPR and administering vital first aid. Remembering that as you progress through each lesson will serve you well. Welcome again to ProFirstAid. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3645/intro-to-profirst-aid-2015.jpg Yes 45 https://www.procpr.org/training/cpr-first-aid/video/when-cpr-doesnt-work https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2041.mp4 When CPR Doesn't Work This is the last lesson in the cardiac arrest section, and a difficult topic to tackle for most. Whether you're a licensed paramedic, family member, neighbor, or stranger, the question remains the same for many people: Why didn't CPR work? That's a fair question. Even when you do everything perfectly, the desired outcome often isn't what you expected or hoped for. However, some of that hope and desire can be rooted in a misunderstanding of what CPR really is, which is the point of this lesson. CPR was designed to buy time, and nothing more. During cardiac arrest the heart is either in a fibrillatory state, meaning it's wiggling around in a disordered fashion, or it's completely asystolic, meaning it's not contracting at all. When a heart is healthy and operating as it should, it beats from top to bottom in a very organized way utilizing one-way valves. It works perfectly to circulate oxygenated blood throughout the entire body, and it does so efficiently. However, during cardiac arrest, regardless of what caused it, the heart is unable to circulate blood and oxygen and the body begins to die. The patient isn't breathing. There's no pulse. At this point, that person is clinically dead. Now, it doesn't mean that person will remain that way, as there is a difference between clinical death and biological death. What CPR aims to do, specifically the compressions, is to make up for the circulation that isn't happening naturally. The reality, though, is that even when CPR is performed perfectly, it's delivering only a small percentage of what the body needs to survive. It wasn't designed to be equal to artificial life support. Remember, it's simply a way to buy time. People have this idea that if they perform chest compressions on an unresponsive person, the body will remain alive. And he or she will remain alive so long as the chest compressions continue. But this isn't the case. CPR doesn't stop the dying process. It slows down biological death a little. But that's all it does. The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives – an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. – and the underlying cause of the cardiac arrest can be addressed. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival. CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology. The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are. If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact – by performing high quality CPR, you gave the patient the best possible chance of survival. Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way. That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. Now, you may be asking yourself, if CPR rarely works, is it even worth trying? EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying. And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember – we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them. The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough (even strangers) to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live. Isn't that the greatest gift we can give to another? This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. If you've ever performed CPR on a cardiac arrest victim, but the patient still remained dead, hopefully this greater understanding of what CPR really is has brought some peace to you, as the pain, agony, and guilt can be immense. Go forth and rescue confidently! And be at peace with yourself when you do. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/training/cpr-first-aid/video/arterial-bleeding-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2036.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding injury. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. Pro Tip #1: The most important thing with an arterial bleeding wound is to apply pressure and stop the bleeding. Apply pressure. Stop the bleeding. Keep these in mind as you progress through this lesson. Find the source of the bleeding. You may have to remove or cut away clothing to reveal the wound. Pro Tip #2: An arterial bleed can be a frightening situation. Reassure the victim and let them know that you'll stay with them until additional help arrives and that you'll take good care of them while you wait. Cover the wound as long as no impaled objects are protruding from it. Ideally, a sterile pad or bandage would work best, but use whatever you have available, so long as it's clean. Apply direct and constant pressure to the wound. If the victim is conscious and can assist, this will help. Warning: Remember, arterial wounds will be pulsating or spurting, and it will likely take several dressing pads to control the bleeding. So, don't be surprised by the amount of blood or the difficulty you may experience in controlling it. Apply new pressure pads or bandages as needed, if blood begins to soak through the one(s) already applied. DO NOT remove the old bandage or pad, as this can strip the wound of blood trying to clot and only delay your ability to control the bleeding. After bleeding is controlled, you can begin to wrap the wound using an elastic bandage. Start at the furthest point from the body and wrap over any and all dressing pads you placed over the wound. (If the wound is on the arm, begin wrapping at the end where the fingers are.) Wrap around the wound at least an inch on each side and overlap the bandage as you wrap. Go down the arm, up the arm, and repeat as many times as necessary. Pro Tip #3: To apply even more pressure to a difficult wound, twist the bandage one time directly over the wound and repeat as necessary. This will tighten-up the pressure where pressure is most needed. When done wrapping, cut the end of the bandage and either tape it down or tuck it into the wrap to hold it in place. An arterial bleed is an automatic 911 call. It's always a good idea to activate EMS in an emergency. You can always cancel the call or send them away once they arrive. But if the situation suddenly turns dire, you'll be glad knowing they're on the way. Warning: Watch for signs of shock. Does the victim appear pale, sweaty, or cold? (Shock is very dangerous and something we'll get into more in a subsequent lesson.) Also monitor the victim for difficulties breathing, circulation problems, or other injuries you may not have noticed earlier. At this point, the victim should be stabilized and the bleeding under control. If you activated EMS, simply wait for them to arrive. If EMS is not on the way, you can find another way to get the victim to the next level of medical care, most likely an emergency room. A Few Common Arterial Bleeding Questions Should I elevate the wound above the heart? No, not anymore. While this was once the protocol for dealing with a bleeding wound, we're no longer doing this. Should I apply a tourniquet if I cannot control the bleeding? Yes, but only if you can't stop the bleeding and it's a matter of life and death. Cutting off circulation to any part of the body is a serious event and best left to professionals. Can I let the victim drive himself or herself to the hospital? No, especially not in this case, as blood loss from an arterial wound can be severe and cause reactions that don't mix well with operating a moving vehicle. However, in general, this should be avoided. There may be a chance that the victim has difficulty seeing his or her own blood, which could cause psychogenic shock. It's always better if the victim is a passenger rather than the driver. How do I know if I wrapped the wound too tightly? This can be a real concern and one reason we only use tourniquets in serious situations, as you don't want to cut off blood supply to ANY part of the body for too long. Look at the fingers or toes or whatever extremities are closest to the wound. Are the nail beds still pink or are they beginning to turn blue? Pinch a nail and the fleshy underside between two of your fingers. The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. https://d3imrogdy81qei.cloudfront.net/video_images/3631/arterial-bleeding-child-2015.jpg Yes 236 https://www.procpr.org/training/cpr-first-aid/video/diabetes-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2057.mp4 Diabetes In this lesson, you'll learn how to help a person with a blood sugar emergency. Some things to keep in mind about blood sugar problems: Signs and symptoms are the same for low blood sugar and high blood sugar Blood sugar issues will get worse without treatment Without treatment, the person could become unresponsive and die The three most common signs and symptoms of someone experiencing a blood sugar issue are: Confusion Coordination issues Talking nonsense A person with a blood sugar issue might also randomly fidget with something and appear quite out of it. There are two major types of diabetic emergencies – high blood sugar and low blood sugar. High blood sugar is different than low blood sugar for a few important reasons. The signs and symptoms of high blood sugar can take hours or days to appear. It usually involves noticeable increases in thirst and urination, as the body tries to rid itself of excess sugar. (Incidentally, these are often the first signs of diabetes.) There's very little treatment that can be provided outside of a healthcare environment. In high blood sugar emergencies, call 911 or get the person to an emergency room for treatment. Pro Tip #1: The latter stages of a high blood sugar emergency will involve something called ketoacidosis, which produces a tell-tale sign of a fruitiness or cheap wine smell on the breath. While you cannot do anything about high blood sugar, you can provide help to those suffering from low blood sugar emergencies. Warning: Low blood sugar emergencies can easily catch people by surprise, as symptoms can appear in seconds or minutes. Some common signs and symptoms of low blood sugar include: Dizziness Lethargy Confusion Slurred speech Agitation How to Provide Care Treatment for low blood sugar can be summed up with one word: Sugar. However, some delivery methods are faster than others. And some sugars aren't really sugars at all. Let's explain. Sugary food sources are abundantly available, which makes them good options in a diabetic emergency. However, you'll want to steer clear of the carbs, particularly grains and fibers, as these are slow digesting and will hinder the quick fix you're looking for. Instead, focus on candy, or better yet, drinks. Sodas and especially orange juice are great food options. Just make sure the ingredients in your “medicine” includes sugar and not a sugar substitute. So, no diet sodas for sure. A Better Option – Glucose Tabs, Liquid, Gel This option is especially key for known diabetics or friends and family members of known diabetics. Glucose products have been specially designed to be absorbed quickly. These products are more beneficial for reasons beyond how fast they work though, including: Long shelf life Stable in extreme heat and cold Small, easy to carry in a purse, backpack, etc. While glucose products are a great option for all of these reasons, they can be quite difficult to open. They naturally come sealed to avoid tampering, and while not particularly difficult to open when lucid and sober, when you're confused and dizzy and in the grips of a diabetic emergency, it could be problematic. Not to worry. Simply remove the seal in advance of any emergencies, and you may just shave some precious time off the delivery of treatment. Pro Tip #2: Known diabetics should know what their glucose dose is, just like any other type of medicine. This is something a physician can address. Knowing how much glucose you need in a diabetic emergency may be invaluable, and a much better option than guessing. A Few Common Questions About Diabetic Emergencies How long does it take for glucose products to work? It can take up to 15 minutes to feel the effects of consuming sugar or glucose after a hypoglycemic event. Known diabetics will hopefully know what their dose is and how long to wait after the first dose before taking another. If the person having the diabetic emergency isn't a known diabetic, you'll have to guess when it comes to dosing. If symptoms aren't improving after a couple of doses (for glucose products) or a full 16-ounce bottle of soda or orange juice, there could be something else going on; call 911 and activate EMS if you haven't already done so. What if the person having the diabetic emergency is having trouble swallowing or keeping food and fluids down? A person can only consume a glucose or sugar product if they are able to swallow safely. If their sugar event has escalated to the point where they cannot control their swallow reflex, it's too late. Sugar will need to be administered through an IV or by intermuscular injection. Call 911 immediately and activate EMS if this is the situation. In what other situations should I call 911? Any situation beyond the scope of your care should involve a 911 call. But as it pertains to diabetic emergencies, call 911 if the victim: Isn't breathing normally Loses consciousness Loses a pulse Goes into shock This is your first hypoglycemic event You may have gone through a diabetic emergency before, either involving yourself or someone else. But if this is your first diabetic emergency, be on the safe side (whether you're the victim or the rescuer) and call 911. https://d3imrogdy81qei.cloudfront.net/video_images/3673/diabetes-child-2015.jpg Yes 483 https://www.procpr.org/training/cpr-first-aid/video/musculoskeletal-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2053.mp4 Musculoskeletal Injuries The musculoskeletal system is actually the combination of two specific systems – the muscular system and the skeletal system, including each of your 206 bones. And let's not forget the ligaments, tendons, and joints that hold it all together. Breaks, strains, sprains, and soft tissue injuries are some of the most common types of injuries that you'll likely encounter, in everyone from the elderly to youth sports participants. How to Assess and Handle a Musculoskeletal Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "How much pain or discomfort are you in?" So long as the patient is conscious, alert, and breathing normally, activating EMS can likely wait while you investigate further, as calling 911 is often not required with these types of injuries. Pro Tip #1: The real question that needs answering is this: Does this injury require activating EMS, a visit to the ER, or is it something the patient can shake off? So, how do we answer that question? With musculoskeletal injuries, the patient will often times be self-splintering – instinctively holding the area in pain – when you find them. That injury will be obvious, so make sure you also look for those that aren't. "Do you hurt anywhere else?" Also begin to further assess the injured area. If clothing is in the way, cut around that area to expose the injury. Look for bruising, swelling, some kind of deformity or abnormal angulation, bone fragments, bleeding, etc. Do you see any signs of a serious injury? Or a developing condition? How is the victim's skin color? Are the nail beds bluish or pink and normal? Poor circulation can be serious and warrants an immediate 911 call. Ask the patient how he or she feels. People, especially adults, have a sense of whether or not an injury is serious. With children, you may have to read between the lines a bit and pay more attention to body language and whether they're becoming more concerned about the injury or less concerned. If the two of you are coming to the same conclusion – that maybe the injury isn't that bad, help them walk it off, so to speak. Assist them in whatever way they need – getting to their feet or by helping to support their body weight. If it's not bad, as you suspected, they'll be fine. However, if the inverse is obvious, that the patient is in pain and the injury is now causing more discomfort, help them back into a comfortable position, call 911, and help protect and stabilize the injured area as best as you can until help arrives. Pro Tip #2: If you can safely stabilize an injury, do so. But make sure stabilization won't cause secondary problems, increase the patient's discomfort, or aggravate the injury. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. A Word About the Musculoskeletal System Injuries to muscles, bones, and joints can be difficult to detect. Knowing the specific mechanisms of the injury will provide important clues about which body parts are likely injured. There are three basic mechanisms of injury: Direct force – when the injury is located at the point of impact Indirect force – when the injury is located some distance from the point of impact Twisting force – when the injury is caused by a rotating force There are four basic types of musculoskeletal injuries to keep in mind when assessing patients, each of which is caused by one of the mechanisms above. Fractures Fractures are bones that are broken or damaged – chipped, cracked, etc. Fractures can either be closed, meaning the skin over the injury is intact. Or they can be open, in that the injury is exposed, making it much more serious. Open fractures are more prone to infection. And they can include excessive bleeding that may be difficult to control. Dislocations Dislocations are the displacement of a bone. When a severe force causes a bone to move one joint away from its normal position, this is known as a dislocation. Dislocations also typically result in ligaments and tendons that have been stretched, torn, or displaced. Shoulders and fingers dislocate more easily than other areas of the body. Sprains Sprains occur when ligaments are torn or stretched. The greater the number of ligaments involved, the more severe the sprain. Strains Strains are similar to sprains but involve muscles and tendons instead of ligaments. And as tendons are stronger than muscles, making them more resistant to injury, when dealing with strains, they're more likely to involve a muscle than a tendon. https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/training/cpr-first-aid/video/fainting https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2056.mp4 Fainting This lesson focuses on what to do when you come upon a patient who has just fainted. Fainting is defined as a temporary loss of consciousness that's usually related to temporary insufficient blood flow to the brain. Fainting is also referred to as syncope, blacking out, or passing out. There are a number of reasons why a person would pass out and many of those are not at all life-threatening. In fact, when someone faints, the biggest concern is usually the victim's inability to protect themselves as they're falling, which can lead to a number of things going wrong – broken bones, head or face injuries, etc. In many fainting situations, there is no one around who witnessed the accident. Which means you may need to put on your detective hat to properly discover potential injuries. How to Assess and Treat a Patient who Faints As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #1: The first thing you'll want to do is to assess for life-threatening conditions, including head and neck injuries. After ruling out more serious conditions, begin to see if the patient has a simple problem, like low blood sugar or dehydration that contributed to his or her passing out. When you come upon a fainting victim, as long as there is nothing more serious going on, they will likely be awake and responsive. They may be sitting up already or are ready to sit up with your help. At this point you'll want to interview the patient to see what's going on. "Can you tell me what happened here today?" "Do you hurt anywhere?" It's common for fainting victims to be weak and dizzy afterward. The important thing is that the patient is awake and responsive enough to answer your questions. However, continue to monitor for: Airway issues Breathing problems Weak or rapid pulse Pale, clammy skin Pale and clammy skin are signs of shock. If you determine the patient to be in shock, that warrants an immediate 911 call and activation of EMS. As always, err on the side of patient welfare. Pro Tip #2: Just because the situation doesn't appear serious doesn't mean it can't suddenly become serious. If you don't have an AED already, it's a good idea to send someone at the scene to go find one. If, for instance, the fainting was caused by a serious heart dysrhythmia, an AED could be lifesaving. It's typical for fainting victims to begin to recover under their own powers. As they are coming around, gauge their mental alertness, ask again about the presence of pain, and of course, continue to assess for signs of something more serious: Decreased level of consciousness Airway, breathing, or circulation problems Signs of shock Long-bone fractures Varying degrees of responsiveness If you, at any point, notice any of the above, call 911 and activate EMS or call in a code if you're in a healthcare setting. Then treat the patient accordingly. A Word About Syncope and Presyncope Syncope, or fainting, is caused due to a temporary reduction in blood flow to the brain. Depriving the brain of its normal blood flow can cause it to momentarily shut down. When this happens, it triggers a fainting episode or syncope. But what specifically triggers fainting? There are a number of things that trigger it, including: Emotional shock Pain Certain medical conditions Overexertion In pregnant women and older people – getting up from a seated or lying position Syncope can occur without warning. Or there could be some early signs, such as dizziness, the feeling of being lightheaded, or feeling like your about to faint. Together, these symptoms have a name – presyncope. How to Prevent Someone in Presyncope from Fainting Help the patient lay down. Continue to monitor the patient's breathing and level of consciousness. Instruct and help the patient perform physical counter-pressure maneuvers (PCM). Three Examples of Physical Counter-Pressure Maneuvers Have the patient grip one hand at the fingers with the other and try to pull them apart without letting go. They should hold the grip for as long as they can or until their symptoms disappear. Have the patient hold a rubber ball or similar object in their dominant hand and then squeeze the object for as long as they can or until their symptoms disappear. Have the patient cross one leg over the other and squeeze them together tightly. Have them hold this position for as long as they can or until their symptoms disappear. Physical counter-pressure maneuvers help raise the patient's blood pressure through skeletal muscle contraction and, in many cases, will resolve symptoms of faintness. Let the patient know to avoid holding their breath while performing the maneuvers. An easy way to avoid this is to engage the patient and keep him or her talking. https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/training/cpr-first-aid/video/concussion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2038.mp4 Concussion This lesson is for those times when a head injury may have led to one of the more common and serious injuries – concussions. Pro Tip #1: Concussions occur as the brain moves abruptly from side to side inside the skull, essentially bouncing off the walls that protect it. In serious concussion cases, the brain can shut down immediately, causing the victim to lose consciousness. Even in situations that don't involve a loss of consciousness, a person who exhibits other concussion signs and symptoms are at least mildly concussed. Part of your job is to determine if the victim is concussed and how severe it is by reading the signs and asking open-ended questions. Warning: The most important thing to keep in mind as you deal with someone who has sustained a head injury, as soon as it appears to be a concussion, that deserves an immediate 911 call. Even if the patient begins to recover, concussions are too traumatic and can develop into something more life-threatening. How to Assess and Treat a Concussion As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "Do you know if you hit your head?" If you suspect a head injury, ask questions about headaches, blurred vision, nausea, while also looking over the victim for concussion symptoms including: Eye-tracking – can they follow your finger Blurred vision, which indicates swelling in the brain Dizziness, loss of balance Nausea, vomiting Loss of memory Dazed and confused If the victim exhibits any of these symptoms, it's best to call 911 immediately. If they don't, continue assessing them. "Do you know what day it is?" "Do you know what year it is?" If the victim answers those two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. Which as you know by now, deserves a 911 call. Pro Tip #2: When it comes to head injuries, it's better to be safe than sorry. Get the patient to the ER whenever in any doubt and get them properly examined. Always err on the side of patient welfare. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. In concussion cases, the patient will likely require a 24-hour observation period to make sure that symptoms and swelling in the brain are reduced, which is the norm. However, these issues and symptoms can also worsen. A Word About Injuries to the Head The problem is that the head lacks the padding often present in other areas of the body. Which means it can easily be injured. And that injury can easily be considered serious. There are two main types of head injuries – open and closed. An open head injury is one that breaks or penetrates the skull. Excessive bleeding can occur and controlling that bleeding will be vital for a positive outcome. The other type is a closed head injury. Closed head injuries occur when the brain strikes against the inside of the skull and when the skull remains intact. These injuries are much more difficult to detect as there is a decided lack of visible clues. The four subtypes of head injuries are: Concussion Skull fractures Penetrating wounds Scalp injuries Let's take a deeper look into the physical, emotional, and behavioral signs and symptoms of a concussion. Physical symptoms include: Headache Blurry vision Nausea or vomiting Dizziness Sensitivity to noise or light Balance problems Feeling sluggish Emotional symptoms include: Irritability Sadness Heightened emotions Nervousness or anxiety Behavioral symptoms include: Sleeping more or less than usual Difficulty falling asleep Changes in playing habits for kids Changes in eating habits Thinking and remembering skills may also be impacted and include the following symptoms: Difficulty thinking clearly Difficulty remembering events that occurred just prior to the incident and just after the incident Difficulty remembering new information Difficulty concentrating Feeling mentally foggy Difficulty processing information https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/training/cpr-first-aid/video/seizure-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2058.mp4 Seizure In this lesson, you'll learn how to treat a child or adult who goes into a seizure or has just come out of one, including when to call 911. A person can have a seizure for too many reasons to mention. As you are concerned, why it happened isn't important. Being able to recognize it and treat it is the key. For you to know if a seizure took place, ideally you or someone else saw the patient go into a tonic state that exhibited the following signs: Hands are gripped and pointed inward The patient is actively seizing The patient ends the seizure in the postictal state (relaxed recovery) Pro Tip #1: Some seizure victims will be known epileptics and many of the people around them will probably know how to care for one and have been through it before. But if you're helping a person you don't know to be an epileptic, treat this event as the person's first seizure. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. However, if the victim is in the middle of a seizure, you'll want to start with the following: Call 911 and activate EMS. (Or better yet, ask a bystander to do it while you help the victim.) Protect the victim from any environmental hazards, like sharp objects. Pro Tip #2: There are many different types of seizures, some of which can be more active than others and involve the victim violently contracting and releasing. It's also quite common for a seizure victim to hit his or head on the floor or ground while seizing. Warning: Never try to hold down or prevent a seizing person from a having a seizure. All you can do for them is to keep them safe during the episode. Place something under the seizing victim's head like a coat or hoodie or even your hand. After the seizure has passed, begin a secondary assessment of the victim. Do you notice any major injuries or airway obstructions? Are there any other potentially life-threatening issues? Get the victim into a recovery position. The Recovery Position To help keep the victim's airway open and clear, put them into the following recovery position. You want gravity to work with you, as there could be saliva, blood (if the victim bit his or her tongue), or eventually vomit that may need to come out, rather than back into the victim's airway. Elevate the arm closest to you and bring it up over the victim's head before placing it on the ground. Bring the victim's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the victim toward you and onto their side. Pro Tip #3: Always roll the victim toward you, not away. You'll have better control over them and will be much less likely to accidentally roll them too far and onto their face. Plus, being able to see their face could be important for visual clues of how they're doing. Support the head while you place the victim's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the victim's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the victim from rolling over. While waiting for EMS to arrive, continue to assess the victim for breathing and recovery signs, like talking. Any signs that the person is becoming more responsive are good signs. Remember, if the victim begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive. A Few Common Questions About Seizures What about putting something into the victim's mouth to keep them from biting or swallowing their tongue? This practice is no longer recommended. DO NOT put anything into a seizing person's mouth. All you can do is keep them comfortable and safe during the ordeal. What if the person stops breathing while in the recovery position? If there any problems at all – the victim isn't breathing normally, loses a pulse, loses consciousness, etc. – roll them back onto their back and treat them accordingly. If the person stops breathing but still has a pulse, perform rescue breathing. If the victim stops breathing and loses his or her pulse, begin full CPR. Why do seizure victims seem confused after a seizure? A person who has just experienced a seizure – essentially an electrical storm in the brain – will be low on oxygen. As a result, they may be confused or combative and this will likely last a few minutes. https://d3imrogdy81qei.cloudfront.net/video_images/3675/seizure-child-2015.jpg Yes 377 https://www.procpr.org/training/cpr-first-aid/video/capillary-bleeding-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2046.mp4 Capillary Bleeding While you're probably familiar with veins and arteries, capillaries may warrant a quick definition. Capillaries are tiny blood vessels linking arteries and veins that transfer oxygen and other nutrients from the blood to all body cells and remove waste products. Generally speaking, there are three types of bleeding. Arterial is the worst of the three and the hardest to control, as it's under pressure and gushes. Then there's venous bleeding – those wounds drip and ooze and are under negative pressure. And then there's capillary bleeding. Capillary bleeding has the classic appearance of a road rash type of wound. Anyone who has fallen off a bike or while playing sports likely has some experience with this type of bleeding injury. Capillary bleeding distinctions are: The blood tends to ooze or bubble up on the surface of the wound The pressure is very low and will usually clot on its own or with minimal direct pressure The blood is mixed with serous fluid Serous fluid is a yellowish liquid that is made up of proteins and water. It's the same fluid that fills a burn blister and is the body's attempt to heal the wound. How to Provide Care Don't get too distracted by the obvious abrasive wound which isn't probably life-threatening. Instead, think about other areas and possible injuries that may require care and may even be life-threatening, such as: Head wounds, concussions Neck or spinal injuries Fractures Ask the victim if they're hurt anywhere else, and if they're experiencing any other pain. Once you've established that you're only dealing with an abrasion, treat it using the steps below. As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. (If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer.) Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. Find the source of the bleeding. You may have to remove or cut away clothing to reveal the wound. Clean the wound using clean, potable water. Pour or run water over the abrasion while brushing off blood and debris – dirt, loose pebbles, etc. Pro Tip #1: While capillary bleeding wounds tend not to be as serious as arterial or venous, the pain is usually more severe. If you encounter embedded debris in the wound, save it for medical personnel who can numb the area before removing those objects. Dab the wound with (ideally) a sterile pad or bandage. However, anything clean will work, like napkins or tissue. Once the wound is clean and dry and the bleeding has stopped, apply an antibacterial cream (if you have one) to stop any chance of infection. Apply a bandage large enough to cover the entire wound. A standard size band aid isn't going to cut it. If you have a first aid kit, check for a 3”x4” sterile dressing pad. Then put the antibacterial cream directly on the pad, then apply that side to the victim's abrasion. Pro Tip #2: While a bandage would be nice, it's not really necessary. (The antibacterial cream is far more important.) Just make sure the victim is careful with the wound while in transport to a place where a bandage can be applied. To hold the bandage in place, fix two pieces of medical tape (from the first aid kit you hopefully have), one to the top of the dressing bandage and one to the bottom. Ask the victim to hold the bandage in place while you tape it over their wound. Remember, even though capillary bleeding injuries aren't usually serious, it's always important to monitor the victim for signs of shock – pale, cool, sweaty, trouble breathing, etc. Shock can escalate a situation very quickly; better to catch it early and activate EMS immediately if you do. A Few Common Capillary Bleeding Questions Can I clean the wound using hydrogen peroxide? While you may have heard about using hydrogen peroxide for wound cleaning, the medical community is steering rescuers away from this practice, as peroxide is a little too harsh on body tissue. Instead, clean the wound using clean, potable water. It's a much better option. Why are capillary bleeding wounds usually more painful than arterial or venous bleeding wounds? Capillary bleeding injuries affect the epidural layer where the nerve endings are located, which is why they can be more painful than other types of bleeding injuries. What's the biggest area of concern with capillary bleeding injuries? With arterial and venous bleeding injuries, controlling bleeding is the chief concern. However, with capillary bleeding injuries, reducing the chance of infection is BY FAR the greatest area of concern. Remember, these injuries usually involve a collision between a large surface area of the body and an external surface area that's likely far less than sterile, leaving some of that unsterile surface inside the fresh wound. https://d3imrogdy81qei.cloudfront.net/video_images/3651/capillary-bleeding-child-2015.jpg Yes 271 https://www.procpr.org/training/cpr-first-aid/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/cpr-first-aid/video/allergic-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2060.mp4 Allergic Reactions While there are only around 1500 deaths each year in the U.S. from severe allergic reactions, it is nonetheless frightening how quickly these allergic reactions can occur. Around 50 million Americans suffer from an allergy, and this is a number that's apparently on the rise. One theory as to why has to do with our too-sterile modern life. One that includes: Antibacterial soap Hand sanitizer Air-tight homes An increase in environmental pollutants It seems our body's immune systems aren't developing as effectively to fight germs and other foreign invaders like they were in the past. The most common causes of all allergic reactions are from foods (number one) and insects (number two). Children are most affected when it comes to food allergies. And while most kids outgrow their food allergies, according to the CDC, the number of children with food allergies rose by 18 percent in a 10-year span from 1997 to 2007. Pro Tip #1: While most kids outgrow most food allergies, there is one that cannot be outgrown – the peanut. Sadly, peanut allergies are for life. What Causes an Allergy? The job of your immune system is to protect your body from foreign invaders – various bacteria, germs, and viruses. A healthy immune system protects the body even in the presence of these invaders. However, when there is an allergy present, the immune system will mistakenly target and overreact to a threat that doesn't really exist. This results in your immune system attacking a harmless substance that has recently been eaten, inhaled, injected, or come into contact with the skin. And that substance is called an allergen. An allergen can be introduced to the body a number of times with no trouble. Then, for seemingly no reason, the body one day decides to flag that allergen as a foreign invader, which triggers the body to attack the allergen. And to further complicate matters, the body will remember the allergen and produce specific antibodies that will attack the allergen even more fiercely next time it's introduced into the body. Pro Tip #2: This is why allergic reactions are often more severe the second or third time – the build-up of antibodies and larger battles. When the immune system attacks the allergen, high quantities of histamine and other chemicals are released into the surrounding tissues. Depending on the part of the body affected, symptoms can include: Itching Hives and rash Sneezing Wheezing Swelling of the face Runny nose Nausea There is one particular kind of allergic reaction that can be especially life-threatening – anaphylaxis. Anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Warning: Anaphylaxis can cause the body's blood vessels to suddenly dilate – as in opening all the way up, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen-starved. Anaphylactic shock will cause death if not treated. One common and basic treatment for anaphylactic shock is epinephrine (or an epi-pen), as it constricts blood vessels and opens the airway, thereby reducing the effects of the allergen. The most common causes of anaphylaxis are bees and other stinging insects, latex, medications and the following foods: Nuts Fish Shellfish Eggs Milk The most common cause of severe, life-threatening allergic reactions is by far the peanut. How to Treat for Allergic Reactions As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first things you'll want to look for are the signs and symptoms of allergic reactions and anaphylactic shock: Trouble breathing Wheezing Tightness in the throat Itchiness on the tongue Swelling of the face Hives Pale skin Rapid heart rate Low blood pressure Nausea Vomiting Diarrhea Dizziness How children typically describe an allergic reaction may better help understand some of the signs: It feels like there's hair on your tongue You experience tingling Your mouth itches It feels like something is stuck in your throat Your lips feel tight Your body feels weird all over Warning: The key element with allergic reactions is time. Don't wait. Call 911 immediately. If available, use an epi-pen. But don't wait for symptoms to get better. The three steps to providing care for allergic reactions are: Recognize the signs early Call EMS or a code if in a healthcare setting Assist the patient with an epi-pen if needed Pro Tip #3: Keep the patient calm. Sit them down. Make sure they're comfortable. To make breathing easier, have the patient sit straight up and lean forward. If the patient is feeling faint or is losing consciousness, lie them down, elevate their legs, and keep them warm. Talk to them, reassure them, but be prepared to begin CPR if they suddenly stop breathing or become completely unresponsive. Warning: There is the possibility of a secondary reaction after the first. Which is why the patient should be monitored for four to six hours after the initial allergic reaction. A Word About how to Know if it's Anaphylaxis? Depending on the situation, there may be different things to watch out for as you put the puzzle pieces together. Here's a cheat sheet that may help. Situation #1: You know that the patient has been exposed to an allergen. What to Look For: Trouble breathing OR Signs and symptoms of shock Situation #2: You think the patient may have been exposed to an allergen. What to Look For: Any TWO of the following: A skin reaction Swelling of the face, neck, tongue, or lips Trouble breathing Signs and symptoms of shock Nausea, vomiting, cramping, or diarrhea Situation #3: You do not know if the patient has been exposed to an allergen. What to Look For: A skin reaction (such as hives, itchiness, or flushing) OR Swelling of the face, neck, tongue, or lips PLUS Trouble breathing OR Signs and symptoms of shock https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/training/cpr-first-aid/video/how-to-use-an-epipen-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2061.mp4 How to Use an EpiPen There's nothing as scary as a severe and sudden allergic reaction (called anaphylaxis), as the body reacts to a foreign substance that produces a number of different symptoms simultaneously, and usually within mere minutes of the allergen coming into contact with the body. Anaphylactic shock will cause death if not treated. Epinephrine is the first line of defense when it comes to treating anaphylaxis. And the sooner it's administered, the less severe the allergic reaction. In this lesson, we'll cover what anaphylactic shock is, what it does to the body, and how we can help someone who's having a severe allergic reaction until advanced medical personnel arrive. Anaphylaxis Effects on the Body During a severe allergic reaction, there are two biological mechanisms working together, albeit while moving in opposite directions. Blood vessels relax and dilate. As this happens, blood and other fluids leak into the body's tissues, which decreases blood pressure and will eventually starve vital organs of oxygen. At the same time, the airway begins to tighten. The bronchioles and alveoli sacs are filling with mucus and other fluids and breathing becomes more and more difficult. People with a history of allergic reactions should always carry an epinephrine pen. Pens are single dose, pre-filled, automatic injection devices, also known as epi-pens. The following instructions are specifically for Epi-Pen brand. If you're using a different brand of epi-pen, be sure to follow the manufacturer's instructions. How to Provide Care Before we get into how to use an epi-pen, let's look at some common signs and symptoms of an allergic reaction, which include: Hives Itchiness Swollen tongue Scratchy throat Pale Lightheaded Difficulty breathing Pro Tip #1: Any time an epi-pen is used, be sure to call 911 and activate EMS. The person, even if feeling better, must seek further medical attention after a severe allergic reaction. Especially if this is their first allergic reaction. Make sure the epi-pen isn't expired. Remove the pen's safety cap. Grip the pen in your hand with the tip pointing down. Warning: Never put your thumb, fingers, or hand over the tip of the pen (or the back); you may accidentally inject yourself while treating the victim. Firmly push the tip of the pen into the victim's outer thigh at a 90-degree angle and until you hear the pen click. Needles can penetrate clothing. Keep the auto-injector firmly pressed against the patient's thigh; hold for a minimum of three seconds. Pull the epi-pen straight out. Warning: Make sure you don't pull the pen out at an angle. This can cause a lot of pain and bleeding. And if blood comes out of the leg (along with some epinephrine), there's a good chance the effectiveness of the shot will be reduced. Rub the area for 10 seconds, as this will increase absorption of the epinephrine within the leg muscle. Pro Tip #2: A second epi-pen may be used if symptoms persist or recur and if EMS has been delayed for more than 5 to 10 minutes. Usually the patient will notice some airway relief pretty quickly, as the tightness in the throat begins to dissipate. There are, however, some unfortunate side effects that some patients may experience, including: Rapid heartbeat Shakiness Feelings of anxiety Dizziness Headache A Few Common Questions About Anaphylaxis Should I administer the epinephrine, or should I let the victim do it? Let the victim handle the epi-pen if they're able to. If dealing with a small child or someone who's unable to do it themselves, assist as needed. If you do have to assist, try and get permission to do so for reasons of liability. The American Heart Association recommends helping in the following scenarios: Only assist if/when: The patient has a previous diagnosis of anaphylaxis and has been prescribed an epinephrine auto-injector The patient is having signs and symptoms of anaphylaxis The patient requests your help using an auto-injector Your state laws permit giving assistance What if there are complications while waiting for EMS to arrive? It's always a good idea to monitor for other issues while waiting for paramedics to arrive, like loss of consciousness, an increase in breathing difficulties, respiratory arrest, and cardiac arrest. If the person stops breathing but still has a pulse, perform rescue breathing. If the victim stops breathing and loses his or her pulse, begin full CPR. Pro Tip #3: Remember, you can always call 911 and put the phone on speaker. Dispatch can help walk you through any first aid scenarios you may not be comfortable with. Also, it's important to understand that once a person loses consciousness and a pulse, they're technically already dead. And there's no way to make that situation any worse. If the victim begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive. Are there different doses of epinephrine? Yes. Epinephrine devices are available in different doses, as the dose of epinephrine is based on weight – 0.15 mg for children weighing between 33 and 66 pounds, and 0.3 mg for children and adults weighing more than 66 pounds. People with a known history of anaphylaxis would be wise to carry an anaphylaxis kit containing at least two doses of epinephrine with them at all times. https://d3imrogdy81qei.cloudfront.net/video_images/3681/how-to-use-an-epipen-child-2015.jpg Yes 274 https://www.procpr.org/training/cpr-first-aid/video/car-backing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2067.mp4 Car Backing / Reversing This lesson deals with car backing emergencies and how you can prevent them. You're probably well aware of the extreme number of lives lost each year on U.S. roads and highways. But how many of you give consideration to lives lost by another type of traffic accident – those involving vehicles backing up? A number of lives are lost each year from slow-backing accidents, and many of these occur at home in the driveway. The problem is that, even when you're alert and paying attention while backing up, children can still dart behind your vehicle and get quickly into a blind spot in the time it takes to glance at the rearview mirror. Warning: When a small child is behind a vehicle, the driver often cannot see the child in any of the mirrors, creating a dangerous blind spot for the child. Which is why adopting a safe routine for backing up is so important. Create a Safe Backing Routine It's important to have a policy or protocol in place that you can execute each time before you even put the car in reverse to ensure your children are safe before backing out. You can put together a safe backing routine a number of ways, but one that works well is to establish a visible gathering place for all the kids. The gathering place should be in a location you can see them and in front of the vehicle. Do a head count. When all kids are accounted for, put the vehicle in reverse and back out slowly. Be sure to continue to monitor the children for any movement, but also in a way that allows you to scan mirrors for traffic and other people. Backing up at a minimal speed is important, as it may be necessary to suddenly stop in case there's an emergency. Pro Tip: A car moving slowly is a car with the ability to stop quickly. (Not really Pro Tip material, but better than leaving you Pro Tipless this lesson.) Remember that an ounce of prevention is worth a pound of cure. And that any moments of inconvenience are well worth the bit of extra effort. A Word About Lightning Yes, lightning! While it has absolutely nothing to do with car backing emergencies, it does deserve special recognition, as an ounce of prevention is truly worth a pound of cure when it comes to lightning strikes. In the U.S., there are more deaths each year due to lightning strikes (100) than due to any other weather-related hazard or event, including blizzards, hurricanes, floods, tornadoes, earthquakes, and volcanic eruptions. During a lightning strike, the lightning travels back and forth between the ground and the cloud many times during that one visible flash. How's that, you ask? Well, lightning travels at a swift 300 miles per second. The list of possible effects on someone who has been struck by lightning include: Thrown through the air Clothes burned off Heart stops beating Neurological damage Fractures Loss of hearing Loss of sight A single lightning strike can wreak havoc on the human body, as it can deliver up to 50 million volts of electricity, or enough to light 13,000 homes. Precautions You Can Take to Avoid Being Struck by Lightning During storms, it pays to use common sense and to respect the power of nature. Use the following precautions to stay safe in inclement weather. Postpone activities promptly and remember that thunder and lightning can strike without rain. Go inside a completely enclosed building. If you cannot find one, a cave is a good option, but move as far back as possible from the cave entrance. Watch cloud patterns and conditions for signs of an approaching storm. Designate safe locations and use them at the first sound of thunder. And remember, every five seconds between the flash of lightning and the sound of thunder equals one mile of distance. Use the 30-30 rule. When you see lightning, count the seconds until you hear thunder. If that time is 30 seconds or less, the thunderstorm is within six miles. Seek shelter immediately. The threat of lightning continues for a much longer period than most people realize. So, wait at least 30 minutes after the last clap of thunder before leaving the shelter. If inside during a storm, keep away from windows. Injuries may occur from flying debris or glass if a window breaks. Stay away from plumbing, electrical equipment, and wiring during a thunderstorm. Water and metal are both excellent conductors of electricity. Do not use a corded telephone or radio transmitter except for emergencies. Bonus Precaution: If the movie Caddyshack taught us anything, it's the dangers of golfing during a thunderstorm. Hit the clubhouse for an hour or three, or postpone entirely. https://d3imrogdy81qei.cloudfront.net/video_images/3693/car-backing-2015.jpg Yes 110 https://www.procpr.org/training/cpr-first-aid/video/child-proofing-the-home https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2068.mp4 Child Proofing the Home Child-proofing a home is essential to protect children against normal household items that could present a risk to them, such as sharp objects, and choking and electrical hazards. Pro Tip: To see what a child sees, you have to get to their level. So, drop down to your hands and knees and begin crawling around the house looking for hazards that children can get into. You may be surprised what you notice seeing things from that perspective. How to Child Proof a Home There are a number of hazards in any home to be aware of, including: Choking hazards. Any loose item that can fit into a child's mouth will likely end up … in a child's mouth. It takes just a few minutes to pick these items up and prevent a possible emergency. Electrocution hazards. Items that may not be a choking hazard can still be put into an electrical outlet. If those items are metal, that could be a problem. Children are naturally curious and tend to exist according to the mantra, I wonder what happens if. Burn threats. Young kids aren't big enough to reach the stove yet, but that doesn't mean that burn hazards don't exist. Watch where you put hot beverages like coffee, tea, and soup. On the edge of a low-lying tabletop that can be reached by an infant is a burn waiting to happen. Staircase threats. Staircases are dangerous environments for small children. Keep doors to stairs closed or use an adjustable safety gate that fits into stairways. Also, keep stairs clear of items that everyone, adults included, can trip over. Child-proofing a home will greatly help eliminate these unnecessary hazards. Prevention takes only a bit of time and effort, but it can make a huge difference in the health and lives of the children in that home. A Word About Helping a Conscious Choking Infant Since the biggest threat, and reason for child-proofing a home, is likely choking, let's take a look at the exact technique for helping a conscious choking infant. You'll be performing a combination of back slaps and chest thrusts to try and dislodge the airway obstruction. But first, if there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Draw an imaginary line across the infant's nipples and place two fingers on the sternum in the center of the infant's chest. Your fingers should be perpendicular to the chest, meaning your knuckles are directly above your fingers. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. And they can do a quick assessment for internal bleeding or other damage. If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is around 80 percent effective if you perform the back slaps and chest thrusts properly. If you couldn't remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/3695/child-proofing-the-home-2015.jpg Yes 140 https://www.procpr.org/training/cpr-first-aid/video/pool-safety https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2069.mp4 Pool Safety Every year numerous lives are needlessly lost to drowning incidents, and many of those lost are young children. In this lesson, you'll learn how to recognize a drowning victim and how to help them to safety. Many times, a person who is a true drowning victim behaves differently than we might expect. They're likely not yelling for help, as they could be taking in water and unable to speak. It's important to understand what a drowning victim looks like. Signs of a potential drowning victim include: Exaggerated movements Head bobbing up and down at water line Arms flailing Making little noise beyond sounds of splashing How to Safely Rescue a Potentially Drowning Victim Once you've identified a potential drowning victim, use the following methods to rescue them and help them safely out of the pool. Pro Tip #1: The protocol for rescuing a drowning victim can be summed as such: Reach. Throw. Don't go. DO NOT swim out to get them unless you're a trained and certified lifeguard. Otherwise, you could end up a second drowning victim. Try to reach the victim from the side of the pool. If the victim is close enough, make sure you stay low to the ground and maintain a low center of gravity, while reaching out to them with your hand. Pull them out of the pool or assist them in getting to the nearest ladder and then out. Turn a towel into a rope. If you can't reach the victim with a hand, grab a towel and coil it up into a makeshift rope. Swing one end out to the drowning victim while you hang onto the other end. Drag the towel in with the victim in tow and help them out of the water. Use a pole or leaf skimmer. A swimming pool usually has these sorts of poles laying around, either for rescue purposes or cleaning and maintenance. And they often can telescope in and out, making them ideal to aid a drowning victim who is further away from the side of the pool. Pro Tip #2: If using a pole to assist a drowning victim, make sure you're standing with your forward-leading foot out in front of you. Lean back and use your weight as a counterbalance. Extend the pole and lower it down beside the victim. Once they grab it, lean back and pull them to safety. Use a life jacket or floatation device. If the victim is too far out to reach any other way, see if there are some floatation devices, like pool noodles or life jackets that you can toss out to them. Once the victim has the floatation device, instruct them to kick their feet and encourage them to keep coming, as they're likely exhausted and scared. Pull them to safety once they reach the side of the pool. If you called 911 and activated EMS, it's a good idea to keep them coming, especially if the victim took in some water. There could be some potential breathing issues or an aspirational pneumonia developing. Warning: If the victim is unresponsive when pulled from the water, begin CPR immediately. And always call 911 as soon as you think there's an emergency. If it turns out there isn't an emergency, you can always cancel the 911 call. But if turns out to be a real emergency, you'll be glad you activated EMS. A Word About Drowning When it comes to drowning, there are several critical facts and statistics to be aware of. Some important statistics. Drowning is the fifth most common cause of death from accidental injury in the United States for all ages, and it rises to the second leading cause of death for children ages 1 to 14. And males are more than three times more likely to drown than females. On the threat of drowning. Younger children can drown at any moment, even in as little as an inch of water. Young children commonly drown in home pools. Children with seizure disorders are 13 times more likely to drown than those without such disorders. Early recognition is key. Most people who are drowning spend their energy trying to keep their mouth and nose above water. As you learned earlier, recognizing someone who seems to be having trouble in the water, but is not calling out for help, may help save their life. There are three types of water-related victims: A distressed swimmer who is too tired to continue but afloat. A drowning victim who is active and vertical but not moving forward. A drowning victim who is passive, floating, or submerged and not moving. Don't become a victim yourself. Only those trained in swimming rescues should enter the water to assist with drowning emergencies. For your safety, look for a lifeguard before attempting a rescue, have the appropriate safety equipment, call for additional resources immediately if you do not have that equipment, and only swim out if you have the proper training, skills, and equipment. https://d3imrogdy81qei.cloudfront.net/video_images/3697/pool-safety-2015.jpg Yes 340 https://www.procpr.org/training/cpr-first-aid/video/child-abuse https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2070.mp4 Child Abuse and Neglect Child abuse and neglect is a very serious topic and not one that anyone enjoys reading about. But it's vitally important, especially for those of you working in an industry mandated to report any suspicions of abuse and neglect. Pro Tip #1: A mandated reporter is a person required by law to report reasonable suspicions of abuse and neglect, such as teachers, day care providers, EMS personnel, coaches, camp staff, and other professionals. According to statistics from the U.S. Department of Health and Human Services, 679,000 children were the victims of abuse and neglect in 2013, and in that same year 1500 children died as a result. Of those 679,000 child abuse victims, 80 percent suffered from neglect, 18 percent from physical abuse, and nine percent from sexual abuse. These numbers indicate a serious problem that has become far too common. In this lesson, you'll learn the key indicators for recognizing abuse and neglect in children. How to Recognize Abuse and Neglect Child abuse is a prevalent problem that can occur anywhere, including: Child day care centers Schools Religious institutions Recreational and athletic facilities Camps Residential facilities The child's home What is Neglect? Neglect by a parent or primary caregiver is the most prominent type of child abuse. It's defined as a failure to provide adequate food, clothing, shelter, supervision, or medical attention. Indications of neglect include a child who … Looks undernourished Appears lethargic and tired Has poor hygiene Is inappropriately dressed for the weather Sustains injuries due to lack of supervision Has poor self esteem Has trouble relating to others What is Physical Abuse? Physical abuse is defined as non-accidental physical injury to a child – by striking, shaking, throwing, burning, biting, cutting, etc. Pro Tip #2: All kids get bumps and bruises from time to time, particularly those that are more adventurous or into sports. It's important for you to understand when those injuries occur due to abuse versus regular childhood mishaps. Physical indications of physical abuse include: Questionable bruises, cuts, and welts Cuts and bruises to the torso, back, buttocks, and thighs Injuries in various stages of healing, indicating abuse over time Bruises shaped like the objects that were used – belt buckle, electrical cord, etc. Burns like those from cigarettes, particularly on the soles of the feet, palms of the hands, back, and buttocks Immersion burns like you would get from scalding hot water Burns in the shape of irons, stove top burners, etc. Rope burns, especially on the arms, legs, neck, and torso Fractures Black eyes Behavioral indications of physical abuse include when the child is … Uncomfortable with physical contact Wary of adults Apprehensive when other children cry Emotionally unstable, aggressive one moment, withdrawn the next Frightened of own parents Afraid to go home – perpetually arrives to school early and stays late Trying to hide the injuries – reluctant to change in front of others, wears clothes to conceal injuries Pro Tip #3: Does the child have a history of running away from home? A child with a long history of repeated attempts to run away can also be cause for concern, particularly when combined with any other indicators of abuse. What is the Difference Between Discipline and Abuse? This comes up occasionally as corporal punishment (spankings and such) are still allowed in certain areas of the U.S. What defines discipline? It is a learning process to teach appropriate behavior. What defines abuse? Inflicting pain; that's it. There's no learning objective. It's usually the result of anger, frustration, and loss of control. How Can You Tell the Difference Between Abuse and Accidental Injury? As mentioned earlier, kids get hurt sometimes; it's part of being a kid. But sometimes it's much more than that. And while injuries from abuse and accident can look similar, there are some important differences you should know about. When it comes to accidental cuts and bruises, the areas most affected are on the outside of the body, like knees and elbows. However, with abuse, the common areas are the stomach and buttocks. As frequency goes up, the chances of accidental injury go down. Look for injuries, especially bruises, in different stages of healing, as in different colors. This may become a moot point if the child is a tackle football player. Do the injuries resemble an object – like a wooden spoon or electrical cord – or appear in a pattern. These are pretty suspicious circumstances and most likely from an adult. Has the parent or primary caregiver provided the same story as the child? Does their relationship appear normal, or does the child appear afraid of the parent or caregiver? What is Sexual Abuse? Sexual abuse is a complex type of child abuse and is defined as any illegal sexual act upon a child including incest, rape, indecent exposure, fondling, child prostitution, and child pornography. There are often no visible signs to accompany sexual abuse, or else they're too subtle to notice or attributed to something else. Add to that how the adult abuser is usually able to manipulate the child into silence and uncovering sexual abuse becomes even more difficult. For the child, this sort of manipulation is beyond their scope of understanding. It's emotionally confusing. And it results in a wide range of emotional responses. Indications of child sexual abuse include when the child has … Inappropriate knowledge of sex Sexually explicit drawings An unexplained fear of a person or place or is attempting to avoid a familiar adult Nightmares or sleep disruptions Become withdrawn Guilt and shame issues Symptoms of depression and anxiety Wild mood swings Pro Tip #4: The best indicator is when a child says so. Take statements seriously. Resolve doubt in favor of the child. And err on the side of protection. Three Ways Sexually Abused Children Share Their Experience Because of the secrecy involved or the fact they're told something bad will happen, children who are sexually abused rarely tell anyone. They may, however, provide a mix of clues if you're paying attention. Here are three examples of things a child suffering from sexual abuse may say. Indirectly – My babysitter keeps bothering me. Disguised – What would happen if a girl was being touched in a bad way and she told someone? With strings attached – I'm having a problem, but if I tell you about it, you have to promise not to tell anyone. When dealing with a child who has been sexually abused, listen, remain calm, and encourage the child to talk, but never press them. Be honest. Tell them the truth, which is that you may need to tell someone in order to get them the help they need. If you ever suspect abuse or neglect, report your suspicion to local law enforcement or child protective services in your area. And if you're a mandated reporter, you have a legal responsibility to report. https://d3imrogdy81qei.cloudfront.net/video_images/3699/child-abuse-2015.jpg Yes 896 https://www.procpr.org/training/cpr-first-aid/video/unconscious-adult-choking-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2118.mp4 Practice: Unconscious Adult Choking Learn how to give CPR to an adult who is unconscious and choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/training/cpr-first-aid/video/unconscious-child-choking-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2119.mp4 Practice: Unconscious Child Choking Learn how to give CPR with an AED to a child who is unconscious and choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3797/unconscious-child-choking-lay-rescuer-practice-2015.jpg Yes 112 https://www.procpr.org/training/cpr-first-aid/video/adult-cpr-community-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2111.mp4 Practice: Adult CPR Learn how to give CPR to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3781/adult-cpr-community-lay-rescuer-practice-2015.jpg Yes 118 https://www.procpr.org/training/cpr-first-aid/video/child-cpr-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2112.mp4 Practice: Child CPR Learn how to give CPR to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3783/child-cpr-lay-rescuer-practice-2015.jpg Yes 80 https://www.procpr.org/training/cpr-first-aid/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/cpr-first-aid/video/snake-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2059.mp4 Snake Bites In this lesson, you'll learn how to treat a patient who has been bitten by a venomous snake. When dealing with snake bite victims, there is one special point to take note of: If you have the snake, DO NOT bring it to the hospital, just take a picture from a safe distance or remember key features of the snake so the venom can be identified. Just don't get bit yourself trying to look at or take a picture of the snake. How to Treat a Patient who has been Bitten by a Snake As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Call 911 and activate EMS. Give them as much information as possible so that the patient gets routed to a hospital that has the correct antivenom. Get the patient into a comfortable position – seated or laying down – where they can be as calm as possible. They could become dizzy, and you don't want them falling and injuring themselves. Reassure the patient – tell him or her that they're in good hands, that EMS is on the way, and that they'll be taken good care of. You don't want them to get excited, nervous, or agitated, as the patient's heart rate will increase and circulate the venom faster. Warning: What you don't want to do – You don't want to use a cold pack; these have been widely ruled out now. And you certainly don't want to suck out the venom, unless you have a special fondness for urban myths. Keep the patient's snake-bitten limb or area level with the heart, if possible.  Raising or lowering of the extremity may both be correct, but that would depend on the species of snake and the condition of the patient.  Get the patient into the ambulance with as little movement as possible. Is there a golf cart around? How about a stretcher? How close can the ambulance get? You don't want them walking, or moving, any more than is absolutely necessary. Get the patient to the correct hospital with the correct antivenom and the life-saving treatment they may need. A Word About Venomous Snakes Snakebites kill few people in the United States. Of the estimated 7000 to 8000 people reportedly bitten each year, fewer than five die. And most of those deaths occur because the person has an allergic reaction, is in poor health, or because too much time passes before the person receives medical care. When it comes to the biggest threat, rattlesnakes account for most snakebites and nearly all of the deaths from snakebites. Venomous snakebite signs and symptoms include: One or two distinct puncture wounds, which may or may not bleed. The exception is the coral snake, whose teeth leave a semicircular mark Severe pain and burning at the wound site immediately after or within four hours of the bite Swelling and discoloration at the site of the bite immediately after or within four hours of the incident If the bite is from a venomous snake such as a rattlesnake, copperhead, cottonmouth, or coral snake, call 911 and activate EMS for more advanced medical personnel. To give care until help arrives, simply follow the steps outlined above. And if you're interested in more of what not to do, we have a list for that, too: Do not apply ice Do not cut the wound Do not apply suction Do not apply a tourniquet Do not use electric shock, like from a car battery https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/training/cpr-first-aid/video/animal-and-human-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2370.mp4 Animal and Human Bites In this lesson, you'll learn what to do when you come across patients who've been bitten by animals and/or humans. There are a few considerations that differentiate animal and human bites. However, for the most part, general first aid care will be the same for both. How to Treat for Animal and Human Bites As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Let's quickly differentiate between minor wounds and serious wounds. A minor wound is defined as bites that caused teeth marks, bruising, or scratching. When you encounter minor wounds, simply wash the area thoroughly with soap and water. For scratches, apply an antibiotic ointment to prevent infection, then cover the area with a clean bandage. A serious bite wound is one in which the skin has been punctured or torn and is bleeding. A victim with an open bite wound must seek advanced treatment from a physician due to the high risk of infection. A serious bite wound can include severe bleeding. Unless the wound is still oozing or spurting blood, wash the area with soap and water, apply sterile dressing, and seek advanced medical treatment. If the wound is still bleeding, apply direct pressure with a clean dry cloth or sterile gauze pad and first stop the bleeding. Apply a bandage once the bleeding has been controlled. If your serious bite wound does include arterial or severe bleeding, apply direct pressure, call 911, and watch for signs of shock. A severe bleeding incident is one in which the wound is spurting or pulsating blood and the bleeding is difficult to control. Special Considerations for Human Bites The most common type of human bite occurs among young children who are curious, angry, or frustrated. Children at day care centers are most at risk for human bite wounds. Most human bite wounds among children are harmless, as more serious child bite wounds are very unusual. The biggest threat when it comes to human bites is infection, as human saliva contains hundreds of species of bacteria. In fact, a bite wound is more likely to become infected if it came from a human versus an animal. Pro Tip #1: For any human bite wounds that break the skin, the patient will need to seek advanced medical care due to the risk of infection. And while highly unlikely, bloodborne pathogens like HIV and hepatitis B or C can be transmitted by human bites. Special Considerations for Animal Bites Most animal bites come from domestic pets like cats and dogs and typically involve young children. The biggest threat with animal bites, even domesticated animals, is the risk of rabies. If the animal bite included the skin being punctured by a non-immunized animal, or from an animal whose immunization status is unknown, the patient will need to be treated by a physician immediately. Pro Tip #2: Most rabies cases involve wild animals, like foxes, raccoons, skunks, and the most common rabies carrier of them all – bats. If you suspect that a patient was bitten by one of the above, keep in mind the need to seek swift medical treatment for rabies. Warning: Tetanus can be a concern in both animal and human bites. If a patient suffered a deep bite wound and he or she hasn't had a tetanus shot in more than five years, a booster shot should be encouraged. When it comes to animal and human bites, just following the general first aid guidelines, particularly for bleeding control and infection control, will encompass the majority of the treatment you provide. A Word About Animal Bites Dog bites are the most common among all types of wild and domestic animals. It's important that when a person is bitten, that they are quickly removed from the situation if possible. It's equally important to do so in a way in which you're not endangering yourself or others. Clean minor wounds with soap and clean water and do your best to control bleeding with major wounds. If the patient is bleeding severely, apply pressure and control it as best you can until advanced medical personnel arrive. Tetanus and rabies immunizations may be necessary, so it's vital that bites from any wild or unknown domestic animals be reported to the local health department or another agency according to local protocols. If the animal is still loose, follow local protocols regarding contacting animal control to capture the animal. Try to obtain and provide a description of the animal and the area in which the animal was last seen. https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/training/cpr-first-aid/video/spider-bites-tick-bites-and-scorpion-stings https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6491.mp4 Spider Bites, Tick Bites and Scorpion Stings This first aid lesson is for the treatment of spider bites, tick bites, and scorpion stings. While these encounters can be alarming and sometimes painful, knowing the proper first aid steps can help ensure a swift and effective response and recovery. It's important to keep in mind that millions of people are bitten or stung by spiders, ticks, and scorpions every year in the United States alone, and most of these are harmless. However, in this lesson, we’re going to focus on generalized treatment and what to watch for in more severe cases. Remember that the priority is always safety. Once you and the victim are out of harm's way, see if there is a way to identify what bit or stung you, as this can help identify appropriate treatment if needed. But only do this if it can be done safely. Since all of these bites or stings will have punctured the skin, gently washing with soap and water is always the recommended first step. If you notice any concerning reactions or symptoms, seek medical help immediately. In that case, watch for skin discoloration or blistering, nausea, abdominal pain, difficulty breathing, change in responsiveness, or significant pain. If there are no immediate health concerns, here are the steps to handle these bites or stings. First Aid Steps for Spider Bites If you're in a geographical area where there are venomous spiders, remove yourself from the vicinity to avoid further bites.> It's important to identify the spider responsible for the bite whenever safe and possible. Wash the bite area with mild soap and water. Elevate the bitten extremity and apply a cold compress or an ice pack wrapped in a thin cloth to the bite site. Elevating the bitten extremity will help reduce pain and swelling. Leave the compress or ice pack on the bite site for about 10-15 minutes each hour. Symptoms Associated with Spider Bites Symptoms associated with spider bites can vary from minor to severe. Although extremely rare, death can occur in the most severe cases. Possible symptoms resulting from a spider bite include the following: Itching or rash Pain radiating from the site of the bite Muscle pain or cramping Reddish to purplish color or blister Increased sweating Difficulty breathing Headache Nausea and vomiting Fever Chills Anxiety or restlessness High blood pressure Pro Tip #1: For suspected or confirmed bites from venomous spiders, such as black widows or brown recluse spiders, it's crucial to seek immediate medical attention. Call emergency services or visit the nearest hospital. First Aid Steps for Tick Bites The important thing to remember with tick bites is that the longer the tick is attached, the more likely it is to transmit diseases. So acting quickly is definitely in the victim's best interest. Remove the tick promptly using a pair of fine-tipped tweezers. Grasp the tick as close to the skin's surface as possible. Pull the tick away from the skin steadily and slowly with firmness, and try to avoid twisting or crushing the tick during this process. The skin will tent, and the tick will eventually let go. Clean the area with mild soap and water. Pro Tip #2: If you're concerned about tick-borne diseases, you can preserve the tick in a sealed container or a plastic bag. This may assist healthcare professionals in identifying the tick and determining the risk of disease transmission. Please note that if the head comes off and stays embedded in the skin, call emergency services or visit the nearest hospital. A Word of Caution Avoid folklore such as painting the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible – not waiting for it to detach. If you develop a rash or fever within several days to weeks after removing a tick, see your doctor. Tick Bite Bot: An Interactive Tool for Dealing with Tick Bites The CDC has an interactive tool that can assist you in the removal of attached ticks and also advise you on when to seek medical attention. This online mobile-friendly tool asks a series of questions covering topics such as tick attachment time and symptoms. Based on the user's responses, the tool will then provide information on first-aid treatment options. First Aid Steps for Scorpion Stings Like with spider bites, remember to first remove yourself from the area to prevent further stings. Clean the sting site with mild soap and water. Apply a cold compress or an ice pack wrapped in a cloth to the sting site to help with the pain. Pro Tip #3: While most scorpion stings are harmless, seeking medical attention is essential to be safe, as venomous species can be fatal to humans. Call emergency services or visit the nearest hospital immediately. When it comes to scorpions, prevention is key. Be proactive and take precautions by checking your clothing and inside your shoes before putting them on wherever these creatures are common. And remember that if you are stung, stay calm and follow the steps above. And as always, seek professional medical help whenever necessary. Symptoms Associated with Scorpion Stings Symptoms usually subside within 48 hours, although stings from a bark scorpion can be life-threatening. Symptoms of a scorpion sting may include: A stinging or burning sensation at the injection site Extreme pain when the sting site is tapped with a finger Restlessness Convulsions Roving eyes Staggering gait Thick tongue sensation Slurred speech Drooling Muscle twitches Abdominal pain and cramps Respiratory depression https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/training/cpr-first-aid/video/asthma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2062.mp4 Asthma Anyone who has experienced an asthma attack will tell you what a frightening situation it can be, as your airways tighten and no matter what you do, you simply cannot get enough oxygen into your lungs. Pro Tip #1: Want to know what it feels like to have an asthma attack? Imagine only being able to breathe using a thin, plastic coffee stir straw. That would approximate how a severe asthmatic attack would feel. In this lesson we'll discuss one of the best medications for acute and chronic asthma attacks (Albuterol) and how to use it correctly. How to Treat a Patient with Asthma As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: Albuterol comes in a small aerosol container with an actuator. Whether the patient's asthma is exercise induced or persistent, the effect should be the same regardless. In this lesson, we're going to include the use of a spacer with the Albuterol dispenser. Spacers are really expensive, which probably contributes to many people not using one, and sort of resembles a small plastic sippy cup. The spacer goes between the patient's mouth and the Albuterol dispenser. Warning: When not using a spacer, much of the medication, instead of going into the patient's lungs and bronchials where it should go, winds up sitting at the back of the throat and on the tongue. This obviously decreases the dosage and the effectiveness of that dose. How to Administer Albuterol Using a Spacer Pro Tip #3: Before using your Albuterol device, make sure it has actuations remaining. To find this information, look on the back of the dispenser. Most devices have a number there inside a little window that corresponds with the number of actuations remaining. And don't forget to check the expiration date! Shake the Albuterol container just prior to using it. You don't have to shake for long. A few seconds will do the trick. Insert the Albuterol mouthpiece into the end of the spacer where it fits. (It will be obvious.) Place the other end of the spacer into the patients mouth. Make sure he or she completely exhales first. Push down on the Albuterol dispenser one time and instruct the patient to hold his or her breath for 10 seconds. Instruct the patient to exhale. Pro Tip #4: A normal dosage of Albuterol for most adults is two inhalations and children may be one or two doses. So we need to always ask the patient about their specific dosage. Repeat – patient exhales out all air, puts spacer into their mouth, dispense Albuterol, hold for 10 seconds, and exhale. If the patient doesn't get relief from two injections, ask them what their prescribed amount of time is between injections and doses. If the patient is still having trouble breathing, call 911 and activate EMS. They could be suffering from a persistent asthma attack that cannot be stopped with a simple rescue inhaler of Albuterol. Get help on the way immediately, in case the patient begins having a true respiratory emergency. It's important to avoid assumptions that the patient will get better after administering a dosage of Albuterol. Always be prepared for anything. A Word About Asthma Triggers Asthma is an illness in which the airways swell. An asthma attack happens when an asthma trigger, such as exercise, cold air, allergens, or other irritants, causes the airways to suddenly swell and narrow. This makes breathing difficult, which can be very frightening. The Centers for Disease Control and Prevention (CDC) estimates that approximately 24 million Americans are diagnosed with asthma in their lifetimes. Asthma is more common in children and young adults than in older adults, but its frequency and severity are increasing in all age groups. You can often tell when a person is having an asthma attack by the hoarse, whistling sound the person makes while inhaling and/or exhaling. This sound, known as wheezing, occurs because air becomes trapped in the lungs. But what exactly triggers an asthma attack? A trigger is simply anything that sets off an attack. And they can be very different for different people. Common asthma triggers include: Dust, smoke, and air pollution Exercise Plants Molds Perfume Medications Animal dander Temperature extremes and changes in the weather Strong emotions, such as anger, fear, or anxiety Infections, such as colds or other respiratory infections Usually, people diagnosed with asthma control their attacks by controlling environmental variables (exposure to those triggers) and through medication and other forms of treatment. https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/training/cpr-first-aid/video/mechanism-of-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2050.mp4 Mechanism of Injury Physical injuries run the gamut from soft tissue injuries like bruises, cuts, and burns to those involving the musculoskeletal system and/or the head, neck, and back. While injuries can vary greatly, the tools of discovery you'll use to help you assess patients will not. When you arrive on the scene, you'll apply the mechanism of injury method to help you gain a greater understanding of what possible injuries the patient may have based, in large part, on how he or she may have sustained those injuries. How to Apply the Mechanism of Injury Method As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Warning: If the patient does begin showing signs of decreasing levels of consciousness or any problems involving breathing, airway, and/or circulation – numbness, tingling, inability to move limbs – call 911 immediately. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Pro Tip #1: Ask the victim open-ended questions when you're assessing them, rather than yes and no questions. So, instead of asking, does your head hurt?, ask, do you have pain anywhere? Asking yes and no questions can often lead them down the wrong road. During your assessment, involve family members and friends who are nearby and may have witnessed the accident. They'll also be able tell you if the victim is behaving normally or has any medical problems or allergic reactions to medications. This is even more important when dealing with injuries to children. Pro Tip #2: Don't be too myopic. Even though the injury may seem obvious, that doesn't mean another injury isn't also lurking. Keep this in mind as you perform a full head-to-toe examination of the patient. A Word About Soft Tissue Injuries Soft tissues include all the layers of skin, fat, and muscles in the human body. The largest organ is the skin, as it contains three layers of its own – epidermis (outer area that protects against bacteria), dermis (deep layer that protects the nerves), and hypodermis (the deepest layer that protects blood vessels). Soft tissue injuries are classified as closed wounds or open wounds. A closed wound is an injury that occurs beneath the surface of the skin, meaning that the outer layer of skin is still intact. There is usually internal bleeding, even if only minimally in the form of a bruise. An open soft tissue wound involves a break in the skin's outer layer, like a cut, and usually involves external bleeding – arterial, venous, or capillary. Burns deserve a special distinction as a soft tissue injury and are classified as superficial, partial thickness, and full thickness. Closed Wounds Closed wounds occur beneath the surface of the skin and are usually the result of blunt force. The contusion can be minor, like stubbing your toe, to more serious examples of blunt force trauma, like those sustained in motor vehicle accidents. Swelling and discoloration are normal in closed wounds as these are part of the healing process. Closed wounds become more serous when they affect the deeper layers, those that protect larger blood vessels and vital organs. Heavy internal bleeding can occur from a contusion or hematoma and when it affects those deeper layers, the signs may not be immediately noticeable. Opened Wounds Open wounds are those that affect the outer layer of the skin. There are six types of open wounds: Abrasions – scrapes, rug burns, road rashes, etc. – abrasions are more painful due to the presence of nerve endings nearby but don't involve much bleeding as the capillaries are mostly affected. Amputations – the loss of a limb – amputations are serious injuries that rely on controlling blood loss and shock. Avulsions – part of skin peeled away – avulsions can be very painful, and bleeding can be heavy. Crush injuries – extreme weight or force crushes a body part – crush injuries can cause great internal damage to blood vessels and vital organs. Punctures – gun shot wounds, stabbing wounds, etc. – punctures are smaller wounds that typically close around the wound, thereby limiting the amount of external bleeding. However, the puncture can also result in internal bleeding. Lacerations – cut from a sharp object – lacerations vary in severity depending on several factors, including the type of bleeding that the laceration has caused – arterial, venous, or capillary. https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/training/cpr-first-aid/video/child-cpr-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2024.mp4 Child CPR In this lesson, we'll cover how to perform CPR on a child. Much of the process will look the same as adult CPR, but there are some subtle yet crucial differences to take note of. Like in the last lesson, we'll assume that in this scenario, a child has suddenly collapsed and you don't know why. Pro Tip #1: The victim could be in this condition for any number of reasons and it's not a bad idea to consider some of these when you're doing your assessment of the scene and the victim. Is there a live electrical wire nearby? Could the victim have been bitten by a snake? (Incidentally, these two fictional scenarios also drive home the point of scene safety.) Regardless of what led to the child's condition, all you know for sure is that the victim is unresponsive and not breathing normally, if at all. And that CPR is required. What is a Child? According to guidelines, a child is anyone from one-year to the first signs of puberty. And if you just wondered about ambiguity, you'd be correct to be concerned. Let's say puberty begins around age 14. This can still be problematic since some 14-year olds are tiny, while others are bigger than many adults. Which is why it's a better idea to judge the victim by size rather than by age. This should also help reduce wasted time. Instead of having to think about it, just look, decide, and begin. Pro Tip #2: To complicate matters further, the size of your hands also matters. You see, the size of the patient determines whether you use two hands during chest compressions or just one, which means it's much more a matter of ratio (your hand size to their chest size), than it is their size alone. So, perhaps a better way of deciding whether the victim is "adult-size" or "child-size," is to see how your hands fit over their compression point. Depth Compression Matters The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. Pro Tip #3: While two inches may represent an average chest compression depth for children, it's best not to use a fixed depth. Instead, compress to a depth 1/3 the depth of the chest when performing CPR. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue shield available and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Remember, as long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation. If you've determined at this point that the victim is unresponsive and not breathing normally continue immediately with CPR, beginning with chest compressions. Remember your landmarks, which don't change when performing CPR on children: Aim for the center of the chest, between the nipples and on the lower one-third of the sternum. Hand placement: If you've determined that you should use two hands, based on the size of the victim, place your first palm on that landmark, just as you would for adults, and interlock the fingers on your top hand over your first. One-Hand placement: Place your first palm on the same landmark … and that's it. Lean over the victim, position your hand(s) as indicated above, and in the video, and lock your elbows. Use your upper body weight to supply the force needed for chest compressions and compress at a depth equal to 1/3 the depth of the child's chest. Perform 30 chest compressions at a rate between 100 – 120 compressions per minute, which amounts to around two compressions every second. Remember to allow the child's chest to come all the way back up before performing your next compression. Remember, to maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Lift the child's chin and tilt his or her head back slightly. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the child's nose and open their mouth. Deliver two rescue breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Don't forget to watch the victim's chest when performing chest compressions. If the chest doesn't rise, then you might be dealing with another problem and one that likely includes an obstructed airway. Go right back into 30 chest compressions followed again by two rescue breaths. Continue to perform 30 chest compressions to two rescue breaths until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. https://d3imrogdy81qei.cloudfront.net/video_images/3607/child-cpr-profa-2015.jpg Yes 222 https://www.procpr.org/training/cpr-first-aid/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/cpr-first-aid/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/cpr-first-aid/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/cpr-first-aid/video/hemostatic-agents https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2049.mp4 Hemostatic Agents A hemostatic dressing is any dressing treated with an agent or chemical that assists with the formation of blood clots. Much like tourniquets, hemostatic dressings are used with direct pressure to help control severe, life-threatening bleeding. Hemostatic dressings are usually only considered an option if: The bleeding is life-threatening The standard procedure of direct pressure failed The injury is located where a tourniquet wouldn't work, such as the torso, abdomen, groin, and neck A tourniquet was unavailable or ineffective How to Provide Care After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. Once you determine that direct pressure alone isn't working, and you've decided against using a tourniquet, apply a hemostatic agent or dressing to the wound followed by more direct pressure. Pro Tip 1: Hemostatic agents come in powders and dressing pads of numerous sizes. For large open wounds, you can pour the powder into the wound which will help speed up blood coagulation and clotting. If you're using hemostatic dressing with a large open wound, make sure you pack the dressing deep into the wound and apply continuous pressure until the bleeding is controlled. Hemostatic agents are an ideal option when EMS services are delayed or unavailable, perhaps in a wilderness setting, or when normal bleeding control options are ineffective. And like tourniquets, when it comes to hemostatic agents, you're just trying to buy some time before getting the victim to a surgical center for proper care. A Word About Internal Bleeding Internal bleeding is the blood loss from veins, arteries, and capillaries into spaces inside the body. This can be caused by injuries like blunt force trauma and fractures, but also due to certain medical conditions. Internal bleeding can also include external bleeding from the same incident. Consider how a knife wound could cause both internal and external bleeding simultaneously. Common signs of internal bleeding include: Discoloration of the skin Bruising and tenderness Nausea, vomiting, or coughing up blood Discolored, painful, tender, swollen, or firm tissue Victim protectively guarding the injury area Rapid pulse or breathing Moist, cool skin Pale or bluish skin Drop in blood pressure If you suspect that someone is bleeding internally, call 911 immediately and help keep the victim as still and calm as possible to reduce the heart's blood output. Also keep an eye on the victim for any signs of shock. Pro Tip 2: When internal bleeding is from the capillary blood vessels, the result is bruising around the wound area and is not serious. To reduce discomfort for the victim, you can apply an ice pack to the area. Like internal bleeding, injuries requiring a hemostatic dressing should be considered serious. And as with all bleeding injuries, you simply want to find the bleeding and stop the bleeding, by any means necessary. https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/training/cpr-first-aid/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/cpr-first-aid/video/secondary-survey https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2051.mp4 Secondary Survey The secondary survey is simply a head-to-toe examination that you'll perform on injury victims who are awake and responsive. It's important to remember to not get too focused on one obvious symptom. If you come upon a patient with an obvious arterial bleeding wound, remain focused on other potential head-to-toe problems, as you help care for the more obvious injury. How to Conduct a Head-to-Toe Exam As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Pro Tip #1: Even though the patient is awake and responsive, symptoms can always worsen. And conditions that didn't seem life-threatening a minute ago, may seem so now. If at any point things do get worse, call 911 and activate EMS. Remember to ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Notice how much they are able to move. Are they nodding when you ask a question? Are they able to move their fingers and toes? "Can you wiggle your fingers?" Look for the early signs of shock. Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. Early signs of shock include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Pro Tip #2: A quick way to find out if a victim has a circulation problem, which could be a sign of shock, is to pinch a fingernail bed on the patient and count how long it takes to return to a normal pink color. Longer than 3-4 seconds could be a sign that something else is wrong. "Can you wiggle your toes?" Continue working your way down the victim, noticing any potential issues or conditions beyond the obvious. Also, make sure they're in a position of comfort, whether that's sitting, laying down, or getting to their feet and stretching out their legs. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? Warning: It's important to remember that this secondary survey is only for patients who are awake and responsive. If at any point, a once responsive patient goes unresponsive, call 911 immediately and activate EMS. A Word About Chest Injuries Chest injuries are one of the leading causes of trauma deaths in the U.S. each year. Chest injuries are most commonly the result of falls, vehicular accidents, workplace accidents, and direct blows or crushing incidents. Warning: The area around the chest, abdomen, and pelvis contain several vital organs. Therefore, any life-threatening injury in one of these areas can be particularly fatal if left untreated. There are several types of chest injuries: Blunt Trauma Any blow to the chest or abdomen that doesn't penetrate the skin would be considered a blunt trauma injury. Common symptoms include shortness of breath, chest pain, and rapid pulse. Traumatic Asphyxia Traumatic asphyxia occurs due to a severe lack of oxygen caused by a physical trauma, typically one in which the victim was crushed or pinned. Common symptoms include shock, distended neck veins, bluish discoloration, black eyes, broken blood vessels in the eyes, bleeding from the nose or ears, and coughing up blood. Fractured Ribs Fractured ribs, though painful, are rarely life-threatening. For victims, breathing will be labored for a while and deep breaths, in particular, will be very painful. Flail Chest Multiple rib fractures in multiple places results in flail chest. Flail chest is especially serious if it includes the presence of a loose section of ribs that could puncture a lung. Pneumothorax A pneumothorax is the collapse of a lung that results from too much air in the chest cavity. At the very least, breathing will be difficult. At the worst, it could lead to respiratory distress. Hemothorax A hemothorax is excessive lung pressure due to the accumulation of blood between the chest wall and lungs, which prevents the lungs from properly expanding. https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/training/cpr-first-aid/video/head-neck-and-back-injuries-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2052.mp4 Head, Neck, and Back Injuries If you come upon a person who appears to have taken a fall, or was injured in an accident, and there are no bystanders around who witnessed the accident, you'll need to assess the victim to determine the exact injuries and their severity. Hopefully the victim will be able to help, who in this lesson, we are assuming is conscious, alert, and not exhibiting more serious issues involving airway, breathing, circulation, etc. The most important thing to keep in mind as you deal with someone who has sustained potential injuries to their head, neck, and/or back, is minimizing movement, as you inquire more into what happened and how the victim is feeling. How to Provide Care You're going to begin the same way you do with all accidents and illnesses, by making sure the scene is safe, that your gloves are on, and that you have your rescue mask with one-way valve handy if you have one. Begin calling out to the victim to assess whether or not he or she is responsive before touching them. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, check the victim for breathing, airway, or circulation problems. If you've determined that the victim is not responsive, not breathing normally, and doesn't have a pulse, call 911 immediately and go right into CPR. Pro Tip #1: Are there any bystanders around that can assist you in calling 911, locating an AED, etc.? Also, if you're ever unsure how to handle a rescue situation, call 911, put the phone on speaker, and follow the instructions from dispatch while you wait for help to arrive. For the sake of this lesson, we'll assume the victim is breathing normally, has a pulse, and is at least partially responsive. In these cases, proceed with the following steps. Introduce yourself to the victim: "Hi, my name's _____. I'm here to help you. I'm going to ask you some questions; try not to nod. Answer with yes or no. And try not to move other parts of your body.""Do you remember what just happened?""Do you know if you hit your head?""Do you know what day it is?""Do you know what year it is?" If the victim answers the last two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. This altered mental state is enough of a concern to call 911 and activate EMS if you haven't already done so. Otherwise, begin doing a head-to-toe exam in case there are other potentially serious injuries. On the victim's head: Is there blood in the ears? Is there blood in the nose? Does the patient have any broken teeth? Are the pupils equal size and responsive to light? Pro Tip #2: Put your hand over the victim's eyes for a second or two then remove it and see if their pupils react. If they do not, it could be due to a concussion and swelling in the brain. Check their arms and legs for any deformities. If the victim is responsive, you can ask them to squeeze one of your fingers or try to wiggle a toe. Pro Tip #3: When looking over the victim, remember not to move them. Instead, move your body for better assessment angles. Head, neck, and back injuries should be taken seriously; in most cases, it's going to be best to call 911 and activate EMS. Remember, we can always send them away when they arrive – so, better safe than sorry. Reassure the victim while you wait for EMS to arrive. Let them know you'll stay with them until help arrives, and comfort them if they get agitated. A Few Common Head, Neck, and Back Questions How do I know if the injuries are serious enough to call 911? It's not always going to be easy to figure out if EMS is required as you tend to a victim with head, neck, or back injuries. It may be a situation where the victim is able to get up and has no significant lasting injuries. Or it could be a situation that doesn't appear serious initially but suddenly becomes serious. If at any point the situation warrants it, call 911 immediately. There's a tremendous amount of gray area there, but also remember that it's better to call 911 and not need them … than it is to NOT call 911 and suddenly realize that you need them. What are some signs and symptoms of a concussion? Concussion symptoms include those that are physical, emotional, and behavioral, all of which are listed below. Physical symptoms include: Headache Blurry vision Nausea or vomiting Dizziness Sensitivity to noise or light Balance problems Feeling sluggish Emotional symptoms include: Irritability Sadness Heightened emotions Nervousness or anxiety Behavioral symptoms include: Sleeping more or less than usual Difficulty falling asleep Changes in playing habits for kids Changes in eating habits How can I know if the victim has pain or injuries that aren't visible to me? The answer to this question is simple – ask them. In all the confusion, something this simple may escape you. But while you're doing a head-to-toe exam of the victim, try and remember to ask them if anything hurts and where their pain is located. https://d3imrogdy81qei.cloudfront.net/video_images/3663/head-neck-and-back-injuries-child-2015.jpg Yes 212 https://www.procpr.org/training/cpr-first-aid/video/venous-bleeding-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2045.mp4 Venous Bleeding Uncontrolled bleeding is the number one cause of preventable deaths due to a trauma. While venous bleeding is usually less serious than arterial bleeding, it still can pose a serious health risk to the victim. Venous bleeding can be the result of external trauma, as in something cutting or puncturing a vein, or internal trauma, due to a broken bone or organ damage. Venous bleeding involves blood that is returning to the heart, so there won't be as much pressure as arterial bleeding. However, the blood loss can still be severe. Venous bleeding distinctions are: The blood is dark red, not bright like arterial bleeding The blood flow is steady but not spurting; it can still be quick, though The pressure is lower than arterial bleeding so it's usually easier to control How to Provide Care The good news when it comes to venous bleeding wounds is that applying constant pressure for 2-3 minutes will usually be enough to control the bleeding. Pro Tip #1: In most cases, these types of wounds clot pretty easily. However, keep in mind that this won't always be the case, especially if the victim is on blood-thinning medications or has a bleeding disorder. Also, unless the patient is showing signs and symptoms of a life-threatening emergency, you probably won't need to call 911. Just make sure to always err on the side of patient safety if you're ever uncertain. As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. Find the source of the bleeding. You may have to remove or cut away clothing to reveal the wound. Cover the wound as long as no impaled objects are protruding from it. Ideally, a sterile pad or bandage would work best, but use whatever you have available, so long as it's clean. Apply direct and constant pressure to the wound. If the victim is conscious and can assist, this will help. Apply new dressing pads or bandages as needed, if blood begins to soak through the one(s) already applied. DO NOT remove the old bandage or pad, as this can strip the wound of blood trying to clot and only delay your ability to control the bleeding. After bleeding is controlled, you can begin to wrap the wound using an elastic bandage. Start at the furthest point from the body and wrap over any and all dressing pads you placed over the wound. (If the wound is on the arm, begin wrapping at the end where the fingers are.) Wrap around the wound at least an inch on each side and overlap the bandage as you wrap. Go down the arm, up the arm, and repeat as many times as necessary. Remember, to apply even more pressure to a difficult wound, twist the bandage one time directly over the wound while wrapping it and repeat as necessary. This will tighten-up the pressure where pressure is most needed. When done wrapping, cut the end of the bandage and either tape it down or tuck it into the wrap to hold it in place. Pro Tip #2: It's always important to monitor the victim for signs of shock – pale, cool, sweaty, trouble breathing, etc. Shock can escalate a situation very quickly; better to catch it early and call 911 and activate EMS immediately if you do. A Few Common Venous Bleeding Questions How do I know if stitches are required? When you remove pressure, do the folds of skin around the cut begin to come apart, or does the skin appear to be staying together. If the skin is coming apart, stitches are likely necessary. If not, the wound will probably heal on its own and stitches can be avoided. As can a trip to the emergency room. When should I call 911? Call 911 immediately if … The victim is showing signs of shock The victim is having trouble breathing or losing consciousness You cannot stop the bleeding The situation is life-threatening in any way What about the wound getting infected? Before you wrap the wound, it's a good idea to properly clean it using an antibacterial ointment if you have one. This will combat any bacteria that may have gotten into the cut and reduce the chances of infection. As will properly wrapping the wound to avoid any dirt or debris from getting into it. Also, don't forget about the chances of tetanus. If the victim was cut by something dirty and hasn't had a tetanus shot in the last 10 years, a trip to the emergency room is a necessity regardless of the severity of the wound. https://d3imrogdy81qei.cloudfront.net/video_images/3649/venous-bleeding-child-2015.jpg Yes 137 https://www.procpr.org/training/cpr-first-aid/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/cpr-first-aid/video/infant-aed-fa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7176.mp4 Infant AED In this lesson, you'll learn how to use an AED on an infant who's gone into cardiac arrest. The methods of defibrillating an infant differ a little from adults and children, so be sure and make note of those differences. As you know, AED pads come in two sizes – adult and pediatric. Pediatric pads are for patients less than 8 years old or 55 pounds or roughly 25 kilograms, while adult pads are for anyone 8 years and older or weighing more than 55 pounds. So, since we are talking about infants, we will always opt for the pediatric pads. However, if you do not have pediatric pads available, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. Studies have shown using adult pads to be safe and effective based on the limited data available. Pro Tip #1: Some AEDs have a key or button that can be used for switching to pediatric energy levels. Be sure to use pediatric settings or pads when possible. Infant-related cardiac arrests are typically the result of: Drowning Choking/airway obstruction Electrocution This is important for reasons of scene safety. If the infant was pulled from a pool, is he or she laying in too much water to safely use an AED? If the infant was electrocuted, is the source of that electricity still a threat? It's always important to make sure the scene is safe before helping another person, but it's especially important when using an AED, where one spark can cause a lot of problems in the wrong situation. (And why we often mention combustible gases and flammable liquids in our scene safety warnings.) How to Provide Care Just like the last two AED lessons, we're going to assume a few things: The scene is safe, and your gloves are on You or someone else has called 911 You have an AED that's ready to use The infant is already in cardiac arrest (not breathing, not conscious, not moving) CPR is already in progress AED Technique for Infants Turn on the AED. Remove the infant's clothing to reveal a bare chest and dry the chest off if it's wet. Since one pad will go on the infant's back, be sure that area is also accessible and dry. Attach one AED pad to the infant's chest, roll the baby over onto his or her side carefully while supporting the head and neck, and attach the second pad to the center of the infant's back between the shoulder blades. Pro Tip #2: The AED should include a diagram on pad placement if you ever need help. And make sure they adhere well and aren't peeling off, as this will affect the AED's effectiveness. Plug the cable into the AED and be sure no one is touching the victim. The AED should now be analyzing the rhythm of the infant's heart. The AED will automatically charge if the AED finds a shockable rhythm. If the scene is clear and no one is touching the victim, push the discharge button to deliver a shock. Then go right back into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Remember, you want to minimize compression interruptions. Don't delay or interrupt compressions any longer than absolutely necessary and this includes after a shock is delivered. Go right back into your compressions. Perform 30 chest compressions. Grab the rescue shield and place it over the victim's mouth and nose. Seal your mouth over the infant's mouth and nose. Deliver two rescue breaths – Breathe into the rescue mask slowly (over one second) and watch for the chest to rise, then stop. Wait for the chest to fall before administering the next breath, this is about two seconds between breaths. Continue with CPR until the AED interrupts you. At some point, it will reanalyze the victim's heart rhythm and again advise you on what to do next. If the AED advises a shock, do that. If it advises you to NOT shock the victim, continue with CPR only, again over the pads. (The AED will continue to reanalyze.) Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until EMS arrives, the patient is responsive and breathing normally, or someone who's equally trained or better can relieve you. A Few Common Questions About AED Use Why is it so important to not disrupt or delay CPR compressions? Current research suggests that minimizing all delays is important for victim recovery, including that first compression after an AED shock. Compressions immediately help get the victim's pulse pressures back up and oxygenated blood circulating again. Will a wet diaper cause a problem with an AED? No. As wetness concerns AED use, as long as the victim isn't submerged in a pool or puddle of water, you should be fine. Keep in mind that the only areas that need to be dry are those where the pads will go. Can I remove the pads if the victim begins breathing normally again? No. Keep the pads on until EMS or other advanced medical personnel take over. The AED will continue monitoring the victim and will advise you again should problems arise, so keep the pads on and the AED turned on. https://d3imrogdy81qei.cloudfront.net/video_images/13012/infant-aed-2025.jpg Yes 329 https://www.procpr.org/training/cpr-first-aid/video/infant-cpr-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7172.mp4 Infant CPR Infant-related cardiac arrests are typically the result of: Drowning Choking/airway obstruction Electrocution Just as with child CPR, due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the infant is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on his or her forehead and tap on the bottom of the baby's feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check the infant for breathing - you don’t see any. If you've determined at this point that the victim is unresponsive and not breathing normally, continue immediately with CPR. CPR Technique for Infants Place two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should wrap around the chest. Alternatively, you can give compressions using the heel of 1 hand in the center of the chest. Conduct 30 compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face.  Place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About CPR Compression Rate and Depth Performing proper chest compressions is essential for providing high-quality CPR, which greatly improves the patient's chances for a successful outcome. Chest compressions put pressure on the heart to send oxygenated blood through the arteries to the brain and other vital organs. Chest compressions also increase the likelihood of a successful AED shock for the patient, particularly if several minutes have elapsed since the patient collapsed or suffered an incident leading to respiratory distress. Chest compression effectiveness is reduced if: Compressions are too shallow The compression rate is too fast or too slow There isn't a full recoil of the chest cavity There are interruptions during CPR The patient isn't laying on a firm, flat surface Warning: Compression rates that exceed 120 per minute tend to have a negative impact on compression depth, perhaps due to responders rushing through them. Regardless, if the compression rate exceeds 120 per minute, you are less likely to compress the full 1/3 of the chest for infants and children, thereby reducing the effectiveness of CPR. If you are unsure if you're compressing at the correct depth, a feedback device might be helpful. https://d3imrogdy81qei.cloudfront.net/video_images/13004/infant-cpr-2025.jpg Yes 357 https://www.procpr.org/training/cpr-first-aid/video/adult-aed-community-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2115.mp4 Practice: Adult AED Learn how to give CPR with an AED to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3789/adult-aed-community-lay-rescuer-practice-2015.jpg Yes 220 https://www.procpr.org/training/cpr-first-aid/video/child-aed-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2116.mp4 Practice: Child AED Learn how to give CPR with an AED to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3791/child-aed-lay-rescuer-practice-2015.jpg Yes 211 https://www.procpr.org/training/cpr-first-aid/video/conscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7181.mp4 Conscious Infant Choking This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak or babble or make any noise Their lips are beginning to show signs of circumoral cyanosis – a blue ring around the lips that indicates early signs of oxygen starvation Signs that the infant is conscious include: The baby is still moving around The baby's eyes are open Remember to activate EMS as soon as possible so long as it doesn’t delay care. If possible, have another person nearby call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant. How to Provide Care Helping a conscious choking infant isn’t significantly different than helping a child or an adult. You'll still be performing a combination of back slaps and thrusts to try and dislodge the airway obstruction. The biggest difference between infants when compared to adults or children, rather than performing abdominal thrusts, for infants we need to make sure we are performing chest thrusts rather than abdominal thrusts. Warning: Due to the fragile nature of infants performing abdominal thrusts on them could cause severe internal injuries. Chest thrusts should be used for conscious choking infants. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Rest your forearm on your leg for additional support. Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Place the heel of your hand on the sternum in the center of the infant's chest. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is extremely effective if you perform the back slaps and chest thrusts properly. If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. A Word About Pediatric Considerations Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children. The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children: Hot dogs Nuts and seeds Chunks of meat or cheese Whole grapes Hard, gooey or sticky candy Popcorn Chunks of peanut butter Raw vegetables Raisins Chewing gum According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy. It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.  https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/training/cpr-first-aid/video/conscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7180.mp4 Conscious Child Choking This conscious child choking lesson is for situations where you can see that a child is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. Remember to only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing the victim. How to Provide Care The first thing you want to do is face the child and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the child. "Are you choking?" The child will probably nod yes. "May I help you?" You'll likely get another nod. Don't wait too long to receive permission, as children may be a little more flustered than adults. Pro Tip #1: With children, they may not have the same level of awareness as adults. If they're only nodding or making gagging, high-pitched squeaking sounds, these are good indications that the airway is fully obstructed. Pro Tip #2: If the child can respond verbally, that means that they are able to move enough air past the larynx to speak. This is a good indication that something may be stuck but that the airway isn't obstructed. Or it could indicate a partial obstruction of the airway. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Blows Technique for Children Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. You may kneel if needed. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts.   Abdominal Thrust Technique for Children Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. Warning: It's important that when helping a choking victim who's shorter than yourself, that you lower yourself to their height. This will limit unnecessary pressure on the rib cage and prevent broken ribs or other possible harm while you perform the abdominal thrusts. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Remember to stay below the bottom tip of the rib cage (xyphoid process) and above the belly button. This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Lower yourself to the height of the child. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your hands upward as you perform each thrust. Perform five abdominal thrusts unless the object comes out or the child becomes unresponsive. Remember to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. If after the five abdominal thrusts, the object is still not out, alternate between 5 back blows and 5 abdominal thrusts. Once the object comes out, the child will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the child know that he or she is OK now and have them sit down if necessary. Children may experience more confusion and fear than adults, so letting them know that they'll be fine is important. If you called 911, let them come anyway, so the child can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there are no interal injuries. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the child into an urgent care center, hospital, or to see their physician. With children, don't leave it up to them to determine if more care is necessary. If you weren't able to remove the obstruction using the abdominal thrust technique, the child will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious child choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/training/cpr-first-aid/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/cpr-first-aid/video/unconscious-infant-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7182.mp4 Unconscious Infant Choking This unconscious infant choking lesson is for situations where you find an infant who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the infant isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction. In this scenario, you would treat this patient as an unconscious infant choking victim. The method of care will closely resemble performing CPR on an infant, however there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the infant to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Pro Tip #1: While repetitive and maybe not necessary, it bears repeating: The prevalence of technology has reached a point where everyone has a cell phone or mobile device. And those devices tend to have speakers making them hands-free. Also remember that in an emergency your adrenaline will likely be spiked and your brain mildly dazed and confused. If you're having trouble remembering your rescue skills, dispatch can help. Draw an imaginary line across the infant's nipples and place your two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should be wrapping around the infant’s chest. Alternatively, you may also use the heel of one hand in the center of the chest. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, and count as you perform them. Conduct 30 chest compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #2: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face. If you have an infant mask, use that.  If you can, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Here’s the difference between CPR and unconscious choking - open the airway and look for the object before giving your two breaths. If you see the object, use your pinky finger to sweep out the object. Never do a finger sweep unless you see the object. Place the rescue mask and breathe into the mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. Pro Tip #3: Because infants' mouths are small, it's best to use your pinky finger combined with a hooking motion to sweep out obstructions. If the rescue breaths go in this time – causing the chest to rise and fall – check for breathing. If after no more than 10 seconds, you do not see, hear, or feel breathing, start CPR. >Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. https://d3imrogdy81qei.cloudfront.net/video_images/13024/unconscious-infant-choking-2025.jpg Yes 217 https://www.procpr.org/training/cpr-first-aid/video/shock-lay-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7184.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. It is a serious and potentially life-threatening condition that requires immediate medical care as it is a multi-symptom and complex condition. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. There are several types of shock, including psychological shock – a psychological condition in which worry and concern send a person into shock, rather than a physical condition. While this shock lesson is in the bleeding control section, it's important to understand that any first aid emergency could send a person into shock. Pro Tip #1: The important thing to remember with shock is that the symptoms are the same regardless of what contributes to it. It's a serious condition that warrants rapid treatment and an immediate 911 call. Besides psychological shock, there are four main types. The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #2: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue mask with a one-way valve available if necessary. Warning: If at any point the victim stops breathing normally or becomes unresponsive, begin CPR (or rescue breathing) immediately and continue until medical professionals arrive. Pro Tip #3: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #4: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. A Few Common Shock Questions Are there any tests I can perform on the victim to better help identify shock? If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail bed. If it's more than a few seconds – or the time it takes to say capillary refill – your victim is likely in shock. How do I know when to call 911? It's always better to be safe than sorry, so call 911 any time it's an actual emergency or if you're unsure what to do or overwhelmed, and how exactly that's defined will vary from rescuer to rescuer. However, as it pertains to this lesson, always call 911 immediately as soon as you suspect shock or as soon as the victim loses consciousness or begins having breathing issues. In other words, err on the side of victim safety. https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/training/cpr-first-aid/video/eye-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7189.mp4 Eye Injuries Injuries to the eye can involve the eyeball, the bone, and the soft tissue surrounding the eye. Blunt objects, like a fist or a baseball, can injure the eye and/or the surrounding area. Or a smaller object could penetrate the eyeball. Care for open and closed wounds around the eye as you would for any other soft tissue injury. In this lesson, when we talk about treating an eye injury, assume we're referring to treating an injury from an object. Near the end we'll present some information on the other type of eye injury – chemical injuries.> How to Assess and Treat Eye Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Once you've ensured that the patient isn't suffering with airway, breathing, or circulation issues, the first thing you want to do is assess what type of eye injury you're dealing with – object or chemical? Both are serious! Pro Tip #1: Eye injuries are serious and always warrant a trip to the ER, whether by calling 911 and activating EMS or by private vehicle. Therefore, the job of the responder is to stabilize the wound, stop the damage, and ready the patient for safe transport. Sequence of Treatment for Eye Injuries Sit the patient down and facing you if possible. Place a small cup over the injured eye to eliminate any more damage or pressure. Ask the victim to hold the cup in place. Pro Tip #2: If you don't have a medical grade cup, a Dixie cup is a suitable alternative. And smaller is better as you'll have tape over it. Using a gauze bandage, begin wrapping over the cup and injured eye, while asking the patient to let go of the cup.  Cover the victim's head two to three times. Tuck or tape the end of the gauze to hold it in place. Pro Tip #3: The injured person has impaired eye sight with one eye covered. Be sure to be extra communicative and always talk to them as you're helping them. Having an eye covered can be disorienting. Make sure the victim's good eye is free and clear of the bandage to prevent even further impairement. Perform a secondary survey as you do the above. Assess the patient for secondary issues, from head to toe. And as always, continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. A Word About Chemical Eye Injuries This section will mirror the last lesson on the importance of, and strategies for, diluting chemical burns. Only with the eyes, and particularly the mucous membrane, damage can occur very quickly. Meaning your quick actions are essential. There are two types of chemical eye injuries – dry or wet. If you're dealing with dry chemicals, brush as much off the eye as you can before beginning to flush with a solution. If you're dealing with a wet chemical, go right into flushing the eye. Pro Tip #4: Ideally, you'll have a balanced pH solution for moments like this. Otherwise, use what you have access to – tap water, bottled water, etc. Flush the injured eye for at least 20 minutes. Your goal here is to stop the damage from the chemical. Warning: Always rinse from the inside of the eye to the outside of the eye. Flushing the eye the other way – from the outside in – could lead to cross-contamination of the other eye. While readying the patient for transport, and during your secondary survey, make sure the victim didn't get any chemicals into their mouth, nose, ears, etc. if they did, treat accordingly. Prevent Eye Injuries The single most effective measure for both chemical and foreign object injuries is wearing appropriate protective eyewear — ANSI-approved safety glasses or goggles have been shown to reduce workplace eye injuries by up to 90%. For environments involving chemicals, the CDC and OSHA recommend using sealed, indirect-vent goggles rather than standard safety glasses, since chemical splashes can travel around unprotected frames; additionally, knowing the location of the nearest eyewash station and flushing affected eyes with clean water for a minimum of 15–20 minutes is critical to minimizing damage after exposure. https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/training/cpr-first-aid/video/poison-control https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7190.mp4 Poison Control Some of the most dangerous areas of any home, especially for young, curious children, are the places where poisons are stored, such as cleaning products and medications. Limiting access to these areas will always be key to preventing catastrophe. Luckily, there are numerous procedures and products that can easily help secure cupboards, drawers, and cabinets that house these dangers. A couple simple ways to better secure household poisons include: Store all medications and dangerous chemicals up high, so they're out of reach for small children Purchase commercial made locks at the hardware store Warning: It's important to understand how a colorful liquid chemical looks to a child. Those bright colors probably look like Kool-Aid, fruit punch, or the latest soda, and appear more delicious than dangerous. Chemicals don't have to be in liquid form to be tempting to children. Another common threat lately are the dishwasher and laundry cleaning pods that children routinely mistake as candy. However, children consuming poisons is just part of the problem. Kids also don't know the difference between consuming a medication that will help them feel better when they're sick and over-consuming that same medication – something that could hurt them or even kill them. Then add to this the fact that these medications are often flavored to taste good so that children will take them. Which is why medicine cabinets deserve the same amount of precaution as those cabinets where poisons are stored. How to Treat for Poisoning Is you suspect poisoning, the first thing to do is look for clues to corroborate that suspicion, such as: Are there pills scattered about? Are there empty pill bottles or packages around? Does the victim have burns or redness around the lips and mouth? Does the victim have unusual stains or odors, particularly breath that smells like gasoline or paint thinner? Is the victim exhibiting signs of drowsiness or mental confusion? Is the victim having difficulty breathing? Has the victim vomited? Pro Tip #1: First aid treatments for poisoning have changed a lot over the years. Which is why if you suspect poisoning you should call the Poison Control Hotline at 1-800-222-1222. Keep this phone number in a prominent location for quick and easy access. Poison Control will work with you to first help identify the poison in question. And then will guide you in providing treatment for that poison. Pro Tip #2: You may have heard to induce vomiting for poisonings. This is rarely true. One more reason to call poison control and get the proper treatment advice based on the poison that was ingested. Warning: If at any point, the patient goes unconscious or stops showing signs of life (moving, breathing normally, etc.), call 911 immediately and activate EMS. A Word About How Poison Enters the Body There are four categories of poisons based on how they enter the body – ingestion, inhalation, absorption, and injection. Ingestion This category is for all the poisons that can be swallowed – common food poisoning culprits like mushrooms and shellfish, recreational drugs, medications, alcohol, and household items like cleaning supplies. Young children are most at risk, as everything they see looks like it should go into their mouths immediately and often does. Older adults are also more at risk, mostly due to medication errors. Inhalation Inhaled poisons are those gases and fumes that are poisonous. The most common inhaled poison is carbon monoxide, as it's odorless, colorless, and tasteless. To further complicate matters, exposure can lead to death in mere minutes. Carbon monoxide comes from car exhaust, tobacco smoke, fires, and defective gas cooking and heating equipment, like furnaces and hot water heaters. Other less common culprits in this category include carbon dioxide, chlorine gas, ammonia, sulfur dioxide, nitrous oxide, chloroform, dry cleaning solvents, fire extinguisher gases, industrial gases, and hydrogen sulfide. Absorption Absorbed poisons can enter the body through the skin or mucous membranes in the eyes, nose, and mouth. Plants are the biggest offenders when it comes to absorbed poisons, and most of us have probably had a run-in with poison ivy once or twice. Chemicals in fertilizers and pesticides are also commonly absorbed poisons, as are topically applied medications. Injection Injected poisons do include those administered by hypodermic needle, such as recreational and medicinal drugs. But more times than not, instances of poisoning by injection are perpetrated through bites and stings. Poisonous snakes, insects, spiders, and marine life are abundant in certain countries, like Australia, while others like their neighbor New Zealand, can boast a total of zero poisonous animals. https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/training/cpr-first-aid/video/recovery-position https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2063.mp4 Recovery Position In this lesson, you'll learn how to safely use the recovery position, for those times when you encounter a patient who is breathing but unconscious. The recovery position is used in the following scenario: The patient is unresponsive The patient is breathing normally The patient has good skin color, good circulation It's not an immediate CPR situation How to Put a Patient into the Recovery Position As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. In this situation the patient is unresponsive to your taps and shouts, which elicits an immediate 911 call and finding and/or preparing an AED for use, as you begin to assess the scene for clues of what happened. The patient could have ended up unconscious for a number of reasons: Passed out or fainted Suffering from low blood sugar Seizure Electrocution Warning: If you suspect electrocution, take extra measures to make sure the scene is safe. Is the power source still active? Is it still touching the patient? To help keep the patient's airway open and clear, put them into the recovery position using the following steps: Warning: Only use the recovery position if you don't suspect fractures, or serious neck and back injuries. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #1: The purpose of the recovery position is to expel any foods or liquids that come up. What comes up needs to come out. If it doesn't, it could find its way into the patient's lungs. The recovery position is also a great way for the patient to lay safely while waiting for EMS. Using the patient's leg as a kickstand allows his or her body to use gravity without the threat of them rolling completely over. Pro Tip #2: You want gravity working with you as you wait for EMS to arrive. It's important to eliminate the risks of the patient choking or an obstructed airway. Having the patient facing downward will help negate those risks. Warning: If the patient loses their pulse or stops breathing, immediately roll them onto their back and start CPR. Continue to reassess the patient while you wait for EMS to respond, particularly for signs of shock, responsiveness, airway, breathing, and circulation. And treat accordingly should the situation change. A Word About the Signs of Inadequate Breathing Inadequate breathing requires careful monitoring. You may not notice all of the signs and symptoms at once, and some can be hard to spot. If you see any of them, be prepared to give assisted ventilation. When the patient has to expend too much effort to breathe and their breathing has become inadequate, you'll notice the following signs: Muscles between the ribs pull in when the patient breathes in. As the patient enhales, you may notice the muscles pulling inward between the ribs, above the collarbone, around the muscles of the neck and below the rib cage. Pursed lips breathing. The patient exhales through pursed lips, like a whistling motion. This maneuver helps control the patient's breathing pattern. Flaring out of the nostrils on inhalation can be a sign of inadequate breathing in children and infants. Apparent signs of fatigue are also an indication of labored breathing. Excessive use of abdominal muscles to breathe, as in when the patient is using the abdominal muscles to force air out of the lungs. Sweating and anxiousness are also signs of severe respiratory distress. A patient who is sitting upright and leaning forward with hands on knees could be doing so because they're struggling to breathe. Abnormal breathing sounds are also a great sign of inadequate breathing. Listen for abnormal sounds such as wheezing or crackling. Wheezing or whistling sounds indicate restricted air flow and are common with conditions such as asthma, allergic reactions, and emphysema. If the patient has a fine cracking sound on inhalation, that may indicate fluid in the lungs. https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/training/cpr-first-aid/video/cold-related-emergncies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7188.mp4 Cold-Related Emergencies Cold-related emergencies are typically the result of cold temperatures combined with a lack of insulation or protective clothing to deal with those temperatures. How We Lose Heat   Radiation is the most significant and it involves the emission of infrared waves from the skin to cooler surroundings, similar to heat radiating from a stove. Convection contributes the next most heat loss and occurs when warm air or water around the body is replaced by cooler air or water, carrying heat away.  Think of how nice a strong breeze is on a hot day. Conduction is when there is direct contact with other objects. This is often a smaller concern, however, if your skin is in contact with a surface that absorbs heat easily like water, metal or cemet, conduction becomes a much larger concern.  Evaporation is responsible for another large portion of heat loss under normal conditions and becomes the only effective cooling mechanism when the environment is warmer than the skin.  It includes sweat evaporation and moisture loss from the lungs during breathing.    Pro Tip #1:> Protecting yourself from as many of the methods of heat loss as possible will ensure you stay as warm as you can.   Hypothermia begins to set in around the time the patient begins to shiver. And once the core body temperature drops below 95 degrees Fahrenheit, serious side effects ensue, including: Dizziness Delirium/confusion Lethargy Fatigue and weakness Loss of consciousness How to Treat for a Cold-Related Emergency If at any point someone starts showing signs of hypothermia or frostbite, call 911 immediately to activate EMS. Attempt to find warm shelter to keep the patient as comfortable and as warm as possible until help arrives. Monitor for airway, breathing, and circulation issues. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally. Then begin CPR. Treatment for hypothermia is a simple concept of just keeping them warm. It can become difficult in different situations though. This following list includes our priorities, but the order of when we conduct them may change based on the circumstances. Insulate the patient's body as best you can until help arrives. Move the patient to a warmer environment if possible. Remove any wet clothing and cover with blankets. Pro Tip #2: One of your best tools for helping you achieve number one above is a mylar blanket. They're common in first aid and emergency kits, and for good reason. They work by reflecting the heat of the patient and are big enough to cover most adults from head to toe. Warning: Wrapping a patient in a mylar blanket should be done gently using the steps below. You want to make sure not to agitate any frost-bitten extremities. Plus, cardiac arrest is also a concern. Aggressive movements can put the heart into a fatal rhythm. Using a Mylar Blanket Unwrap the blanket and tuck it around the patient as much as possible as this can help with both convection and radiation heat losses. For smaller patients, blankets could be placed under the mylar so long as the blanket is dry and the mylar fits completely over the victim and blankets. Pro Tip #3: The patient may be in a fetal position to try and stay warm. This can help decrease heat loss from radiation, convection and conduction. Leave them in this position if they are comfortable and you can continue to assist them in staying warm such as covering them with blankets. Seal the blanket as best you can, but leave room for the patient to breathe, as mylar isn't breathable material. Put another blanket or coat over the patient. Cover the feet and tuck it in around the patient as best you can, including the top of the head. Pro Tip #4: We lose a ton of heat through our feet, hands, and head, so make sure these areas are covered. Top and sides of head, not the face. Warning: Don't forget to protect yourself. When dealing with cold-related emergencies, you're likely putting yourself in the same environment that felled the patient. And since you're likely kneeling on cold pavement, in snow, and may be working with your gloves off for reasons of manual dexterity, pay extra care that you don't also become a victim.> Rewarming Body Parts in the Field A clinical setting is the preferred location for rewarming, so don't worry about it, especially considering that frozen parts that have been warmed could re-freeze causing additional injury. However, it pays to know that you should only rewarm using water between 99 and 104 degrees Fahrenheit. Higher temperatures could burn the patient, not to mention the pain involved. Rewarming is very painful, as the nerve endings begin to come back and the patient begins feeling again. Which is why a setting that can offer analgesics is the best option. Also, rubbing or massaging the frostbitten portion could cause further injury, so it is best to let the body part warm up on its own. Recognizing Frost Nip and Frost Bite The most common body parts to freeze first are the nose, cheeks, ears, feet, hands, and especially the ends of fingers and toes. When frost bitten, these parts will appear white, hard to the touch, and numb or nearly numb to the patient. A Word About Cold-Related Contributing Factors When it comes to cold-related emergencies, there are several contributing factors to be aware of, including the environment and the age of the patient. Anyone can develop hypothermia; however, the risk factors below could put people at higher risk. A cold environment. Though, even if the ambient temperature isn't that low, it can quickly be made worse if the patient isn't properly protected from the cold, including the use of inappropriate clothing. A wet environment. The presence of moisture – perspiration, rain, snow, etc. – will increase the speed at which body heat is lost. Wind. Wind makes the environment a lot colder than the temperature indicates. The higher the wind chill effect, the lower the actual temperature. Age. The very young and very old usually have a harder time staying warm in cold conditions. Body mass, or lack thereof, is one concern, as is their ability to think clearly when it comes to removing themselves from that environment or better protecting themselves with proper clothing. And in older adults, impaired circulation may also be a concern. Medical conditions. People with certain medical conditions, such as hypoglycemia, shock, and head injury, may be at higher risk of developing hypothermia. Drugs and alcohol. Alcohol and certain types of drugs can reduce a person's ability to feel the cold, or can impair judgment and impede rational thought, preventing the patient from taking proper precautions to stay warm. Trauma. If a person is injured and they are facing issues with hypothermia, both conditions may worsen much quicker. Injured victims must be kept as warm as possible. https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/training/cpr-first-aid/video/burns-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7186.mp4 Burns Burns are a complex injury, as there are varying degrees of burns, different sizes, and different locations that can present unique challenges. And there are also different types of burns – thermal, chemical, and electrical. In this lesson, when we talk overall about burns, then how to treat them, starting with thermal burns. Then, we'll discuss some information on chemical and electrical burns. How to Assess and Treat a Burn Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first thing you want to do is assess how bad the burn is. To determine the degree of burn, look for the following signs: 1st degree (superficial) – usually presents itself as a pink outer ring; characterized by redness and pain 2nd degree (partial-thickness) – will present itself with blistering skin and is usually very painful 3rd degree (full-thickness) – dark, charred areas; can include life-threatening complications Warning:  The following burns should be seen immediately at a hospital for treatment: Large 2nd burns that involve the face, hands, feet, or genitalia All 3rd degree burns Any burn that has concern for inhalation injury (soot around the nose or mouth, difficulty breathing)  The concerning part about burns is that you may not see the full extent or concern of the injury until hours later. After the burning process has ended, the injured skin starts the healing process. This involves the moving of fluid to the injured area causing swelling, pain, dehydration/shock and other potentially life threatening conditions. Minor seeming injuries may be far more serious if not evaluated or treated by professionals. Sequence of Treatment for Burn Victims Remove the body from the burn. This can mean a few different things – like the presence of smoldering clothing or a victim who's laying in burning embers. Cool the burn. Pour cool clean water over the burn for five to 20 minutes. Your goal is to remove residual heat from the burned tissue. This will stop the burning process. Even room temperature water is appropriate as that is still over 20 degrees cooler than normal body temperature and can remove heat from the skin. Apply loose, dry, sterile dressing over the wound. Begin wrapping above the burn and wrap particularly lightly over the burn. During 3rd degree burns, the nerve endings become damaged, so there is less pain. However, 1st and 2nd degree burns can be quite painful. Pro Tip #1: Observe the patient for signs of shock or dizziness. If they are losing their balance, help them into a seated or lying position, whichever is more comfortable. At the first sign of shock, call 911 and activate EMS immediately. Look for inhalation burns. Is the victim wheezing? Is there some swelling or burns around the face? Have the eyebrows been burned? Is there soot on the inside of the victim's mouth or nose? All of these could signal possible future complications in the form of respiratory issues. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Pro Tip #2: Skin is the major organ that controls your body temperature. If we damage it from a burn, then pour cold or cool water over the body (burned area), the victim could become cold and start to shiver, hypothermia has now set in. Once the burn is cooled, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. Chemical Burns You're likely going to encounter two types of chemical burns – those from dry chemicals and those from wet. When you're dealing with dry chemicals, you first want to brush off as much of the loose, dry chemical as you safely can. Safety is key. You don't want to become the next victim. After brushing off the loose chemical, rinse the burn for a minimum of 15 minutes, again using cool clean water. When dealing with wet chemicals, go right into rinsing them off using cool, clean water. Pro Tip #3: Dilution is the solution to pollution. When dealing with chemical burns, rinsing them off with cool, clean water will have a weakening effect, as the chemicals are diluted again and again with every dousing of clean water. Electrical Burns Electrical burn situations require an extra level of safety. Before anything, make sure the energy source has been removed before coming into contact with the patient. This could mean removing the patient from the energy source, cutting the power, or something else. You cannot risk becoming another patient at the scene. Pro Tip #4: There is a significant difference between electrical entry burn wounds and electrical exit burn wounds. Entry wounds look like typical thermal burns. But exit wounds may look more like shotgun exit wounds – huge, explosive, and damaging. Manage the entry wound the same as you would a thermal burn. Manage the exit wound as the situation requires, which will likely include treatment options for tissue damage and excessive bleeding. Warning: As electricity travels through the body it can affect the conductivity of the heart, which could potentially damage the conduction points in the heart and contribute to secondary cardiac issues. With electrical burns, monitoring for heart dysrhythmias for 24 to 72 hours in hospital might be necessary. A Word About Burn Victim Pediatric Considerations It's important to note that children have greater surface areas relative to their weights than adults. This can become a major factor when it comes to staying warm and hydrated. Victims with severe burns tend to lose a lot of water through evaporation and leaking from the burned area. This increases our concerns as it can lead to hypothermia and shock. Monitor the victim for signs of dehyration, shock or hypothermia. Immediately seek advanced medical intervention if any of these are seen. After Burn Care If the burn is minor, and the burning has been completely stopped, at-home treatment might be appropriate. The 2024 ECC Guidelines suggest petrolatum (with or without topical antibiotics such as polymyxin), honey, and aloe have been shown to improve healing time in certain burns. Over the counter pain medications may help with pain when used correctly. All treatment should be under the direction of your physician. https://d3imrogdy81qei.cloudfront.net/video_images/13032/burns-2025.jpg Yes 413 https://www.procpr.org/training/cpr-first-aid/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/cpr-first-aid/video/heat-cold-emergencies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2064.mp4 Heat-Related Emergencies As you know, the human body runs at an internal temperature of 98.6 degrees Fahrenheit, or 37 degrees Celsius. The control center responsible for regulating this internal temperature is located in the brain, and more specifically, the hypothalamus. The hypothalamus receives information and adjusts body functions to maintain this optimal temperature. The temperature range – that which allows cells to stay alive and healthy – is actually quite narrow, at between 97.8 degrees and 99 degrees. Let's quickly look at the process of how the body cools down on its own. The hypothalamus detects a rise in blood temperature. Blood vessels close to the surface of the skin begin to dilate. This brings more blood to the surface and allows heat to escape. At the end of this lesson, we'll get into the five general ways in which the body can be cooled externally, along with several types of heat-related conditions to watch out for. How to Treat for a Heat-Related Emergency Heat-related emergencies typically occur in hot environments and when the patient hasn't been rehydrating enough to compensate for water loss. Common symptoms of a heat-related emergency include: Profuse sweating Dizziness Extreme thirst Cramping, usually in arms or legs Warning: Losing fluids can be very serious. In the absence of proper medical treatment, if the condition cannot be reversed, it will likely progress to the next level which is heatstroke. Pro Tip #1: If the patient suddenly goes from wet to dry and stops sweating, it's because the patient's body doesn't have enough fluids to lose. This is a good indication that the warning above is now likely a reality, making the situation that much more serious. Your number one goal when dealing with a heat-related emergency is to cool the patient down any way you can. Ideally, the patient is able to get some fluids down. But if for some reason they aren't able to drink or swallow or can't hold fluids down, you'll need to cool them off externally. Find a water source and some containers or a hose and begin pouring water over the victim, including their clothing, to help bring their core temperature down to a safe level. Another great aid in these situations is the cold pack. If you have some available, try placing them under the patient's armpits, the back of the neck, or forehead. Pro Tip #2: The key to successfully treating someone who is having a heat-related emergency begins by recognizing that emergency. Time is crucial. Once you've diagnosed the problem, the next step is reversing the condition by cooling them down. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally, call 911 immediately and activate EMS. Then begin CPR. A Word About Heat-Related Emergencies There are several types of heat-related conditions to be aware of, but let's first look at the general ways in which the body can be cooled. Radiation Radiation involves the transfer of heat from one object to another, though without physical contact. The human body also loses heat due to radiation, mostly through the head, feet, and hands. Convection Convection occurs when cold air moves over the skin and carries heat away. The faster the flow of air, the faster the body will be cooled. Convection is why warm skin feels cooler in a breeze. Convection also assists in the evaporation process. Conduction Conduction occurs when the body is in direct contact with something that is cooler than the body's temperature. Conduction allows the body's heat to transfer to the cooler object. Think about swimming in a cold lake or leaning against a cool slab of stone. Evaporation Evaporation is the process by which a liquid or solid becomes a vapor. When body heat causes one to perspire and the perspiration evaporates, the heat that was absorbed into the sweat dissipates into the air which cools off the skin. Respiration The last way in which the body can cool itself is through respiration. Before air is exhaled, it's warmed by the lungs and airway. Respiration accounts for around 10 to 20 percent of heat loss. There are several types of heat-related illnesses (hyperthermia) to be aware of, including dehydration, exercise-associated muscle cramps, exertional heat exhaustion, and heatstroke. Dehydration Dehydration occurs when there is an inadequate supply of water in the body's tissues. Dehydration can be serious and life-threatening, particularly for the very young and very old. Symptoms, which include fatigue, headaches, irritability, nausea, and dizziness, will worsen as the body continues to lose water. Exercise-Associated Muscle Cramps Muscle cramps are thought to occur due to a combination of fluid and electrolyte loss through sweating. Muscle cramps typically come on quickly and after rigorous work or exercise and are particularly more common in warmer environments. Exertional Heat Exhaustion Exertional Heat Exhaustion occurs when the body loses more fluids than are replenished. As this happens, the body will divert blood from the surface of the body to vital organs like the heart and brain. This type of heat-related illness is usually the result of intense physical activities and often in hot and humid climates – athletes, firefighters, construction workers, etc. Heatstroke Heatstroke is the most serious type of heat-related illness and can be life-threatening if quick action isn't taken. As there is a progressive nature to these conditions, ignoring the warning signs of exertional heat exhaustion can quickly lead to a body that will become overwhelmed by heat and begin to stop functioning. https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/training/cpr-first-aid/video/2025-guidelines-update-for-cpr-and-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7289.mp4 2025 Guidelines Update for CPR and First Aid for All Ages In this lesson, we're going to summarize the latest information from the 2025 American Heart Association Emergency Cardiovascular Care guidelines as they relate to lay rescuer CPR. The goal of these guideline changes is simple: improve survival by improving early recognition, high-quality CPR, and early defibrillation. For out-of-hospital cardiac arrest, survival rates depend heavily on what happens in the first few minutes. The 2025 ECC updates continue to emphasize that early action by lay rescuers is what saves lives. Many of the changes you'll see focus on improving CPR quality, reducing delays, and removing the barriers that prevent people from stepping in to help. Initiation of Resuscitation for Adults The ECC continues to reinforce the importance of CPR with breaths in adult cardiac arrest. For trained rescuers who are able to provide ventilations safely, compressions and breaths should be delivered together. If a rescuer is not trained or does not have the ability to give breaths, hands-only CPR can be used, as providing compressions alone is far better than doing nothing at all. Whenever feasible, and without delaying chest compressions, CPR should be performed where the person is found, as long as high-quality CPR can be delivered safely and effectively. It's preferred that the patient be on their back, on a firm surface, since firm surfaces improve compression depth and effectiveness. Delays caused by unnecessary movement of the patient are associated with worse outcomes. When possible, chest compressions should be performed with the patient's torso positioned approximately at the level of the rescuer's knees to allow better body mechanics and improved compression depth. Rescuers may also consider placing their dominant hand on the sternum when performing compressions, which may further improve overall CPR quality. Pro Tip #1: The key takeaway is this: don't delay chest compressions. If high-quality CPR can be delivered safely where the patient is found, begin it immediately. This was re-emphasized to include the giving of breaths for high-quality CPR. AED Use and Patient Dignity AEDs have become more widely available and continue to prove their effectiveness everyday. However, statistically, women have a much lower rate of AED use than men. So while the 2025 guidelines address the importance of early AED use, the emphasis was particularly for women. Evidence suggests that the need to expose the chest may contribute to lower rates of AED use in female patients. While proper pad placement is always preferred, current evidence shows that successful defibrillation can still occur even when pad placement is not perfect. What this means is rather than the need to remove all clothing from the chest, it's reasonable to just adjust the clothing and apply AED pads under clothing, directly to the skin.> Pro Tip #2: If needed, rather than removing all clothing from the chest, simply adjust clothing, including bras, to have appropriate pad placement on the skin. This has been shown to be safe and effective Foreign Body Airway Obstruction In conscious adults and children with severe foreign body airway obstruction, rescuers should perform repeated cycles of 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unresponsive. Ironically, the back blows are something that was taught years ago. However, this sequence reflects evidence suggesting that back blows may be more effective and cause fewer injuries than abdominal thrusts alone. Remember, for patients in late-stage pregnancy or the rescuer cannot reach their arms around the victim’s waist, chest thrusts should be used instead.  Pro Tip #3: A key update in 2025 is that chest thrusts for infants should now be performed using the heel of one hand, placed in the center of the chest, rather than the previously recommended two-finger technique. This change is based on evidence showing improved compression depth and effectiveness during severe airway obstruction.   Cardiac Arrest Following Drowning When an adult or child is rescued from the water and unconscious and not breathing, CPR with breaths should be started before AED application. Further, if you are in a position that full CPR cannot be started, just performing breaths can still be helpful. This is due to drowning-related cardiac arrest being caused by low oxygen levels. So the idea here is that If we apply the AED immediately without providing ventilations, we still have not addressed the cause of the cardiac arrest. If we delay the application of the AED for a short amount of time, we can provide the needed oxygen back into the victim to stabilize the underlying issue in the first place. Then, when applying and using an AED, resetting the heart should be more effective. Eye Injuries with an Embedded Foreign Object A small but important update: when caring for a person with a foreign object embedded in the eye, rescuers should now cover only the affected eye rather than both eyes. This change is intended to reduce anxiety in the patient by allowing them to maintain vision in the unaffected eye. The previous concept was that if you covered both eyes, then that would reduce the movement of the good and the injured eye. Data is showing that with the increased anxiety and potential for further injury caused by the temporary blindness, it would be safe to just bandage the injured eye.  ProTip #4: Our goal is to prevent any further injury to the eyes. Protect the injured eye(s) from any excessive pressure with a shield or cup and seek immediate medical attention. Managing Shock When caring for a person showing signs of shock who remains alert, it is reasonable to place or maintain them on their back. If the person is at risk for airway obstruction — such as decreased alertness or active vomiting — or if they cannot be continuously monitored, it is reasonable to place them in the recovery position, on their side. While elevating the feet has been shown occasionally to help the patient, the effects are often short lasting only a few minutes. Pro Tip #5: In situations where there is no evidence of trauma or injury, such as fainting or dehydration, some studies suggest that raising the feet approximately 6 to 12 inches may still be beneficial. Though our main focus is getting the patient safely to the ground, keeping them warm and monitoring them for airway concerns, such as vomiting, or the need for CPR. A Unified Chain of Survival The 2025 guidelines introduce a single, standardized Chain of Survival that now applies to infants, children, and adults. This unified approach emphasizes early recognition, early CPR, early defibrillation, advanced care, and recovery as a continuous process across all age groups. CPR in Infants and Children In infants and children, studies consistently show that CPR with both compressions and breaths provides the best chance of survival. However, if a lay rescuer is unable or unwilling to provide breaths to an infant or child in cardiac arrest, compression-only CPR is still reasonable. Large observational studies show that compression-only CPR is far better than providing no CPR at all, and significantly improves survival outcomes compared to no bystander intervention. Lastly, further evidence shows that using 2 fingers for infant chest compressions or chest thrusts are minimally effective. Therefore, the ECC has eliminated the use of two-fingers and recommends using a two-thumb hand encircling technique or the heel of one hand. You will see further demonstrations of both techniques throughout the course. Closing Thoughts The 2025 ECC CPR guideline updates continue to reinforce a simple but powerful message: early recognition, early CPR, and early defibrillation save lives. These updates are designed to improve CPR quality, reduce delays, and remove the barriers that prevent rescuers from acting — whether that rescuer is a parent, a bystander, or a trained professional. Guidelines will continue to evolve as new science emerges, but the mission remains the same: recognize the emergency, take action, and do the best you can. CPR doesn't need to be perfect to save a life. Doing something is always better than doing nothing, and confident, informed rescuers make a measurable difference. https://d3imrogdy81qei.cloudfront.net/video_images/13120/2025-guidelines-update-for-cpr-and-first-aid.jpg Yes 458 https://www.procpr.org/es/training/cpr-first-aid/video/hemorragias-nasales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6487.mp4 Hemorragias nasales https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/es/training/cpr-first-aid/video/traumatismos-penetrantes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6490.mp4 Traumatismos penetrantes https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/es/training/cpr-first-aid/video/lesiones-del-oido https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6488.mp4 Lesiones del oído https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/es/training/cpr-first-aid/video/lesiones-dentales-y-bucales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6489.mp4 Lesiones dentales y bucales https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/es/training/cpr-first-aid/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/cpr-first-aid/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/cpr-first-aid/video/adulto-rcp-rescatista-lego-comunidad-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2023.mp4 RCP en adultos La RCP para adultos se realiza comprobando la capacidad de respuesta del paciente, la respiración anormal y el contacto con los servicios de emergencia. A continuación, compruebe si hay un pulso durante 10 segundos como máximo y comience la RCP si el paciente no tiene pulso. Realice 30 compresiones a una velocidad de 100-120 por minuto ya una profundidad de 2-2.4 pulgadas en el centro del pecho. Estas 30 compresiones deben ser seguidas de dos respiraciones de rescate, y repetir el ciclo hasta que llegue un DEA o servicios de emergencia. https://d3imrogdy81qei.cloudfront.net/video_images/3605/adult-cpr-lay-rescuer-community-2015.jpg Yes 216 https://www.procpr.org/es/training/cpr-first-aid/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/cpr-first-aid/video/adulto-dea-rescatista-lego-comunidad-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2026.mp4 DEA en adultos Si el paciente es un paro cardiaco presenciado, compruebe primero para asegurar que la escena es segura. Compruebe la capacidad de respuesta del paciente y póngase en contacto con los servicios de emergencia. Compruebe si hay un pulso durante no más de 10 segundos. Encienda el DEA si el paciente no tiene pulso y no respira. Adjunte las almohadillas AED al paciente, y no toque al paciente mientras se analiza el DEA. Después de un choque se entrega, comenzar la RCP durante unos 5 ciclos o dos minutos. El DEA se interrumpirá después de dos minutos y volverá a analizar al paciente. Siga las instrucciones del AED hasta que llegue el soporte de vida avanzado. https://d3imrogdy81qei.cloudfront.net/video_images/3611/adult-aed-lay-rescuer-community-2015.jpg Yes 244 https://www.procpr.org/es/training/cpr-first-aid/video/dea-nino-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2027.mp4 DEA en niños Compruebe la capacidad de respuesta del paciente, póngase en contacto con los servicios de emergencia y compruebe si hay un pulso. Encienda el DEA si el paciente no está respirando normalmente. Adjunte las almohadillas DEA al paciente, y no toque al paciente mientras se analiza el DEA. Después de un choque se entrega, comenzar la RCP durante unos 5 ciclos o dos minutos. El DEA se interrumpirá después de dos minutos y volverá a analizar al paciente. Siga las instrucciones del DEA hasta que llegue el soporte de vida avanzado. https://d3imrogdy81qei.cloudfront.net/video_images/3613/child-aed-fa-2015.jpg Yes 250 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-adulto-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2033.mp4 Asfixia en adulto inconsciente Una vez que una víctima de asfixia se convierte en inconsciente, asegúrese de que EMS se ha activado. Dar 30 compresiones torácicas. Compruebe el objeto en la boca del paciente y barrerlo si es posible. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Si todavía no entra aire, realice 30 compresiones torácicas, revise el objeto nuevamente y, si es posible, retírelo. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Continúe este proceso hasta que la vía aérea esté abierta y el aire entre en los pulmones. https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/es/training/cpr-first-aid/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-nino-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2034.mp4 Asfixia en niño inconsciente Una vez que un niño asfixia víctima se convierte en inconsciente, asegúrese de que EMS se ha activado. Dar 30 compresiones torácicas. Compruebe el objeto en la boca del paciente y barrerlo si es posible. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Si todavía no entra aire, realice 30 compresiones torácicas, revise el objeto nuevamente y, si es posible, retírelo. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Continúe este proceso hasta que la vía aérea esté abierta y el aire entre en los pulmones. https://d3imrogdy81qei.cloudfront.net/video_images/3627/unconscious-child-choking-first-aid-2015.jpg Yes 190 https://www.procpr.org/es/training/cpr-first-aid/video/respiracion-agonica-no-respirar-normalmente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2022.mp4 Respiración agónica (no respirar normalmente) Un signo de parada cardiaca se describe como respiración agonal. Esto ocurre cuando una persona está haciendo un jadeo o tragarse el movimiento y no está respirando normalmente. La respiración agónica ocurre en el 40% de los paros cardiacos tempranos. Saber cuándo una persona es respiratoria agonal puede prevenir intentos agresivos de RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/es/training/cpr-first-aid/video/torniquetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2048.mp4 Cómo aplicar un torniquete https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/es/training/cpr-first-aid/video/amputacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2047.mp4 Amputación https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/es/training/cpr-first-aid/video/introduccion-Pro-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2043.mp4 Introducción a primeros auxilios https://d3imrogdy81qei.cloudfront.net/video_images/3645/intro-to-profirst-aid-2015.jpg Yes 45 https://www.procpr.org/es/training/cpr-first-aid/video/cuando-rcp-no-funciona-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2041.mp4 Cuando la RCP no funciona La RCP es un intento de compensar la circulación en el corazón que no está sucediendo normalmente. La RCP no detiene el proceso de morir; Simplemente disminuye la muerte celular biológica. La esperanza es que este procedimiento puede comprar tiempo para que el ccsme llegue a probar otros métodos de restaurar la circulación apropiada de la sangre oxigenada por todo el cuerpo para comprar aún más tiempo de modo que la razón subyacente por la cual la persona entró en paro cardiaco en el primer lugar puede ser Explorado Si la RCP no funciona, recuerde que le dio a esa persona la mejor oportunidad de sobrevivir. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/es/training/cpr-first-aid/video/sangrado-arterial-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2036.mp4 Sangrado arterial El sangrado arterial se caracteriza por una sangre roja más brillante que puede palpitar o chorro. Aplique presión directa con un vendaje. Si hay fugas de sangre, aplique más apósitos en la parte superior. Nunca quite un vendaje. Una vez que el sangrado está bajo control, use gasa de rodillo para asegurar el vendaje, comenzando en el extremo distal y trabajando hacia el corazón. Usted puede girar la gasa para aplicar más presión. Asegúrese de que la sangre no esté goteando y que el vendaje no tenga efecto de torniquete. Eleve la herida y llame a EMS o lleve al paciente al hospital más cercano. https://d3imrogdy81qei.cloudfront.net/video_images/3631/arterial-bleeding-child-2015.jpg Yes 236 https://www.procpr.org/es/training/cpr-first-aid/video/diabetes-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2057.mp4 Las emergencias diabéticas https://d3imrogdy81qei.cloudfront.net/video_images/3673/diabetes-child-2015.jpg Yes 483 https://www.procpr.org/es/training/cpr-first-aid/video/lesiones-musculoesqueleticas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2053.mp4 Lesiones musculoesqueléticas https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/es/training/cpr-first-aid/video/desvanecimiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2056.mp4 Desvanecimiento https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/es/training/cpr-first-aid/video/conmocion-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2038.mp4 Conmoción cerebral https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/es/training/cpr-first-aid/video/convulsiones-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2058.mp4 Convulsiones https://d3imrogdy81qei.cloudfront.net/video_images/3675/seizure-child-2015.jpg Yes 377 https://www.procpr.org/es/training/cpr-first-aid/video/sangrado-capilar-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2046.mp4 Sangrado capilar https://d3imrogdy81qei.cloudfront.net/video_images/3651/capillary-bleeding-child-2015.jpg Yes 271 https://www.procpr.org/es/training/cpr-first-aid/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/cpr-first-aid/video/reacciones-alergicas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2060.mp4 Reacciones alérgicas https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/es/training/cpr-first-aid/video/como-usar-epipen-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2061.mp4 Cómo usar un Epipen https://d3imrogdy81qei.cloudfront.net/video_images/3681/how-to-use-an-epipen-child-2015.jpg Yes 274 https://www.procpr.org/es/training/cpr-first-aid/video/reversa-auto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2067.mp4 Reversa / marcha atrás en auto https://d3imrogdy81qei.cloudfront.net/video_images/3693/car-backing-2015.jpg Yes 110 https://www.procpr.org/es/training/cpr-first-aid/video/hogar-a-prueba-ninos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2068.mp4 Hogar a prueba de niños https://d3imrogdy81qei.cloudfront.net/video_images/3695/child-proofing-the-home-2015.jpg Yes 140 https://www.procpr.org/es/training/cpr-first-aid/video/seguirdad-piscina-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2069.mp4 Seguridad en la piscina https://d3imrogdy81qei.cloudfront.net/video_images/3697/pool-safety-2015.jpg Yes 340 https://www.procpr.org/es/training/cpr-first-aid/video/abuso-infantil-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2070.mp4 Abuso y abandono infantil https://d3imrogdy81qei.cloudfront.net/video_images/3699/child-abuse-2015.jpg Yes 896 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-adulto-inconsciente-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2118.mp4 Práctica: Asfixia en adulto inconsciente Aprenda a dar RCP a un adulto que está inconsciente y ahogándose observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-nino-inconsciente-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2119.mp4 Práctica: Asfixia en niño inconsciente Aprenda a dar RCP con un DEA a un niño que está inconsciente y ahogándose observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3797/unconscious-child-choking-lay-rescuer-practice-2015.jpg Yes 112 https://www.procpr.org/es/training/cpr-first-aid/video/cpr-adulto-comunidad-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2111.mp4 Práctica: RCP en adultos Aprenda a dar CPR a un adulto que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3781/adult-cpr-community-lay-rescuer-practice-2015.jpg Yes 118 https://www.procpr.org/es/training/cpr-first-aid/video/cpr-nino-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2112.mp4 Práctica: RCP en niños Aprenda a darle RCP a un niño que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3783/child-cpr-lay-rescuer-practice-2015.jpg Yes 80 https://www.procpr.org/es/training/cpr-first-aid/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/cpr-first-aid/video/mordeduras-serpiente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2059.mp4 Mordeduras de serpiente https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/es/training/cpr-first-aid/video/mordeduras-animales-y-humanos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2370.mp4 Mordeduras de animales y humanos https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/es/training/cpr-first-aid/video/picaduras-de-escorpiones-garrapatas-y-aranas https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6491.mp4 Picaduras de escorpiones, garrapatas y arañas Ahora discutiremos el tratamiento de primeros auxilios para picaduras de arañas, picaduras de garrapatas y picaduras de escorpiones. Estos encuentros pueden ser alarmantes, pero conocer los pasos adecuados puede ayudar a garantizar una respuesta rápida y efectiva. Primero, sepa que millones de personas son mordidas o picadas cada año solo en los Estados Unidos. y la mayoría de estas son inofensivas. Queremos enfocarnos en el tratamiento generalizado y en qué observar en casos más graves. La prioridad siempre es la seguridad. Una vez que usted y la víctima estén a salvo, vea si hay una forma de identificar qué lo mordió o picó, ya que esto puede ayudar a identificar el tratamiento adecuado si es necesario. Dado que todas estas mordeduras o picaduras habrán perforado la piel, se recomienda siempre lavar suavemente con jabón y agua. Si se notan picaduras o signos o síntomas preocupantes, busque ayuda médica de inmediato. En ese caso, observe si hay decoloración o ampollas en la piel, náuseas, dolor abdominal, dificultad para respirar, cambio en la capacidad de respuesta, o dolor significativo. Si no hay preocupaciones inmediatas, aquí es cómo podemos manejar estos casos de manera independiente siempre y cuando no se noten síntomas preocupantes. Para las arañas: Si se encuentra en un área conocida por las arañas venenosas, aléjese del lugar para evitar más mordeduras. Es importante identificar la araña responsable de la mordedura. Luego, lávese con jabón suave y agua. Para reducir el dolor y la hinchazón, eleve la extremidad mordida y aplique una compresa fría o una bolsa de hielo envuelta en un paño delgado en el lugar de la mordedura. Déjelo actuar durante unos 10-15 minutos cada hora. Para mordeduras sospechosas o confirmadas de arañas venenosas como las viudas negras o las arañas reclusas pardas, es crucial buscar atención médica inmediata. Llame a los servicios de emergencia o diríjase al hospital más cercano. Ahora hablemos de las garrapatas. Si encuentra una garrapata adherida a su piel, retírela rápidamente ya que cuanto más tiempo estén adheridas, más probable es que transmitan enfermedades. Use unas pinzas de punta fina para agarrar la garrapata lo más cerca posible de la superficie de la piel. Tire de ella alejándola de la piel de manera constante y lenta con firmeza, evitando torcer o aplastar la garrapata. La piel se tensará y la garrapata finalmente se soltará. Limpie el área con agua y jabón suave. Si está preocupado por las enfermedades transmitidas por garrapatas, puede conservar la garrapata en un recipiente sellado o una bolsa de plástico. Esto puede ayudar a los profesionales de la salud a identificar la garrapata y determinar el riesgo de transmisión de enfermedades. Tenga en cuenta que si la cabeza se desprende y queda incrustada en la piel, esto es una llamada al profesional médico para pedir ayuda. Ahora hablemos de los escorpiones. Aléjese del área para prevenir más picaduras. Limpie el sitio de la picadura con jabón suave y agua, similar a las mordeduras de araña, y aplique una compresa fría o una bolsa de hielo envuelta en un paño en el sitio de la picadura para ayudar con el dolor. Aunque la mayoría de las picaduras de escorpión son inofensivas, buscar atención médica es esencial para estar seguro, ya que las especies venenosas pueden ser mortales para los humanos. Llame a los servicios de emergencia o diríjase el hospital más cercano inmediatamente. Recuerde, la prevención es clave, así que tome precauciones revisando su ropa y vistiendo la indumentaria adecuada siempre que estas criaturas sean comunes. Mantenga la calma y siga estos pasos si se encuentra con una mordedura o picadura. Y siempre busque ayuda médica profesional cuando sea necesario. https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/es/training/cpr-first-aid/video/asma-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2062.mp4 Asma https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/es/training/cpr-first-aid/video/mecanismo-lesion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2050.mp4 Mecanismo de lesión https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/es/training/cpr-first-aid/video/rcp-ninos-pro-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2024.mp4 RCP en niños Si un niño no responde y no está respirando, comience la RCP. Realizar compresiones torácicas con una mano en el centro del pecho durante treinta compresiones. Estas compresiones deben realizarse a una profundidad de por lo menos 1/3 de la profundidad del pecho. Dar dos respiraciones más, seguido por 30 compresiones, y repetir hasta que el niño revive o un DEA está disponible, o avanzado soporte de vida llega. https://d3imrogdy81qei.cloudfront.net/video_images/3607/child-cpr-profa-2015.jpg Yes 222 https://www.procpr.org/es/training/cpr-first-aid/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/cpr-first-aid/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/cpr-first-aid/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/cpr-first-aid/video/agentes-hemostaticos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2049.mp4 Agentes hemostáticos https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/es/training/cpr-first-aid/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/cpr-first-aid/video/valoracion-secundaria-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2051.mp4 Valoración secundaria https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/es/training/cpr-first-aid/video/lesiones-cabeza-cuello-espalda-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2052.mp4 Lesiones de cabeza, cuello y espalda https://d3imrogdy81qei.cloudfront.net/video_images/3663/head-neck-and-back-injuries-child-2015.jpg Yes 212 https://www.procpr.org/es/training/cpr-first-aid/video/sangrado-venoso-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2045.mp4 Sangrado venoso https://d3imrogdy81qei.cloudfront.net/video_images/3649/venous-bleeding-child-2015.jpg Yes 137 https://www.procpr.org/es/training/cpr-first-aid/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/cpr-first-aid/video/dea-bebe-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7176.mp4 DEA en bebés https://d3imrogdy81qei.cloudfront.net/video_images/13012/infant-aed-2025.jpg Yes 329 https://www.procpr.org/es/training/cpr-first-aid/video/rcp-bebe-pro-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7172.mp4 RCP en bebés https://d3imrogdy81qei.cloudfront.net/video_images/13004/infant-cpr-2025.jpg Yes 357 https://www.procpr.org/es/training/cpr-first-aid/video/dea-adulto-comunidad-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2115.mp4 Práctica: DEA en adultos Aprenda a dar RCP con un DEA a un adulto que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3789/adult-aed-community-lay-rescuer-practice-2015.jpg Yes 220 https://www.procpr.org/es/training/cpr-first-aid/video/dea-nino-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2116.mp4 Práctica: DEA en niños Aprenda a dar CPR con un DEA a un niño que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3791/child-aed-lay-rescuer-practice-2015.jpg Yes 211 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-bebe-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7181.mp4 Asfixia en bebé consciente https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-nino-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7180.mp4 Asfixia en niño consciente https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/cpr-first-aid/video/asfixia-bebe-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7182.mp4 Asfixia en bebé inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/13024/unconscious-infant-choking-2025.jpg Yes 217 https://www.procpr.org/es/training/cpr-first-aid/video/conmocion-rescatista-lego-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7184.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/es/training/cpr-first-aid/video/lesiones-oculares-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7189.mp4 Lesiones oculares https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/es/training/cpr-first-aid/video/control-envenenamiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7190.mp4 Control de envenenamiento https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/es/training/cpr-first-aid/video/posicion-lateral-seguridad-recuperacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2063.mp4 Posición lateral de seguridad https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/es/training/cpr-first-aid/video/emergencias-relacionadas-frio-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7188.mp4 Emergencias relacionadas con el frío https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/es/training/cpr-first-aid/video/quemaduras-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7186.mp4 Quemaduras https://d3imrogdy81qei.cloudfront.net/video_images/13032/burns-2025.jpg Yes 413 https://www.procpr.org/es/training/cpr-first-aid/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/cpr-first-aid/video/emergencias-relacionadas-calor-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2064.mp4 Emergencias relacionadas con el calor https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/es/training/cpr-first-aid/video/2025-guidelines-update-for-cpr-and-first-aid-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7289.mp4 Actualización de las Guías 2025 - RCP y primeros auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13120/2025-guidelines-update-for-cpr-and-first-aid.jpg Yes 458 https://www.procpr.org/training/first-aid/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/first-aid/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/first-aid/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/first-aid/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/first-aid/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/first-aid/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/first-aid/video/amputation https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2047.mp4 Amputation An amputation from trauma involves the loss of an extremity like a finger or toe but could also include an arm or a leg. It's important to not get too distracted looking for the amputated part and focus on the wellbeing of the victim. As amputation injuries often occur in machine accidents, the amputated part can get thrown quite a distance from the scene of the accident. It may also be covered in saw dust or shavings of some kind, which could make finding it more problematic. If there are other people on the scene, you may want to consider asking for help to locate the missing part. Amputation injuries are quite serious. It’s important to assess the patient beyond the amputation, including: Did the victim lose consciousness? If so, did they hit their head and are now suffering from a concussion? Is the victim showing signs of being in shock? How to Provide Care Clean-cut amputations bleed less than you might expect and often less than crushed extremities or partial amputations. The reason for this is that the arteries contract up into the stump and clamp down, which helps to control the bleeding for at least the first few minutes following the amputation. After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. If there is already a cloth or dressing pad covering the stump, don’t remove it, as this will pull off some of the clotting blood. Apply a second piece of gauze padding and, if necessary, subsequent pieces until bleeding is controlled and apply pressure. If the victim can't help apply pressure, you'll need to manage it yourself or ask someone to assist you. Pro Tip 1: With amputation injuries, there will sometimes be a protruding bone fragment. These can be very sharp and may cut you while you attend to the victim. Therefore, it's important to be careful when dressing the wound. If you're not, you could easily: Damage the bone further Cause more pain to the victim Introduce bacteria into the wound Once you've controlled the bleeding, meaning it is no longer leaking through the dressing pads, it's time to wrap the wound with a roller gauze bandage. Pro Tip 2: Your goal in wrapping the wound is to apply enough pressure to hold the dressing pads in place and control the bleeding. Be careful not to wrap so tight that you cut off circulation. Remember to use the pinch test on finger and toe nails if appropriate and you are able to. If blood begins to leak through while you're wrapping the wound, simply insert another dressing pad and continue wrapping. If you need extra pressure at that point, twist the bandage over the wound area. This will apply a bit more torque and should help control the bleeding. When you're done wrapping, tuck or tape the end of the bandage. By this point, the bleeding should be controlled, and the patient should be stable. Continue assessing the victim for signs of shock or other health concerns. How to Handle the Amputated Extremity If you or someone at the scene were able to find the amputated part, it’s important that you handle it properly using the following steps. Make sure it's clean. Wrap it in a sterile gauze pad, preferably an abdominal dressing pad if you have one. This will offer much more insulation than regular pads and help protect the part from cold damage. Place the part into a sealable plastic bag. Put the bag with the part between two cold packs or into a bag filled with ice water and seal that bag. Warning: The amputated part has no blood flowing through it, which makes it much more susceptible to frost bite and tissue damage. You want to keep it cold, not frozen. It's also important to keep it dry. When skin becomes water logged and gets pruney, this is actually the onset of that tissue breaking down and will make reattachment more difficult. Pro Tip 3: It's important to keep the amputated part with the victim and, if possible, out of sight from the victim. You don't want to encourage psychosomatic shock, but you want the surgeons at the hospital to have access to both victim and part immediately. As amputations are serious injuries, you should be continually assessing the victim for signs of shock or other life-threatening conditions. A Word About Early Signs of Shock We will be discussing shock in great detail in the next lesson, but it's important to know that it's a progressive condition. Symptoms may seem minor at first, but the situation can quickly get worse. Your rapid response is vital. Early symptoms of shock include: The victim expresses anxious or apprehensive feelings The victim's body temperature is lower than normal The victim's breathing is quicker than normal The victim's pulse has increased The victim's blood pressure has decreased The victim's skin appears pale or clammy If you suspect that the victim is in shock, it's important to call 911 immediately. It's impossible to know when an individual will go into shock, but with amputation injuries you may want to consider the threat more elevated. And knowing the warning signs and being able to spot them early on could make a big difference. https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/training/first-aid/video/hemostatic-agents https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2049.mp4 Hemostatic Agents A hemostatic dressing is any dressing treated with an agent or chemical that assists with the formation of blood clots. Much like tourniquets, hemostatic dressings are used with direct pressure to help control severe, life-threatening bleeding. Hemostatic dressings are usually only considered an option if: The bleeding is life-threatening The standard procedure of direct pressure failed The injury is located where a tourniquet wouldn't work, such as the torso, abdomen, groin, and neck A tourniquet was unavailable or ineffective How to Provide Care After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. Once you determine that direct pressure alone isn't working, and you've decided against using a tourniquet, apply a hemostatic agent or dressing to the wound followed by more direct pressure. Pro Tip 1: Hemostatic agents come in powders and dressing pads of numerous sizes. For large open wounds, you can pour the powder into the wound which will help speed up blood coagulation and clotting. If you're using hemostatic dressing with a large open wound, make sure you pack the dressing deep into the wound and apply continuous pressure until the bleeding is controlled. Hemostatic agents are an ideal option when EMS services are delayed or unavailable, perhaps in a wilderness setting, or when normal bleeding control options are ineffective. And like tourniquets, when it comes to hemostatic agents, you're just trying to buy some time before getting the victim to a surgical center for proper care. A Word About Internal Bleeding Internal bleeding is the blood loss from veins, arteries, and capillaries into spaces inside the body. This can be caused by injuries like blunt force trauma and fractures, but also due to certain medical conditions. Internal bleeding can also include external bleeding from the same incident. Consider how a knife wound could cause both internal and external bleeding simultaneously. Common signs of internal bleeding include: Discoloration of the skin Bruising and tenderness Nausea, vomiting, or coughing up blood Discolored, painful, tender, swollen, or firm tissue Victim protectively guarding the injury area Rapid pulse or breathing Moist, cool skin Pale or bluish skin Drop in blood pressure If you suspect that someone is bleeding internally, call 911 immediately and help keep the victim as still and calm as possible to reduce the heart's blood output. Also keep an eye on the victim for any signs of shock. Pro Tip 2: When internal bleeding is from the capillary blood vessels, the result is bruising around the wound area and is not serious. To reduce discomfort for the victim, you can apply an ice pack to the area. Like internal bleeding, injuries requiring a hemostatic dressing should be considered serious. And as with all bleeding injuries, you simply want to find the bleeding and stop the bleeding, by any means necessary. https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/training/first-aid/video/secondary-survey https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2051.mp4 Secondary Survey The secondary survey is simply a head-to-toe examination that you'll perform on injury victims who are awake and responsive. It's important to remember to not get too focused on one obvious symptom. If you come upon a patient with an obvious arterial bleeding wound, remain focused on other potential head-to-toe problems, as you help care for the more obvious injury. How to Conduct a Head-to-Toe Exam As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Pro Tip #1: Even though the patient is awake and responsive, symptoms can always worsen. And conditions that didn't seem life-threatening a minute ago, may seem so now. If at any point things do get worse, call 911 and activate EMS. Remember to ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Notice how much they are able to move. Are they nodding when you ask a question? Are they able to move their fingers and toes? "Can you wiggle your fingers?" Look for the early signs of shock. Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. Early signs of shock include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Pro Tip #2: A quick way to find out if a victim has a circulation problem, which could be a sign of shock, is to pinch a fingernail bed on the patient and count how long it takes to return to a normal pink color. Longer than 3-4 seconds could be a sign that something else is wrong. "Can you wiggle your toes?" Continue working your way down the victim, noticing any potential issues or conditions beyond the obvious. Also, make sure they're in a position of comfort, whether that's sitting, laying down, or getting to their feet and stretching out their legs. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? Warning: It's important to remember that this secondary survey is only for patients who are awake and responsive. If at any point, a once responsive patient goes unresponsive, call 911 immediately and activate EMS. A Word About Chest Injuries Chest injuries are one of the leading causes of trauma deaths in the U.S. each year. Chest injuries are most commonly the result of falls, vehicular accidents, workplace accidents, and direct blows or crushing incidents. Warning: The area around the chest, abdomen, and pelvis contain several vital organs. Therefore, any life-threatening injury in one of these areas can be particularly fatal if left untreated. There are several types of chest injuries: Blunt Trauma Any blow to the chest or abdomen that doesn't penetrate the skin would be considered a blunt trauma injury. Common symptoms include shortness of breath, chest pain, and rapid pulse. Traumatic Asphyxia Traumatic asphyxia occurs due to a severe lack of oxygen caused by a physical trauma, typically one in which the victim was crushed or pinned. Common symptoms include shock, distended neck veins, bluish discoloration, black eyes, broken blood vessels in the eyes, bleeding from the nose or ears, and coughing up blood. Fractured Ribs Fractured ribs, though painful, are rarely life-threatening. For victims, breathing will be labored for a while and deep breaths, in particular, will be very painful. Flail Chest Multiple rib fractures in multiple places results in flail chest. Flail chest is especially serious if it includes the presence of a loose section of ribs that could puncture a lung. Pneumothorax A pneumothorax is the collapse of a lung that results from too much air in the chest cavity. At the very least, breathing will be difficult. At the worst, it could lead to respiratory distress. Hemothorax A hemothorax is excessive lung pressure due to the accumulation of blood between the chest wall and lungs, which prevents the lungs from properly expanding. https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/training/first-aid/video/musculoskeletal-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2053.mp4 Musculoskeletal Injuries The musculoskeletal system is actually the combination of two specific systems – the muscular system and the skeletal system, including each of your 206 bones. And let's not forget the ligaments, tendons, and joints that hold it all together. Breaks, strains, sprains, and soft tissue injuries are some of the most common types of injuries that you'll likely encounter, in everyone from the elderly to youth sports participants. How to Assess and Handle a Musculoskeletal Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "How much pain or discomfort are you in?" So long as the patient is conscious, alert, and breathing normally, activating EMS can likely wait while you investigate further, as calling 911 is often not required with these types of injuries. Pro Tip #1: The real question that needs answering is this: Does this injury require activating EMS, a visit to the ER, or is it something the patient can shake off? So, how do we answer that question? With musculoskeletal injuries, the patient will often times be self-splintering – instinctively holding the area in pain – when you find them. That injury will be obvious, so make sure you also look for those that aren't. "Do you hurt anywhere else?" Also begin to further assess the injured area. If clothing is in the way, cut around that area to expose the injury. Look for bruising, swelling, some kind of deformity or abnormal angulation, bone fragments, bleeding, etc. Do you see any signs of a serious injury? Or a developing condition? How is the victim's skin color? Are the nail beds bluish or pink and normal? Poor circulation can be serious and warrants an immediate 911 call. Ask the patient how he or she feels. People, especially adults, have a sense of whether or not an injury is serious. With children, you may have to read between the lines a bit and pay more attention to body language and whether they're becoming more concerned about the injury or less concerned. If the two of you are coming to the same conclusion – that maybe the injury isn't that bad, help them walk it off, so to speak. Assist them in whatever way they need – getting to their feet or by helping to support their body weight. If it's not bad, as you suspected, they'll be fine. However, if the inverse is obvious, that the patient is in pain and the injury is now causing more discomfort, help them back into a comfortable position, call 911, and help protect and stabilize the injured area as best as you can until help arrives. Pro Tip #2: If you can safely stabilize an injury, do so. But make sure stabilization won't cause secondary problems, increase the patient's discomfort, or aggravate the injury. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. A Word About the Musculoskeletal System Injuries to muscles, bones, and joints can be difficult to detect. Knowing the specific mechanisms of the injury will provide important clues about which body parts are likely injured. There are three basic mechanisms of injury: Direct force – when the injury is located at the point of impact Indirect force – when the injury is located some distance from the point of impact Twisting force – when the injury is caused by a rotating force There are four basic types of musculoskeletal injuries to keep in mind when assessing patients, each of which is caused by one of the mechanisms above. Fractures Fractures are bones that are broken or damaged – chipped, cracked, etc. Fractures can either be closed, meaning the skin over the injury is intact. Or they can be open, in that the injury is exposed, making it much more serious. Open fractures are more prone to infection. And they can include excessive bleeding that may be difficult to control. Dislocations Dislocations are the displacement of a bone. When a severe force causes a bone to move one joint away from its normal position, this is known as a dislocation. Dislocations also typically result in ligaments and tendons that have been stretched, torn, or displaced. Shoulders and fingers dislocate more easily than other areas of the body. Sprains Sprains occur when ligaments are torn or stretched. The greater the number of ligaments involved, the more severe the sprain. Strains Strains are similar to sprains but involve muscles and tendons instead of ligaments. And as tendons are stronger than muscles, making them more resistant to injury, when dealing with strains, they're more likely to involve a muscle than a tendon. https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/training/first-aid/video/recovery-position https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2063.mp4 Recovery Position In this lesson, you'll learn how to safely use the recovery position, for those times when you encounter a patient who is breathing but unconscious. The recovery position is used in the following scenario: The patient is unresponsive The patient is breathing normally The patient has good skin color, good circulation It's not an immediate CPR situation How to Put a Patient into the Recovery Position As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. In this situation the patient is unresponsive to your taps and shouts, which elicits an immediate 911 call and finding and/or preparing an AED for use, as you begin to assess the scene for clues of what happened. The patient could have ended up unconscious for a number of reasons: Passed out or fainted Suffering from low blood sugar Seizure Electrocution Warning: If you suspect electrocution, take extra measures to make sure the scene is safe. Is the power source still active? Is it still touching the patient? To help keep the patient's airway open and clear, put them into the recovery position using the following steps: Warning: Only use the recovery position if you don't suspect fractures, or serious neck and back injuries. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #1: The purpose of the recovery position is to expel any foods or liquids that come up. What comes up needs to come out. If it doesn't, it could find its way into the patient's lungs. The recovery position is also a great way for the patient to lay safely while waiting for EMS. Using the patient's leg as a kickstand allows his or her body to use gravity without the threat of them rolling completely over. Pro Tip #2: You want gravity working with you as you wait for EMS to arrive. It's important to eliminate the risks of the patient choking or an obstructed airway. Having the patient facing downward will help negate those risks. Warning: If the patient loses their pulse or stops breathing, immediately roll them onto their back and start CPR. Continue to reassess the patient while you wait for EMS to respond, particularly for signs of shock, responsiveness, airway, breathing, and circulation. And treat accordingly should the situation change. A Word About the Signs of Inadequate Breathing Inadequate breathing requires careful monitoring. You may not notice all of the signs and symptoms at once, and some can be hard to spot. If you see any of them, be prepared to give assisted ventilation. When the patient has to expend too much effort to breathe and their breathing has become inadequate, you'll notice the following signs: Muscles between the ribs pull in when the patient breathes in. As the patient enhales, you may notice the muscles pulling inward between the ribs, above the collarbone, around the muscles of the neck and below the rib cage. Pursed lips breathing. The patient exhales through pursed lips, like a whistling motion. This maneuver helps control the patient's breathing pattern. Flaring out of the nostrils on inhalation can be a sign of inadequate breathing in children and infants. Apparent signs of fatigue are also an indication of labored breathing. Excessive use of abdominal muscles to breathe, as in when the patient is using the abdominal muscles to force air out of the lungs. Sweating and anxiousness are also signs of severe respiratory distress. A patient who is sitting upright and leaning forward with hands on knees could be doing so because they're struggling to breathe. Abnormal breathing sounds are also a great sign of inadequate breathing. Listen for abnormal sounds such as wheezing or crackling. Wheezing or whistling sounds indicate restricted air flow and are common with conditions such as asthma, allergic reactions, and emphysema. If the patient has a fine cracking sound on inhalation, that may indicate fluid in the lungs. https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/training/first-aid/video/heat-cold-emergencies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2064.mp4 Heat-Related Emergencies As you know, the human body runs at an internal temperature of 98.6 degrees Fahrenheit, or 37 degrees Celsius. The control center responsible for regulating this internal temperature is located in the brain, and more specifically, the hypothalamus. The hypothalamus receives information and adjusts body functions to maintain this optimal temperature. The temperature range – that which allows cells to stay alive and healthy – is actually quite narrow, at between 97.8 degrees and 99 degrees. Let's quickly look at the process of how the body cools down on its own. The hypothalamus detects a rise in blood temperature. Blood vessels close to the surface of the skin begin to dilate. This brings more blood to the surface and allows heat to escape. At the end of this lesson, we'll get into the five general ways in which the body can be cooled externally, along with several types of heat-related conditions to watch out for. How to Treat for a Heat-Related Emergency Heat-related emergencies typically occur in hot environments and when the patient hasn't been rehydrating enough to compensate for water loss. Common symptoms of a heat-related emergency include: Profuse sweating Dizziness Extreme thirst Cramping, usually in arms or legs Warning: Losing fluids can be very serious. In the absence of proper medical treatment, if the condition cannot be reversed, it will likely progress to the next level which is heatstroke. Pro Tip #1: If the patient suddenly goes from wet to dry and stops sweating, it's because the patient's body doesn't have enough fluids to lose. This is a good indication that the warning above is now likely a reality, making the situation that much more serious. Your number one goal when dealing with a heat-related emergency is to cool the patient down any way you can. Ideally, the patient is able to get some fluids down. But if for some reason they aren't able to drink or swallow or can't hold fluids down, you'll need to cool them off externally. Find a water source and some containers or a hose and begin pouring water over the victim, including their clothing, to help bring their core temperature down to a safe level. Another great aid in these situations is the cold pack. If you have some available, try placing them under the patient's armpits, the back of the neck, or forehead. Pro Tip #2: The key to successfully treating someone who is having a heat-related emergency begins by recognizing that emergency. Time is crucial. Once you've diagnosed the problem, the next step is reversing the condition by cooling them down. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally, call 911 immediately and activate EMS. Then begin CPR. A Word About Heat-Related Emergencies There are several types of heat-related conditions to be aware of, but let's first look at the general ways in which the body can be cooled. Radiation Radiation involves the transfer of heat from one object to another, though without physical contact. The human body also loses heat due to radiation, mostly through the head, feet, and hands. Convection Convection occurs when cold air moves over the skin and carries heat away. The faster the flow of air, the faster the body will be cooled. Convection is why warm skin feels cooler in a breeze. Convection also assists in the evaporation process. Conduction Conduction occurs when the body is in direct contact with something that is cooler than the body's temperature. Conduction allows the body's heat to transfer to the cooler object. Think about swimming in a cold lake or leaning against a cool slab of stone. Evaporation Evaporation is the process by which a liquid or solid becomes a vapor. When body heat causes one to perspire and the perspiration evaporates, the heat that was absorbed into the sweat dissipates into the air which cools off the skin. Respiration The last way in which the body can cool itself is through respiration. Before air is exhaled, it's warmed by the lungs and airway. Respiration accounts for around 10 to 20 percent of heat loss. There are several types of heat-related illnesses (hyperthermia) to be aware of, including dehydration, exercise-associated muscle cramps, exertional heat exhaustion, and heatstroke. Dehydration Dehydration occurs when there is an inadequate supply of water in the body's tissues. Dehydration can be serious and life-threatening, particularly for the very young and very old. Symptoms, which include fatigue, headaches, irritability, nausea, and dizziness, will worsen as the body continues to lose water. Exercise-Associated Muscle Cramps Muscle cramps are thought to occur due to a combination of fluid and electrolyte loss through sweating. Muscle cramps typically come on quickly and after rigorous work or exercise and are particularly more common in warmer environments. Exertional Heat Exhaustion Exertional Heat Exhaustion occurs when the body loses more fluids than are replenished. As this happens, the body will divert blood from the surface of the body to vital organs like the heart and brain. This type of heat-related illness is usually the result of intense physical activities and often in hot and humid climates – athletes, firefighters, construction workers, etc. Heatstroke Heatstroke is the most serious type of heat-related illness and can be life-threatening if quick action isn't taken. As there is a progressive nature to these conditions, ignoring the warning signs of exertional heat exhaustion can quickly lead to a body that will become overwhelmed by heat and begin to stop functioning. https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/training/first-aid/video/profirstaid-only-intro https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2110.mp4 ProFirstAid Only Intro Welcome to ProFirstAid Only. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. And even though you'll just be learning hand's only CPR, at the end we'll give you a little information on why learning CPR is so important. Your instructor for the duration of your ProFirstAid Only course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and also a cofounder of ProCPR and ProFirstAid. In other words, you're in good hands. We created ProFirstAid Only with you in mind. In our busy modern world, it's hard to imagine fitting anything else into our already jam-packed schedules and especially several hours' worth of first aid training. Since your schedule is already hectic, we created ProFirstAid Only to be available whenever you are, 24 hours a day, seven days a week. You can squeeze in a quick lesson whenever you have a few minutes to spare, whether it's day or night, weekend or workday. It's there when you need it. Regardless of your occupation, you'll be getting the best training available for adult, child, and infant first aid. Whether it's a sudden illness or an injury-related emergency, you'll be better prepared to handle it thanks to the skills you're about to learn; important skills that you can use in the workplace, and also at home. The list of occupations that can benefit from the ProFirstAid Only course is long and includes: Individuals who have CPR certification and require First Aid only to meet OSHA and other requirements Construction Workers Manufacturing Forestry Transportation Electricians Security Personnel Adult Foster Care Restaurant Staff Home Health Care Aids Hotel Staff CNAs High School Teachers High School Coaches The total course time includes 2 hours and 56 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual here: Student Manual. What You Will Learn in this Course Your ProFirstAid Only course curriculum is quite substantial. Some of the important things you'll be learning are: Introductory First Aid Training• The Five Fears of CPR Rescue Heart Attack and Stroke• Stroke• Heart Attacks Choking• Conscious Choking Bleeding and Shock• Capillary, Venous, Arterial Bleeding• Shock Management Sudden Illness and Injury• Mechanism of Injury• Secondary Survey• Musculoskeletal Injuries• Amputation• Head, Neck, and Back Injuries• Seizure• Eye Injuries• Allergic Reactions• Snake Bites• Diabetes• Burns  Heat and Cold Emergencies• Snow Safety - Prevention, Hypothermia, Frostbite• Heat and Cold Emergencies Prevention• Car Backing• Child Proofing the Home• Poison Control• Pool Safety• Child Abuse and Neglect Bloodborne Pathogens• Reducing Your Risk• Glove Removal• Hand Hygiene Pro First Aid Only is an online first aid certification that meets OSHA guidelines for the general workplace where CPR certification is not required. If you need ONLY first aid training without CPR, you are welcome to utilize this course and receive a new, two-year First Aid Only certificate. And if you ever decide to become CPR certified in the future, check out our CPR & First Aid course for all ages. Those of you old enough to remember may recall that McDonald's signs used to include a running total of the number of hamburgers sold until that number outgrew the sign. More than 14,000 satisfied professionals just like yourself have completed this ProFirstAid Only course. And although our numbers aren't growing as quickly as McDonald's, we do sincerely hope that you'll be the next person who has a satisfying experience. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Why Learning High-Quality CPR is Important ProFirstAid Only is different from the typical first aid courses. We believe that high-quality CPR and first aid training is something everyone should be able to access, for free. So, rather than paying simply to learn CPR and first aid, the payment is at the very end, only for those who need a certification card for work. We also believe that the problem with CPR isn't that everyone is doing CPR incorrectly. The bigger problem is that people aren't doing CPR at all. That's why we start with the "why." Why are people afraid to rescue? What happens when CPR doesn't work? These are just a few of the parts of the training that will make even the most seasoned professional walk away from the course learning something new or thinking about CPR and first aid differently. Gaining confidence in your skills is a big part of performing high-quality CPR (even hand's only CPR) and administering vital first aid. Remembering that as you progress through each lesson will serve you well. Welcome again to ProFirstAid Only. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3779/profirstaid-only-intro-2015.jpg Yes 47 https://www.procpr.org/training/first-aid/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/first-aid/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/first-aid/video/snake-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2059.mp4 Snake Bites In this lesson, you'll learn how to treat a patient who has been bitten by a venomous snake. When dealing with snake bite victims, there is one special point to take note of: If you have the snake, DO NOT bring it to the hospital, just take a picture from a safe distance or remember key features of the snake so the venom can be identified. Just don't get bit yourself trying to look at or take a picture of the snake. How to Treat a Patient who has been Bitten by a Snake As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Call 911 and activate EMS. Give them as much information as possible so that the patient gets routed to a hospital that has the correct antivenom. Get the patient into a comfortable position – seated or laying down – where they can be as calm as possible. They could become dizzy, and you don't want them falling and injuring themselves. Reassure the patient – tell him or her that they're in good hands, that EMS is on the way, and that they'll be taken good care of. You don't want them to get excited, nervous, or agitated, as the patient's heart rate will increase and circulate the venom faster. Warning: What you don't want to do – You don't want to use a cold pack; these have been widely ruled out now. And you certainly don't want to suck out the venom, unless you have a special fondness for urban myths. Keep the patient's snake-bitten limb or area level with the heart, if possible.  Raising or lowering of the extremity may both be correct, but that would depend on the species of snake and the condition of the patient.  Get the patient into the ambulance with as little movement as possible. Is there a golf cart around? How about a stretcher? How close can the ambulance get? You don't want them walking, or moving, any more than is absolutely necessary. Get the patient to the correct hospital with the correct antivenom and the life-saving treatment they may need. A Word About Venomous Snakes Snakebites kill few people in the United States. Of the estimated 7000 to 8000 people reportedly bitten each year, fewer than five die. And most of those deaths occur because the person has an allergic reaction, is in poor health, or because too much time passes before the person receives medical care. When it comes to the biggest threat, rattlesnakes account for most snakebites and nearly all of the deaths from snakebites. Venomous snakebite signs and symptoms include: One or two distinct puncture wounds, which may or may not bleed. The exception is the coral snake, whose teeth leave a semicircular mark Severe pain and burning at the wound site immediately after or within four hours of the bite Swelling and discoloration at the site of the bite immediately after or within four hours of the incident If the bite is from a venomous snake such as a rattlesnake, copperhead, cottonmouth, or coral snake, call 911 and activate EMS for more advanced medical personnel. To give care until help arrives, simply follow the steps outlined above. And if you're interested in more of what not to do, we have a list for that, too: Do not apply ice Do not cut the wound Do not apply suction Do not apply a tourniquet Do not use electric shock, like from a car battery https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/training/first-aid/video/concussion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2038.mp4 Concussion This lesson is for those times when a head injury may have led to one of the more common and serious injuries – concussions. Pro Tip #1: Concussions occur as the brain moves abruptly from side to side inside the skull, essentially bouncing off the walls that protect it. In serious concussion cases, the brain can shut down immediately, causing the victim to lose consciousness. Even in situations that don't involve a loss of consciousness, a person who exhibits other concussion signs and symptoms are at least mildly concussed. Part of your job is to determine if the victim is concussed and how severe it is by reading the signs and asking open-ended questions. Warning: The most important thing to keep in mind as you deal with someone who has sustained a head injury, as soon as it appears to be a concussion, that deserves an immediate 911 call. Even if the patient begins to recover, concussions are too traumatic and can develop into something more life-threatening. How to Assess and Treat a Concussion As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "Do you know if you hit your head?" If you suspect a head injury, ask questions about headaches, blurred vision, nausea, while also looking over the victim for concussion symptoms including: Eye-tracking – can they follow your finger Blurred vision, which indicates swelling in the brain Dizziness, loss of balance Nausea, vomiting Loss of memory Dazed and confused If the victim exhibits any of these symptoms, it's best to call 911 immediately. If they don't, continue assessing them. "Do you know what day it is?" "Do you know what year it is?" If the victim answers those two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. Which as you know by now, deserves a 911 call. Pro Tip #2: When it comes to head injuries, it's better to be safe than sorry. Get the patient to the ER whenever in any doubt and get them properly examined. Always err on the side of patient welfare. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. In concussion cases, the patient will likely require a 24-hour observation period to make sure that symptoms and swelling in the brain are reduced, which is the norm. However, these issues and symptoms can also worsen. A Word About Injuries to the Head The problem is that the head lacks the padding often present in other areas of the body. Which means it can easily be injured. And that injury can easily be considered serious. There are two main types of head injuries – open and closed. An open head injury is one that breaks or penetrates the skull. Excessive bleeding can occur and controlling that bleeding will be vital for a positive outcome. The other type is a closed head injury. Closed head injuries occur when the brain strikes against the inside of the skull and when the skull remains intact. These injuries are much more difficult to detect as there is a decided lack of visible clues. The four subtypes of head injuries are: Concussion Skull fractures Penetrating wounds Scalp injuries Let's take a deeper look into the physical, emotional, and behavioral signs and symptoms of a concussion. Physical symptoms include: Headache Blurry vision Nausea or vomiting Dizziness Sensitivity to noise or light Balance problems Feeling sluggish Emotional symptoms include: Irritability Sadness Heightened emotions Nervousness or anxiety Behavioral symptoms include: Sleeping more or less than usual Difficulty falling asleep Changes in playing habits for kids Changes in eating habits Thinking and remembering skills may also be impacted and include the following symptoms: Difficulty thinking clearly Difficulty remembering events that occurred just prior to the incident and just after the incident Difficulty remembering new information Difficulty concentrating Feeling mentally foggy Difficulty processing information https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/training/first-aid/video/animal-and-human-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2370.mp4 Animal and Human Bites In this lesson, you'll learn what to do when you come across patients who've been bitten by animals and/or humans. There are a few considerations that differentiate animal and human bites. However, for the most part, general first aid care will be the same for both. How to Treat for Animal and Human Bites As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Let's quickly differentiate between minor wounds and serious wounds. A minor wound is defined as bites that caused teeth marks, bruising, or scratching. When you encounter minor wounds, simply wash the area thoroughly with soap and water. For scratches, apply an antibiotic ointment to prevent infection, then cover the area with a clean bandage. A serious bite wound is one in which the skin has been punctured or torn and is bleeding. A victim with an open bite wound must seek advanced treatment from a physician due to the high risk of infection. A serious bite wound can include severe bleeding. Unless the wound is still oozing or spurting blood, wash the area with soap and water, apply sterile dressing, and seek advanced medical treatment. If the wound is still bleeding, apply direct pressure with a clean dry cloth or sterile gauze pad and first stop the bleeding. Apply a bandage once the bleeding has been controlled. If your serious bite wound does include arterial or severe bleeding, apply direct pressure, call 911, and watch for signs of shock. A severe bleeding incident is one in which the wound is spurting or pulsating blood and the bleeding is difficult to control. Special Considerations for Human Bites The most common type of human bite occurs among young children who are curious, angry, or frustrated. Children at day care centers are most at risk for human bite wounds. Most human bite wounds among children are harmless, as more serious child bite wounds are very unusual. The biggest threat when it comes to human bites is infection, as human saliva contains hundreds of species of bacteria. In fact, a bite wound is more likely to become infected if it came from a human versus an animal. Pro Tip #1: For any human bite wounds that break the skin, the patient will need to seek advanced medical care due to the risk of infection. And while highly unlikely, bloodborne pathogens like HIV and hepatitis B or C can be transmitted by human bites. Special Considerations for Animal Bites Most animal bites come from domestic pets like cats and dogs and typically involve young children. The biggest threat with animal bites, even domesticated animals, is the risk of rabies. If the animal bite included the skin being punctured by a non-immunized animal, or from an animal whose immunization status is unknown, the patient will need to be treated by a physician immediately. Pro Tip #2: Most rabies cases involve wild animals, like foxes, raccoons, skunks, and the most common rabies carrier of them all – bats. If you suspect that a patient was bitten by one of the above, keep in mind the need to seek swift medical treatment for rabies. Warning: Tetanus can be a concern in both animal and human bites. If a patient suffered a deep bite wound and he or she hasn't had a tetanus shot in more than five years, a booster shot should be encouraged. When it comes to animal and human bites, just following the general first aid guidelines, particularly for bleeding control and infection control, will encompass the majority of the treatment you provide. A Word About Animal Bites Dog bites are the most common among all types of wild and domestic animals. It's important that when a person is bitten, that they are quickly removed from the situation if possible. It's equally important to do so in a way in which you're not endangering yourself or others. Clean minor wounds with soap and clean water and do your best to control bleeding with major wounds. If the patient is bleeding severely, apply pressure and control it as best you can until advanced medical personnel arrive. Tetanus and rabies immunizations may be necessary, so it's vital that bites from any wild or unknown domestic animals be reported to the local health department or another agency according to local protocols. If the animal is still loose, follow local protocols regarding contacting animal control to capture the animal. Try to obtain and provide a description of the animal and the area in which the animal was last seen. https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/training/first-aid/video/nosebleeds https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6487.mp4 Nosebleeds In this lesson, we're going to cover nosebleeds and how to apply first aid in the event you or someone you know gets one. Nosebleeds, also known medically as epistaxis, can catch us off guard and happen when we least expect them. However, they’re often quite harmless and can usually be managed easily. Each year, around 60 million people get nosebleeds in the United States alone. They are most likely to occur in the winter when cold weather and indoor heating dry the nasal passages. Most nosebleeds are minor and the bleeding will often stop on its own, but some people may require medical attention. This lesson will teach you the proper way to handle them. But before we proceed, bear in mind that while most nosebleeds are benign, there are exceptions. Pro Tip #1: If a nosebleed is intense, continues for over 20 minutes, or pairs with other symptoms, one should seek immediate medical help. It's important to note that if someone is on prescription blood thinners, their risk of a continued hemorrhage increases significantly, as these medications can intensify bleeding and challenge the standard control techniques. It's important and recommended that these patients seek further medical attention. First Aid Steps for Nosebleeds While nosebleeds are usually nothing to worry about, the presence of blood can make people feel anxious or queasy, particularly if it is their own blood. Reassure the affected person and urge them to stay calm. Ask the nosebleed victim to sit down and lean forward slightly, as this helps keep the blood from trickling down the back of the throat. Once you have your safety gloves on, or if the individual can do it themselves, pinch the soft section of the affected person's nostrils just past the nasal bone. Hold this pinch for about 10-15 minutes without releasing any of the pressure. This simple act applies pressure on the blood vessels of the nose and helps facilitate clotting. If the victim has any blood pooling in their mouth or throat, instruct them to carefully spit it out rather than swallow it. It is important to contain the blood spray or splatter through this process, which can be associated with sneezing, coughing, spitting, or speaking. Pro Tip #2: A backward tilt could lead to potential complications like aspiration or ingestion and vomiting. So step two is more vital than it may sound. Eye protection along with a face shield may be necessary - in addition to gloves – to fully protect the care provider appropriately. If no PPE (Personal Protective Equipment) is available, be sure to stand next to the patient, rather than in front of their face, as this may help protect you. Pro Tip #3: It's important to note that while a cold compress can help constrict blood vessels, cold blood does not clot swiftly. If you choose to use an ice pack, it is suggested to be placed on the bridge of the nose or the rear of the neck. Once the victim's nose stops bleeding, encourage the patient to resist the urge to blow their nose, as this can dislodge the clot and cause the nose to begin bleeding again. One common misconception is to pack the nose with gauze or tissue. This should be avoided in a first-aid scenario. And remember, only a physician should decide on medical nose packing. Also, for those patients who may be on blood thinners, the pressure might need to be maintained longer, and a physician's intervention may be required. Utilizing these first-aid methods, most nosebleeds can be managed easily. But remember, persistent bleeding, recurring episodes, or additional symptoms or complications may warrant prompt medical attention via a 911 emergency services phone call. A Word About Applying Pressure to a Stubborn Nosebleed The two most important factors when successfully controlling a nosebleed are: The amount of pressure applied. The amount of time the pressure is maintained. Remember that the pressure must be firm, and it must be maintained for a long time. Methods of applying pressure include pinching the nose with your fingers or using gauze or cloth placed over the nose and then pinching. If bleeding continues, try adjusting where you are pinching the nose or adjusting the pressure with which you are pinching the nose. About Hereditary Hemorrhagic Telangiectasia HHT is a genetic disorder in which blood vessels do not develop normally leading to bleeding that can be serious or life-threatening. A person with HHT may form abnormal capillaries or abnormal capillary connections between the arteries and veins. Capillaries are tiny blood vessels that pass blood from arteries to veins. The abnormal blood vessels formed in HHT are often fragile and can burst, which then causes bleeding. Men, women, and children from all racial and ethnic groups can be affected by HHT and experience the problems associated with this disorder, some of which are serious and potentially life-threatening. Nosebleeds are the most common sign of HHT, resulting from small abnormal blood vessels within the inside layer of the nose. While rare, it's important to understand that sometimes a nosebleed is a sign of a greater underlying problem. https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/training/first-aid/video/dental-and-oral-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6489.mp4 Dental and Oral Injuries In this lesson, we'll take a look at dental and oral injuries and how you can apply first aid to treat them. Dental and oral injuries, such as tooth, tongue, or lip injuries, can occur unexpectedly and may require immediate first aid. Knowing how to assess and provide initial treatment can help alleviate pain and prevent further complications. This lesson will guide you through the assessment phase and first aid treatment options for some of the more common dental and oral injuries. Pro Tip: Before we begin, it is really important to remember that dental and oral injuries can vary in severity. For more severe injuries, seeking prompt dental or medical assistance is crucial. However, in minor cases, you can provide initial first aid to alleviate discomfort and help the healing process. First Aid Treatment for Tooth, Tongue, and Lip Injuries If a permanent tooth is lost, follow the first aid steps below. Try to locate the tooth and handle it only by the crown. Avoid contact with the root – the part that is hidden in the gums - as touching this could damage the tooth. If the tooth is dirty, gently and quickly rinse the tooth with water. Do not scrub or remove any tissue fragments. Gently reposition the tooth back into its socket and have the patient bite on a clean cloth, such as a piece of gauze, to hold it in place. If the first option is not possible, place it in a suitable storage medium, such as milk, saliva, or a tooth preservation kit, and seek dental care immediately, as the chance of saving a knocked-out tooth decreases with time. Additionally, according to the latest guidelines of the International Association of Dental Traumatology, it is not recommended to replant a primary tooth. It is still advisable to place the tooth in a storage medium and seek further evaluation by a dentist. There are many other dental injuries that could occur, but there is very little we can do about these. The best recommendation is not to move or irritate the area and seek immediate dental care. If there's bleeding from the tongue or lip, have the person rinse their mouth with water to clear any blood. You can gently clean the injured area with a damp cloth or gauze pad to remove debris. This will allow you to assess the extent of the injury. Apply direct pressure to the wound with a clean cloth or sterile gauze to control bleeding. If there is significant bleeding or the wound is deep, seek immediate medical attention since this may lead to breathing problems as blood can make breathing increasingly difficult. It may also cause the patient to swallow blood which can quickly lead to nausea and vomiting, further compromising the airway. Encourage the person to avoid hot or spicy foods and to maintain good oral hygiene. Remember, while these first aid measures can provide relief, seeking professional dental or medical care is always essential. A Word About Dental Avulsion Injuries A dental avulsion injury - also known as a knocked-out tooth - can damage both the tooth and the supporting soft tissue and bone, resulting in the permanent loss of the tooth. Dental avulsion is relatively uncommon compared to other dental injuries but can occur in various age groups, particularly among children and young adults involved in sports or accidents. It most commonly affects children and adolescents, often due to falls or sports-related injuries. The peak incidence is seen in the 7-14 age group. Studies suggest that dental avulsion accounts for approximately 0.5 to 3 percent of all dental injuries. It tends to affect males more frequently than females, possibly due to higher participation rates in contact sports. Participation in contact sports (e.g., football, hockey, and basketball), inadequate use of mouthguards during sports activities, and accidents (falls and collisions) are significant risk factors. Immediate reimplantation of an avulsed tooth is believed to result in the greatest chance of tooth survival. The longer a tooth is out, the more likely it will be permanently lost. In situations that do not allow for immediate reimplantation of an avulsed tooth, it is beneficial to temporarily store it in a variety of solutions that are shown to prolong the viability of dental cells. If available, place the avulsed tooth in Hanks' Balanced Salt Solution or in another oral rehydration salt solution, or wrap the tooth in cling film to prevent dehydration and improve the likelihood of successful replantation by a dental professional. This should always be done as quickly as possible. If an avulsed permanent tooth cannot be immediately replanted in either Hanks’ Balanced Salt Solution, oral rehydration salt solutions, or cling film, store the tooth in cow’s milk or saliva, as these are your best secondary options. Keeping the tooth "safe" in the saliva inside the person's mouth is also not suggested as the patient will often keep moving the tooth around which can further damage to the roots of the tooth. An avulsed tooth should never be stored in tap water.  The viability of an avulsed tooth stored in any of the above solutions is limited. And reimplantation of the tooth within an hour after avulsion provides the best chance for tooth survival. Following the loss of a permanent tooth, it is essential to seek rapid medical assistance for reimplantation. The long-term success of replantation depends on various factors, including the extra-alveolar time (time the tooth is out of its socket), the storage medium used for transporting the tooth, and the condition of the tooth and surrounding tissues. Complications may include pulp necrosis (death of the tooth's inner tissue), infection, root resorption (breakdown of the tooth root), and periodontal issues. Prevention is often a key to avoiding oral injuries while playing contact sports. The proper use of mouthguards is highly recommended. https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/training/first-aid/video/penetrating-trauma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6490.mp4 Penetrating Trauma In this lesson, we'll go over the treatment options for penetrating injuries like gunshot wounds, knife stabbings, or any other type of similar penetrating trauma. Penetrating injuries can often be life-threatening and will usually require immediate treatment. Knowing how to assess and provide first aid for these injuries can make a critical difference in the outcome of the victim.  In this lesson, we will guide you through the assessment phase and initial treatment of penetrating injuries. Pro Tip #1: Before we begin, it's essential to remember that first aid is not a substitute for professional medical care. In the case of penetrating injuries, it is vital to call emergency services immediately. Your main goal is to provide initial care and support until professional medical help arrives. First Aid Steps for Penetrating Trauma Injuries As always, the first thing you want to do is ensure that the scene is safe. Carefully assess the scene for any ongoing danger and ensure your safety and the safety of others before approaching the injured person. If there is an active threat, prioritize your safety and seek a safe location before providing aid. Your safety and the safety of others is always the most important step. Once you have determined that the scene is safe, follow the steps below. Step 1: Call 911 for help. If you cannot call emergency services yourself, ask someone else at the scene to do this, providing others are in the vicinity, as you may have your hands full with the victim. Step 2: Provide accurate details to emergency services about the situation, including your location and the nature of the injury. Calling for professional medical help is crucial for the injured person's survival. Also, remaining calm, if possible, will help to ensure the proper communication of vital information Step 3: Control the bleeding by applying direct pressure to the wound using a clean cloth, a sterile dressing, or even your gloved hand. Pro Tip #2: It is always recommended that you utilize universal precautions. Use personal protective equipment (PPE) at all times. Protecting yourself should not be overlooked. Step 4: Maintain pressure until medical professionals take over. If the object causing the penetration is still in the wound, don't remove it, as it may be acting as a plug to control the bleeding. If you believe there is a possibility that the penetrating item such as a bullet, knife, or other item may have gone through the body, check to see if there is a wound where the object came out. With bullets especially, the exit wound is usually larger than the entry wound. Pro Tip #3: Controlling the bleeding is of the utmost importance. Apply firm and continuous pressure to the wound. Treating the wound with a dressing and bandage will help the clot to form and stop the bleeding. Step 5: Once the bleeding has been controlled, help the victim get into a comfortable position, preferably lying flat on the ground if possible. Then, cover the injured person with a blanket or any available material to help maintain their body heat. This can reduce the risk of hypothermia, help with the clotting process, and provide comfort to the victim. Step 6: Lastly, provide reassurance. Keep the injured person calm and reassure them that help is on the way. It's important not to lie to them or give them false hope. Minimizing their movement to avoid exacerbating the injury, keeping them calm, and reassuring them that you are taking good care of them can all aid in their recovery. Pro Tip #4: Do not probe or irrigate the wound. Inserting objects into the wound or attempting to clean the wound extensively may cause further damage or introduce infection. It's important to resist the urge to probe or irrigate the wound. Your focus should be on controlling bleeding, keeping them warm, providing comfort and reassurance, and waiting for professional medical help to arrive. Remember, in most cases, maintaining the victim’s airway, breathing, and circulation will be the most important steps in a critical penetrating trauma emergency, as cardiac arrest may become an additional threat. These are the basic steps for providing the initial care for a penetrating injury. Once emergency medical services arrive, they'll take over and provide the appropriate medical treatment. A Word About Cardiac Arrests Associated with Penetrating Traumas According to the American Heart Association, basic and advanced life support for the trauma patient are fundamentally the same as that for the patient with a primary cardiac arrest, with a focus on support of the airway, breathing, and circulation. Cardiopulmonary deterioration associated with trauma has several possible causes including: Hypoxia secondary to respiratory arrest, airway obstruction, large open pneumothorax, tracheobronchial injury, or thoracoabdominal injury Injury to vital structures, such as the heart, aorta, or pulmonary arteries Severe head injury with secondary cardiovascular collapse Underlying medical problems or other conditions that led to the injury, such as sudden cardiac arrest Diminished cardiac output or pulseless arrest from tension pneumothorax or pericardial tamponade Extreme blood loss leading to hypovolemia and diminished delivery of oxygen Even with a rapid and effective out-of-hospital response, victims with out-of-hospital cardiac arrest due to trauma rarely survive. Those patients with the best outcome from trauma arrest generally are young, have treatable penetrating injuries, have received early endotracheal intubation, and undergo prompt transport to a trauma care facility. Remembering your CPR training during a penetrating trauma injury could be vital for whomever you're administering first aid to should they fall victim to a cardiac arrest. It pays to be prepared. https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/training/first-aid/video/head-neck-and-back-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2098.mp4 Head, Neck, and Back Injuries If you come upon a patient who appears to have taken a fall, or was injured in an accident, and there are no bystanders around who witnessed the accident, you'll need to figure out the mechanism of injury. Hopefully the victim will be able to help, who in this lesson, we are assuming is conscious, alert, and not exhibiting more serious issues involving airway, breathing, circulation, etc. The most important thing to keep in mind as you deal with someone who has sustained potential injuries to their head, neck, and/or back, is minimizing movement, as you inquire more into what happened and how the patient is feeling. Pro Tip #1: Part of your job is to figure out if EMS is required as you tend to them. It may be a situation where the victim is able to get up and has no significant injuries. Or it could be a situation that doesn't appear serious initially, but suddenly becomes serious. If at any point the situation warrants it, call 911 immediately. How to Handle a Patient with Head, Neck, and Back Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. When dealing with potential back and neck injuries, it's best not to touch the patient while you assess them. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions; try not to nod. Answer with yes or no. And try not to move other parts of your body." "Do you remember what just happened?" "Do you know if you hit your head?" "Do you know what day it is?" "Do you know what year it is?" If the victim answers the last two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. This altered mental state is enough of a concern to call 911 and activate EMS if you haven't already done so. The fact that you're able to talk with the patient is a good sign. It indicates that they're awake, breathing normally, and have a pulse, all of which indicate a lack of an immediate emergency. However, that doesn't mean the situation cannot suddenly change. As you're talking with the victim, you're also looking them over for injuries, beginning with their head. Is there blood in the ears? Is there blood in the nose? Does the patient have any broken teeth? Are the pupils equal size and responsive to light? Pro Tip #2: Put your hand over the victim's eyes for a second or two then remove it and see if their pupils react. If they do not, it could be due to a concussion and swelling in the brain. Determine how injured they are by seeing how much they can move and with open-ended questions. "Can you tell me what hurts?" "Can you wiggle your fingers?" "Can you wiggle your toes?" A victim in paralysis is prone to going into spinal shock. Remember, shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. Early signs of shock to look for include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Warning: Should you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. If at any point during your assessment, the patient goes unresponsive, appears to be having trouble breathing normally, or goes into full cardiac arrest, activate EMS and treat the patient accordingly until help arrives, an AED arrives, or the patient is responding positively. A Word About Injuries to the Neck and Spine Injuries to the neck and spine can damage soft tissue and bone, including the spinal cord. Unfortunately, assessing the level of this damage on the scene, and without proper diagnostic equipment, is very difficult. Which is why you should always proceed with caution. Some common situations in which serious neck and spine injuries tend to be seen include: Swimming pool diving accidents Vehicular accidents Accidents that include a broken hard hat or helmet Some common symptoms for serious neck injury are: Obvious lacerations or swelling Impaled object Excessive external bleeding Difficulty speaking Air escaping through the trachea and/or larynx An airway obstruction Some common symptoms for serious spine injury are: Back pain or pressure Pain with movement Numbness, weakness, tingling in limbs or extremities Loss of feeling in limbs or extremities Breathing problems Loss of bladder and bowel control https://d3imrogdy81qei.cloudfront.net/video_images/3755/head-neck-and-back-injuries-2015.jpg Yes 229 https://www.procpr.org/training/first-aid/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/first-aid/video/asthma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2062.mp4 Asthma Anyone who has experienced an asthma attack will tell you what a frightening situation it can be, as your airways tighten and no matter what you do, you simply cannot get enough oxygen into your lungs. Pro Tip #1: Want to know what it feels like to have an asthma attack? Imagine only being able to breathe using a thin, plastic coffee stir straw. That would approximate how a severe asthmatic attack would feel. In this lesson we'll discuss one of the best medications for acute and chronic asthma attacks (Albuterol) and how to use it correctly. How to Treat a Patient with Asthma As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: Albuterol comes in a small aerosol container with an actuator. Whether the patient's asthma is exercise induced or persistent, the effect should be the same regardless. In this lesson, we're going to include the use of a spacer with the Albuterol dispenser. Spacers are really expensive, which probably contributes to many people not using one, and sort of resembles a small plastic sippy cup. The spacer goes between the patient's mouth and the Albuterol dispenser. Warning: When not using a spacer, much of the medication, instead of going into the patient's lungs and bronchials where it should go, winds up sitting at the back of the throat and on the tongue. This obviously decreases the dosage and the effectiveness of that dose. How to Administer Albuterol Using a Spacer Pro Tip #3: Before using your Albuterol device, make sure it has actuations remaining. To find this information, look on the back of the dispenser. Most devices have a number there inside a little window that corresponds with the number of actuations remaining. And don't forget to check the expiration date! Shake the Albuterol container just prior to using it. You don't have to shake for long. A few seconds will do the trick. Insert the Albuterol mouthpiece into the end of the spacer where it fits. (It will be obvious.) Place the other end of the spacer into the patients mouth. Make sure he or she completely exhales first. Push down on the Albuterol dispenser one time and instruct the patient to hold his or her breath for 10 seconds. Instruct the patient to exhale. Pro Tip #4: A normal dosage of Albuterol for most adults is two inhalations and children may be one or two doses. So we need to always ask the patient about their specific dosage. Repeat – patient exhales out all air, puts spacer into their mouth, dispense Albuterol, hold for 10 seconds, and exhale. If the patient doesn't get relief from two injections, ask them what their prescribed amount of time is between injections and doses. If the patient is still having trouble breathing, call 911 and activate EMS. They could be suffering from a persistent asthma attack that cannot be stopped with a simple rescue inhaler of Albuterol. Get help on the way immediately, in case the patient begins having a true respiratory emergency. It's important to avoid assumptions that the patient will get better after administering a dosage of Albuterol. Always be prepared for anything. A Word About Asthma Triggers Asthma is an illness in which the airways swell. An asthma attack happens when an asthma trigger, such as exercise, cold air, allergens, or other irritants, causes the airways to suddenly swell and narrow. This makes breathing difficult, which can be very frightening. The Centers for Disease Control and Prevention (CDC) estimates that approximately 24 million Americans are diagnosed with asthma in their lifetimes. Asthma is more common in children and young adults than in older adults, but its frequency and severity are increasing in all age groups. You can often tell when a person is having an asthma attack by the hoarse, whistling sound the person makes while inhaling and/or exhaling. This sound, known as wheezing, occurs because air becomes trapped in the lungs. But what exactly triggers an asthma attack? A trigger is simply anything that sets off an attack. And they can be very different for different people. Common asthma triggers include: Dust, smoke, and air pollution Exercise Plants Molds Perfume Medications Animal dander Temperature extremes and changes in the weather Strong emotions, such as anger, fear, or anxiety Infections, such as colds or other respiratory infections Usually, people diagnosed with asthma control their attacks by controlling environmental variables (exposure to those triggers) and through medication and other forms of treatment. https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/training/first-aid/video/treating-ear-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6488.mp4 Ear Injuries In this lesson, we'll take a look at both external and internal ear injuries and how to apply first-aid treatment for both. Ear injuries can occur due to various causes, such as trauma, loud noises, or foreign objects that have been accidentally or purposely inserted into the ear. Knowing how to assess and provide initial first aid treatment for any ear injury is essential to minimize discomfort and prevent further complications. This lesson will guide you through the assessment and first aid treatment options for some of the more common ear injuries. Pro Tip #1: Before we begin, it's important to note that ear injuries can range from minor to severe. In cases of severe ear injury or if the injury involves hearing loss, it's crucial to seek medical assistance. Therefore, assessment of the ear injury is vital. Having said that, even in the event of a severe ear injury, you should still provide first aid to alleviate discomfort. Now let's take a look at how to assess and provide first-aid treatment for an ear injury. First Aid Treatment for External Ear Injuries Inspect the external ear for any visible injuries, cuts, or bleeding. If there is bleeding, apply gentle pressure with a clean cloth or sterile gauze to control it. Maintain pressure until the bleeding stops. Do not insert any objects into the ear canal, and do not attempt to clean the ear extensively. If there are signs of infection, such as redness, swelling, or discharge, seek medical attention. First Aid Treatment for Foreign Objects in the Ear If a foreign object - such as a small toy or insect – is visible and can be easily removed without pushing it in further, use clean tweezers or your fingers to fish it out. However, remember to use EXTREME caution and try to remove it gently. Avoid using sharp objects or excessive force, as this may cause injury or push the object deeper into the ear potentially causing permanent hearing loss. If the object cannot be easily removed, or if moving the object causes pain, discomfort, or bleeding, be sure to stop and seek medical attention. First Aid Treatment for Bleeding from in the Ear Foreign bodies or significant head trauma can lead to bleeding from the ear canal. For this type of bleeding injury, it is best to quickly seek medical attention. As for the bleeding, loosely apply a dressing or other clean materials to the outside of the ear and track how much blood came out, such as how many gauze pads or towels were used. Pro Tip #2: If you try to apply direct pressure, this could cause a build-up of pressure in the ear and cause an increase in pain or lead to other complications. Monitoring the victim and asking how they are doing will help determine if the pain is suddenly getting worse. If it is, it might be caused by this direct pressure. Remember, while these first aid measures can provide initial relief, seeking professional medical care for significant ear injuries, severe pain, changes in hearing, or especially head trauma that causes bleeding from the ear is essential. A Word About Basilar Skull Fractures Basilar skull fractures are fractures that occur in the base of the skull, which is the area at the bottom of the skull that supports the brain. Symptoms related to the ear that can occur with basilar skull fractures include: Battle's Sign: This refers to bruising behind the ear and is a common sign of basilar skull fracture. It typically appears a few days after the injury and is due to bleeding beneath the skin. Hearing Loss: Basilar skull fractures can affect the structures of the middle and inner ear, leading to conductive or sensorineural hearing loss. Conductive hearing loss occurs when sound waves cannot reach the inner ear due to damage to the ear canal, eardrum, or middle ear bones. Sensorineural hearing loss occurs due to damage to the inner ear or auditory nerve. Tinnitus: Ringing or buzzing in the ear (tinnitus) can occur as a result of the injury to the inner ear structures. Ear Bleeding: Bleeding from the ear canal (otorrhagia) can occur if the fracture involves damage to the temporal bone or surrounding structures. Dizziness and Vertigo: Damage to the inner ear or vestibular system can cause dizziness, vertigo (the sensation of spinning), and imbalance. Facial Nerve Dysfunction: Fractures involving the temporal bone can affect the facial nerve (cranial nerve VII), leading to facial weakness or paralysis on the affected side. CSF Leak: In severe cases of basilar skull fracture, cerebrospinal fluid (CSF) can leak from the nose or ear (otorrhea). This can be a serious complication requiring medical attention. https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/training/first-aid/video/mechanism-of-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2050.mp4 Mechanism of Injury Physical injuries run the gamut from soft tissue injuries like bruises, cuts, and burns to those involving the musculoskeletal system and/or the head, neck, and back. While injuries can vary greatly, the tools of discovery you'll use to help you assess patients will not. When you arrive on the scene, you'll apply the mechanism of injury method to help you gain a greater understanding of what possible injuries the patient may have based, in large part, on how he or she may have sustained those injuries. How to Apply the Mechanism of Injury Method As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Warning: If the patient does begin showing signs of decreasing levels of consciousness or any problems involving breathing, airway, and/or circulation – numbness, tingling, inability to move limbs – call 911 immediately. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Pro Tip #1: Ask the victim open-ended questions when you're assessing them, rather than yes and no questions. So, instead of asking, does your head hurt?, ask, do you have pain anywhere? Asking yes and no questions can often lead them down the wrong road. During your assessment, involve family members and friends who are nearby and may have witnessed the accident. They'll also be able tell you if the victim is behaving normally or has any medical problems or allergic reactions to medications. This is even more important when dealing with injuries to children. Pro Tip #2: Don't be too myopic. Even though the injury may seem obvious, that doesn't mean another injury isn't also lurking. Keep this in mind as you perform a full head-to-toe examination of the patient. A Word About Soft Tissue Injuries Soft tissues include all the layers of skin, fat, and muscles in the human body. The largest organ is the skin, as it contains three layers of its own – epidermis (outer area that protects against bacteria), dermis (deep layer that protects the nerves), and hypodermis (the deepest layer that protects blood vessels). Soft tissue injuries are classified as closed wounds or open wounds. A closed wound is an injury that occurs beneath the surface of the skin, meaning that the outer layer of skin is still intact. There is usually internal bleeding, even if only minimally in the form of a bruise. An open soft tissue wound involves a break in the skin's outer layer, like a cut, and usually involves external bleeding – arterial, venous, or capillary. Burns deserve a special distinction as a soft tissue injury and are classified as superficial, partial thickness, and full thickness. Closed Wounds Closed wounds occur beneath the surface of the skin and are usually the result of blunt force. The contusion can be minor, like stubbing your toe, to more serious examples of blunt force trauma, like those sustained in motor vehicle accidents. Swelling and discoloration are normal in closed wounds as these are part of the healing process. Closed wounds become more serous when they affect the deeper layers, those that protect larger blood vessels and vital organs. Heavy internal bleeding can occur from a contusion or hematoma and when it affects those deeper layers, the signs may not be immediately noticeable. Opened Wounds Open wounds are those that affect the outer layer of the skin. There are six types of open wounds: Abrasions – scrapes, rug burns, road rashes, etc. – abrasions are more painful due to the presence of nerve endings nearby but don't involve much bleeding as the capillaries are mostly affected. Amputations – the loss of a limb – amputations are serious injuries that rely on controlling blood loss and shock. Avulsions – part of skin peeled away – avulsions can be very painful, and bleeding can be heavy. Crush injuries – extreme weight or force crushes a body part – crush injuries can cause great internal damage to blood vessels and vital organs. Punctures – gun shot wounds, stabbing wounds, etc. – punctures are smaller wounds that typically close around the wound, thereby limiting the amount of external bleeding. However, the puncture can also result in internal bleeding. Lacerations – cut from a sharp object – lacerations vary in severity depending on several factors, including the type of bleeding that the laceration has caused – arterial, venous, or capillary. https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/training/first-aid/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/first-aid/video/tourniquets https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2048.mp4 Tourniquets Tourniquets are tight, wide bands placed around an arm or a leg to constrict blood vessels in order to stop blood flow to a wound. Generally, tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. Other reasons to consider using a tourniquet include: If bleeding cannot be controlled by direct pressure If the injury is in a location where direct pressure isn't possible If multiple people need help with life-threatening injuries and help is limited If the scene is unsafe or becoming unsafe Warning: Tourniquets can be extremely painful. Therefore, it's best to warn the victim beforehand. And tell them why they'll be wearing a tourniquet. How to Provide Care If you have a commercial tourniquet, great. If not, anything that you can wrap around an injured limb will work – a piece of rope, an insulated wire. Tie that into a knot and then insert a screwdriver, stick, or pen and begin twisting to tighten. Your goal in using a tourniquet is to control bleeding before hypovolemic shock sets in due to blood loss. Pro Tip 1: What may seem like a wound that won't stop bleeding, may just be due to pressure that's not being applied directly over the wound. Bandages can slip. Victims could be in shock and not applying as much pressure as it appears. Make certain that direct pressure truly fails before considering a tourniquet. We will assume that you've already made sure the scene is safe, and you're wearing latex-free gloves or have thoroughly washed your hands and have determined that the victim is currently not in shock. Apply the tourniquet over the extremity where the injury as occurred and a couple inches above the wound to limit tissue damage. Avoid wrapping around joints and follow the manufacturer's instructions. Secure the tourniquet as tightly in place as possible. Slowly tighten the tourniquet handle until bleeding stops. Fasten the handle to the tourniquet. Test the victim's toenail or fingernail to make sure you get a delayed capillary response, so you know the tourniquet is working as it should. Write down on the victim's dressing what time the tourniquet was applied and give that information to EMS. The ABCs of Bleeding Regardless of the bleeding incident, it's important to understand these simplified steps to trauma care response: A – Alert! Call 911.B – Bleeding. Find the bleeding injury.C – Compress. Apply pressure and stop the bleeding by: Applying direct pressure with a clean cloth or dressing pads. Using a tourniquet. Packing or stuffing the wound and then applying pressure. A Word About Perfusion Perfusion is how your body's circulatory system delivers oxygen and nutrients to your organs, all of which require varying amounts of perfusion. Your heart, for instance, requires constant perfusion to continue working. Your brain can last four-to-six minutes without perfusion, before damage begins to set in. Your kidneys can last 45 minutes and your skeletal system about two hours. What does this have to do with tourniquets? Pro Tip 2: It's important to keep in mind that limiting perfusion is a bad thing. But when we apply a tourniquet to a victim, that's exactly what we're doing. We're voluntarily cutting off the supply of oxygen and nutrients to a part of someone's body. So, it bears repeating: Tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/training/first-aid/video/diabetes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2100.mp4 Diabetes In this lesson, you'll learn how to treat a patient with a blood sugar emergency. Some things to keep in mind about blood sugar problems: Signs and symptoms are the same for low blood sugar and high blood sugar Blood sugar issues will get worse without treatment Without treatment, a patient could become unresponsive and die The three most common signs and symptoms of someone experiencing a blood sugar issue are: Confusion Coordination issues Talking nonsense A person with a blood sugar issue might also randomly fidget with something and appear quite out of it. Pro Tip #1: Even though the signs of high blood sugar are the same as those for low blood sugar, in patients suffering from high blood sugar, those symptoms will come on much more slowly and will likely be less intense. How to Treat a Blood Sugar Event As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: When a patient has high blood sugar, the body will try to rid itself of it through urination, and failing that, through hyperventilation. Which is why, in patients with high blood sugar, you'll often notice a hint of fruit or cheap wine on their breath. The reason for this is called ketoacidosis – a byproduct of unused sugars in the body that become toxic. Pro Tip #3: If a patient is showing signs of a blood sugar issue, rule it out using sugar – either over-the-counter products like soda or professional glucose products specifically for diabetic events. Follow the pro tip above as long as the patient is coherent enough to follow commands and isn't getting agitated or aggressive. Then begin encouraging the consumption of sugar or glucose. Warning: A patient can only consume a glucose or sugar product if they are able to swallow safely. If their sugar event has escalated to the point where they cannot control their swallow reflex, it's too late. Sugar will need to be administered through an IV or by intermuscular injection. If the patient did have low blood sugar, you should notice improvements in 10 to 15 minutes. If the symptoms aren't improving after 15 minutes, there could be something else going on; call 911 and activate EMS. Professional glucose products like tabs and gels are your best bet, as they're designed for quick absorption. They're also encased in more stable packaging, meaning they can withstand freezing temperatures and other environmental threats. If you don't have any glucose products available, a full-sugar soda is your best option. Candy bars aren't a bad option either. However, more fibrous snacks will take too long to be absorbed by the body. Pro Tip #4: Most patients with sugar problems will know the dosage of sugar or glucose they need in emergencies like this. Read labels on the packaging and multiply or divide as needed to get the proper dosage. Keep in mind that high fructose corn syrup burns much more quickly compared to the longer-acting dextrose you'll find in many glucose products. If this was the patient's first sugar event, follow up with EMS to make sure they get the help they need moving forward. If this wasn't the patient's first sugar event, and they can explain what likely caused it, help them get back on their plan to avoid it happening again. And encourage them to check-in with their physician to make sure everything is all right. A Word About Diabetic Emergencies Diabetes mellitus is one of the leading causes of death and disability in the U.S. In 2016, 29 million Americans had diabetes, while another 86 million had prediabetes – a condition that increases your risk for developing type 2 diabetes and other chronic diseases like kidney disease, heart disease, gum disease, stroke, and amputations. The Two Types of Diabetes Type 1 Diabetes – Also known as juvenile diabetes or insulin-dependent diabetes, this condition results in a body that produces little to no insulin. Which is why most people who have type 1 diabetes inject themselves with insulin daily. Type 2 Diabetes – More common than type 1 diabetes, type 2 is characterized by a body that produces insulin, but either the cells can't use it effectively or not enough is being produced. People with type 2 diabetes can often improve their symptoms and regulate their blood glucose levels with dietary changes and sometimes medications. High Blood Glucose High blood glucose, or hyperglycemia, is when the body's insulin level is too low, and the sugar level is too high. However, the body cannot transport that sugar into the cells without insulin. Which results in a body that's about to have an energy crisis. The body then attempts to meet its need for energy by using other stored food and energy sources, such as fats. However, converting fat to energy is less efficient, produces waste products, and increases the acidity level in the blood, causing a condition known as diabetic ketoacidosis (DKA), which could ultimately result in a diabetic coma. Low Blood Glucose The exact inverse of the above – Low blood glucose, or hypoglycemia, occurs when the body's insulin level is too high, and the sugar level is too low. This can happen for a number of reasons, including when the patient: Takes too much insulin Fails to eat adequately Over-exercises and burns off sugar faster than normal Experiences great emotional stress Regardless of whether you're dealing with a patient who has type 1 diabetes or type 2 diabetes, the signs and symptoms are the same: Dizziness, drowsiness, or confusion Irregular breathing Abnormally weak or rapid pulse Feeling and looking ill Abnormal skin characteristics https://d3imrogdy81qei.cloudfront.net/video_images/3759/diabetes-2015.jpg Yes 500 https://www.procpr.org/training/first-aid/video/how-to-use-an-epipen https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2102.mp4 How to Use an EpiPen Epinephrine is the first line of defense when it comes to treating anaphylaxis. And the sooner it's administered, the less severe the allergic reaction. Remember, anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Anaphylaxis can cause the body's blood vessels to suddenly dilate, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen starved. Anaphylactic shock will cause death if not treated. People with a history of allergic reactions should always carry an epinephrine pen. Pens are single dose, pre-filled, automatic injection devices, also known as epi pens. The following instructions are specifically for Epi Pen brand. If you're using a different brand of epi pen, be sure to follow the manufacturer's instructions. How to Use an Epi Pen Pro Tip #1: Any time an epi pen is used, be sure to call 911 and activate EMS. The person, even if feeling better, must seek further medical attention after a severe allergic reaction. Remove the pen's safety cap. Grip the pen in your hand with the tip pointing down. Warning: Never put your thumb, fingers, or hand over the tip of the pen; you may accidentally inject yourself while treating the patient. Firmly push the tip of the pen into the patient's outer thigh at a 90-degree angle and until you hear the pen click. Needles can penetrate clothing. Keep the auto injector firmly pressed against the patient's thigh; hold for 3 seconds. Pull the epi pen straight out. Warning: Make sure you don't pull the pen out at an angle. This can cause a lot of pain and bleeding. And if blood comes out of the leg, there's a good chance the effectiveness of the shot will be reduced. Rub the area for 10 seconds, as this will increase absorption of the epinephrine within the leg muscle. Pro Tip #2: A second epi pen may be used if symptoms persist or recur and if EMS has been delayed for more than 5 to 10 minutes. Usually the patient will notice some airway relief pretty quickly, as the tightness in the throat begins to dissipate. There are, however, some unfortunate side effects that some patient's may experience, including: Rapid heartbeat Shakiness Feelings of anxiety Dizziness Headache Pro Tip #3: Once you administer an epinephrine injection, make note of the time it was delivered and tell EMS when they arrive. A Word About Epinephrine Epinephrine is a drug that slows or stops the effects of anaphylaxis. If a patient is known to have an allergy that could lead to anaphylaxis, they may carry an epinephrine auto-injector (an epi pen) that can deliver a single dose of the drug. Epinephrine devices are available in different doses, as the dose of epinephrine is based on weight – 0.15 mg for children weighing between 33 and 66 pounds, and 0.3 mg for children and adults weighing more than 66 pounds. People with a known history of anaphylaxis would be wise to carry an anaphylaxis kit containing at least two doses of epinephrine with them at all times. Why a second dose? Because more than one dose may be needed to stop a strong anaphylactic reaction. It's important to remember that a second dose is administered only if emergency medical responders are delayed and the patient is still having signs and symptoms of anaphylaxis 5 to 10 minutes after administering the first dose. It's important to act fast when a patient is having an anaphylactic reaction, as difficulty breathing and shock are both life-threatening conditions that could suddenly erupt. If the patient is unable to self-administer the medication, you may need to help them with the epi pen. Only assist if/when: The patient has a previous diagnosis of anaphylaxis and has been prescribed an epinephrine auto-injector The patient is having signs and symptoms of anaphylaxis The patient requests your help using an auto-injector Your state laws permit giving assistance https://d3imrogdy81qei.cloudfront.net/video_images/3763/how-to-use-an-epipen-2015.jpg Yes 140 https://www.procpr.org/training/first-aid/video/seizure https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2101.mp4 Seizure In this lesson, you'll learn how to treat an adult patient who goes into a seizure or has just come out of one. A person can go into a seizure for too many reasons to mention. As you are concerned, why it happened isn't important. Being able to recognize that it did happen is the key. For you to know if a seizure took place, ideally you or someone else saw the patient go into a tonic state that exhibited the following signs: Hands are gripped and pointed inward The patient is actively seizing The patient ends the seizure in the postictal state (relaxed recovery) How to Treat a Patient who is Actively Seizing There are a few important things that you can do when a person is suffering from a seizure to help protect them from further harm. First, is there anything around the patient that could injure them, such as sharp objects? If there is, remove the threat from the scene or move the patient to a safer area. If the patient is having a zootomic clonic seizure – in which they are fluctuating between contracting and relaxing – they could bang their head on the ground. To protect their head, simply cup your hands together and place them underneath the patient's head. Warning: Never hold down a seizing patient or try to stop the seizure in any way. Just support and protect the patient during the seizure. Then, once the seizure is over, assess for more serious situations like cardiac arrest. How to Treat a Patient after a Seizure Pro Tip #1: There are several things to do post-seizure, but the most important is calling 911 and activating EMS if it hasn't already been done. As soon as you determined that the patient had a seizure, and you don't know if the patient is an ongoing epileptic, call 911 immediately. After EMS has been activated, begin to assess the patient for a couple of things. Is the patient moving and breathing normally again? Are they beginning to return to consciousness? If the patient isn't moving or breathing normally, and isn't responsive to your taps and shouts, go right into CPR and retrieve or find an AED. If the patient is beginning to breathe normally again, does the breathing appear to be agonal respirations or more corrective breathing? To help keep the patient's airway open and clear, put them into the following recovery position. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #2: A person who has just experienced a seizure – essentially an electrical storm in the brain – will be low on oxygen. As a result, they may be confused or combative and this will likely last a few minutes. While waiting for EMS to arrive, continue to assess the patient for breathing and recovery signs, like talking. Any signs that the patient is becoming more responsive are good signs. If the patient begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive. A Word About Pediatric Seizures A seizure is a disorder in the brain's electrical system, which is sometimes marked by loss of consciousness and often by uncontrollable muscle movement, also referred to as convulsions. In children, febrile seizures are the most common type of seizure. These seizures occur with a rapidly-rising or excessively-high fever, typically higher than 102° F. Children with febrile seizures may exhibit some or all of the following signs and symptoms: Sudden rise in body temperature Jerking of the head and limbs Loss of bladder or bowel control Confusion Drowsiness Crying out Becoming rigid Holding the breath Rolling the eyes upward To assess what type of seizure the child has had and why, it's important to ask good questions: Has the child ever had seizures before? If so, is the child on medications for them? If not, is there a family history of seizures? Does the child have diabetes? If so, what type of insulin/medication is being used and when was the last time it was given? Has the child started taking any new medications lately? If the child takes medications, is it possible there may have been an overdose? Could the child have taken someone else's medication by accident? Could the child have ingested anything poisonous? Has the child had a recent injury, particularly a head trauma? Has the child seemed sick or had a high fever, stiff neck, or headaches? What did the seizure look like? Did it involve the child's whole body, or only one half of the body? Did it start in one area and progress to the rest? Did the child fall when the seizure began and if so, was it possible the child's head struck an object or the floor? These are just some of the questions you can use to help decipher what type of seizure the child had and why. https://d3imrogdy81qei.cloudfront.net/video_images/3761/seizure-2015.jpg Yes 246 https://www.procpr.org/training/first-aid/video/bleeding-control-venous-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2095.mp4 Venous Bleeding Uncontrolled bleeding is the number one cause of preventable deaths due to a trauma. While venous bleeding is usually less serious than arterial bleeding, it still can pose a serious health risk to the victim. Venous bleeding can be the result of external trauma, as in something cutting or puncturing a vein, or internal trauma, due to a broken bone or organ damage. Venous bleeding involves blood that is returning to the heart, so there won't be as much pressure as arterial bleeding. However, the blood loss can still be severe. Venous bleeding distinctions are: The blood is dark red, not bright like arterial bleeding The blood flow is steady but not spurting; it can still be quick, though The pressure is lower than arterial bleeding so it's usually easier to control How to Provide Care A person who is the victim of venous bleeding will likely be applying pressure to the wound or cut by the time you arrive to help. Some things to keep in mind with venous bleeding are: It will often stop on its own in 4-6 minutes It's usually easy to control with direct pressure What may seem like a lot of blood is likely to just be smeared, dripping blood which often looks like more than it really is As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. Find the source of the bleeding and ask the victim if he or she is cut anywhere else to make sure you're not missing another wound. Place a dressing pad or cloth over the wound. Apply pressure. At this point, the one dressing pad will usually be enough to control venous bleeding. However, you may also want to consider assessing the severity of the cut. Pro Tip 1: When you remove pressure, do the folds of skin around the cut begin to come apart, or does the skin appear to be staying together. If the skin is coming apart, stitches are likely necessary. If not, the wound will probably heal on its own and stitches can be avoided. As can a trip to the emergency room. If a trip to the emergency room is warranted but EMS services are not, it's still a good idea to have someone else drive the victim. There may be a chance that the victim has difficulty seeing his or her own blood, which could cause psychogenic shock. It's always better if the victim is a passenger rather than the driver. Before you wrap the wound, make sure it's properly cleaned using a bacterial ointment if you have one. This will combat any bacteria that may have gotten into the cut and reduce the chances of infection. Pro Tip 2: Consider the chances of tetanus. If the victim was cut by something dirty and hasn't had a tetanus shot in the last 10 years, a trip to the emergency room is a necessity regardless of the severity of the wound. After cleaning the wound, reapply a dressing pad that completely covers the area. Wait and see if the bleeding stops or if it leaks through. Most venous cuts will stop after applying the first pad. Warning: There are reasons why venous bleeding cannot be easily controlled and these include: the victim has a bleeding disorder or is on blood thinners. Make sure to ask the victim if it appears that the bleeding is difficult to stop. It's now time to wrap the wound, and taping the pad is usually sufficient. Just be aware to maintain constant pressure while you tape. And as before with arterial bleeding, pinch the finger or toe nails if the extremities are involved and see if blood returns to the nails. You don't want to cut off blood supply. Your goals in tapping or bandaging the wound are: Maintain pressure and control bleeding Cover completely so dirt and debris cannot get inside the cut At this point it's always a good idea to make sure the patient is stable and not in shock. If their skin has good color and isn't cold or clammy, and if they haven't lost consciousness, EMS probably will not be needed. A Word About Disease Transmission To reduce your risk of disease transmission, there are a few guidelines to keep in mind: Avoid contact with the victim's blood by wearing latex-free gloves and protective eyewear if you have them. Avoid touching your mouth, nose, and eyes while providing care, and don't drink or eat anything before washing your hands. Wash your hands thoroughly after providing care, even if you wore gloves. Always dispose of the gloves or change gloves before helping someone else. As venous bleeding is often not a severe injury, it's still important to remember that it still has the potential to become a serious situation, especially if bleeding cannot be controlled or the victim goes into shock. When in doubt, it's best to call 911 and let the EMS professionals handle the situation. https://d3imrogdy81qei.cloudfront.net/video_images/3749/bleeding-control-venous-bleeding-2015.jpg Yes 214 https://www.procpr.org/training/first-aid/video/bleeding-control-arterial-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2094.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care A person who is the victim of arterial bleeding will instinctively grab and cover the wound to reduce the amount of blood flow, if that person is conscious and able to. To best assist in treating the wound, you should: Make sure the scene is safe. Put on latex-free gloves if available. If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer. Find the source of the bleeding; you may have to remove clothing over the wound. Make the switch from the victim's hand to a dressing pad or a clean cloth. Apply pressure. The wound will be pulsating, and it will likely take several dressing pads to control the bleeding. If the victim is conscious and can assist, this will help. Ask the victim to maintain pressure over the dressing pad or cloth. The blood will probably soak through, so apply a second pad on top of the first, rather than removing it. Continue to apply firm, direct pressure over the wound. If the victim is becoming light-headed from the blood loss, have them sit or lie down. The goal is to control the bleeding to the point where the wound is not leaking through each new dressing pad. If blood continues to leak through, continue to apply another pad or piece of cloth until it stops. Consider using a tourniquet if – you cannot control the bleeding with dressing pads and the blood loss is extreme. This is a life-threatening situation and last resort. In most cases, even arterial bleeding can be controlled using pressure plus dressing and bandages. Once you have the bleeding controlled, it's time to wrap the wound. Using an ACE roller bandage like you find in most first aid kits, start from the end of the extremity where the injury is located. If the wound is on the wrist, began wrapping from the hand. Pro Tip #1: it's important to extend the bandage several inches beyond the wound on both sides. This will help keep the wound clean and limit the chances of infection. When wrapping the wound, if extra pressure is required, twist the bandage once over the wound and continue wrapping. Repeat as often as necessary. To finish, tuck the end of the bandage into the wrap to hold it in place. Pro Tip #2: While pressure is important to control the bleeding, you don't want to cut off circulation to the extremity on which the wound occurred. Pinch a nail and the fleshy underside between two of your fingers (if the wound occurred on an arm or a leg). The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. At this point, you'll want to decide whether to call 911 for EMS services or transport the victim to the emergency room by private vehicle. Call 911 if: The victim has lost consciousness or is showing signs of losing consciousness The victim is exhibiting signs of shock – pale, cold, sweaty skin You cannot stop the bleeding A Word About Dressings and Bandages Dressings are sterile pads used to absorb blood and other fluids, help promote clotting, and prevent infection. Gauze pads are most common. Most dressing pads are porous, which allows air to circulate to the wound and promote healing. Common sizes range from 2-4-inch squares. Universal or trauma dressings are larger in size and used for larger wounds. Occlusive dressings are not porous, which means no air or fluids can pass through, and typically used for abdominal wounds. Bandages are strips of material used to hold the dressing in place, maintain pressure over the wound, control bleeding, and protect from dirt and infection. The most common type of bandage is the roller bandage that is usually made of gauze and comes in assorted widths and lengths. These are the type of bandages you find in most first aid kits. However, there are other types of bandages including: Pressure bandage – for more pressure and a snugger fit Bandage compress – thick gauze dressing attached to a gauze bandage Elastic bandage – type of roller bandage typically used for muscles, bones, and joints Triangular bandage – large bandage that can folded and used as a sling As arterial bleeding is the most severe type of bleeding, it's important to properly assess the situation quickly as a rapid response is vital for a positive outcome. If you feel like the situation is too serious to handle yourself, it's important that you or someone else at the scene call 911 immediately. https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/training/first-aid/video/bleeding-control-capillary-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2096.mp4 Capillary Bleeding While you're probably familiar with veins and arteries, capillaries may warrant a quick definition. Capillaries are tiny blood vessels linking arteries and veins that transfer oxygen and other nutrients from the blood to all body cells and remove waste products. Capillary bleeding has the classic appearance of a road rash type of wound. Anyone who has fallen off a bike or while playing sports likely has some experience with this type of bleeding injury. Capillary bleeding distinctions are: The blood tends to ooze or bubble up on the surface of the wound The pressure is very low and will usually clot on its own or with minimal pressure The blood is mixed with serous fluid Serous fluid is a yellowish liquid that is made up of proteins and water. It's the same fluid that fills a burn blister and is the body's attempt to heal the wound. How to Provide Care Capillary bleeding is usually not a concern in healthy people. The blood vessels are quite small, and the pressure is minimal. Some things to keep in mind with capillary bleeding are: Because it affects the epidermal layer where the nerve endings are located, it can be more painful than other types of bleeding injuries Infection is likely to be the biggest area of concern Thoroughly cleaning the wound is the greatest weapon against infection, particularly if the victim fell on a dirty surface As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. Remove any visible debris from the wound – dirt, sand, pebbles, and shavings of glass or metal. Blot the area with a dressing pad and apply direct pressure if the bleeding hasn't stopped on its own. Thoroughly clean the wound with soap and water. Apply an over-the-counter triple antibiotic to the area using a clean dressing pad. Pro Tip 1: When cleaning off debris from the wound, if you notice that those things are embedded into the wound, the victim will need to make a trip to the ER, where the medical staff will probably need to numb the area before removing the debris. The nerve endings could be quite raw, and it's important to keep in mind that the victim may be in a good deal of pain. Once the wound is cleaned and the antibiotic has been applied, put a fresh dressing pad over the area. Make sure it's large enough to cover the wound completely with room to spare on all sides. Using medical grade tape, if you have it, hold the dressing pad in place with a couple strips of tape or however much is needed. Let the victim know that he or she can replace the pad with a large band aid after a day or two. Pro Tip 2: It's important to help the victim understand what the signs of infection are, as this is likely to be the biggest threat with capillary bleeding wounds. Signs of infection include: Puss oozing or draining from the wound The wound becomes puffy and more painful A wound that begins to turn red around the site Warning: Capillary bleeding is usually not a life-threatening injury, but infections could be. If the victim notices any of the above, it's important that he or she go to the ER or their doctor to avoid the chance of serious infection. However, keeping the wound area clean is often enough to avoid this complication. Also let the victim know what a healthy outcome of capillary bleeding looks like: The wound will begin to scab over after 48 – 72 hours After a couple of more weeks, it should be completely healed as the scab begins to fall off A Word About Life-Threatening Bleeding While capillary bleeding is often very easy to control, it's important to understand the concept of the Golden Hour – the critical first hour after a traumatic bleeding injury has occurred. During the Golden Hour: The risk of shock is at its highest Extensive blood loss can quickly result in death Quick action and proper intervention will result in the victim's best chance of survival As all bleeding injuries occur from arteries, veins, and capillaries, it's important to understand what a life-threatening bleeding incident looks like. Blood that is spurting out of a wound. Blood that won't stop coming out of a wound. Blood that is pooling on the ground. The victim's clothing is soaked with blood. Bandages that are soaked with blood. Loss of part, or all, of an arm or leg. Bleeding in a victim who is confused or unconscious. If you experience any of these situations while providing care, be aware that these can be life-threatening, and you should call 911 immediately and get EMS involved. Capillary bleeding is often the least severe type of bleeding injury, but don't get lulled into a false sense of security. Any bleeding situation can become serious. And it deserves repeating that with capillary bleeding, it's especially important to clean the wound well to reduce the chances of infection. https://d3imrogdy81qei.cloudfront.net/video_images/3751/bleeding-control-capillary-bleeding-2015.jpg Yes 235 https://www.procpr.org/training/first-aid/video/fainting https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2056.mp4 Fainting This lesson focuses on what to do when you come upon a patient who has just fainted. Fainting is defined as a temporary loss of consciousness that's usually related to temporary insufficient blood flow to the brain. Fainting is also referred to as syncope, blacking out, or passing out. There are a number of reasons why a person would pass out and many of those are not at all life-threatening. In fact, when someone faints, the biggest concern is usually the victim's inability to protect themselves as they're falling, which can lead to a number of things going wrong – broken bones, head or face injuries, etc. In many fainting situations, there is no one around who witnessed the accident. Which means you may need to put on your detective hat to properly discover potential injuries. How to Assess and Treat a Patient who Faints As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #1: The first thing you'll want to do is to assess for life-threatening conditions, including head and neck injuries. After ruling out more serious conditions, begin to see if the patient has a simple problem, like low blood sugar or dehydration that contributed to his or her passing out. When you come upon a fainting victim, as long as there is nothing more serious going on, they will likely be awake and responsive. They may be sitting up already or are ready to sit up with your help. At this point you'll want to interview the patient to see what's going on. "Can you tell me what happened here today?" "Do you hurt anywhere?" It's common for fainting victims to be weak and dizzy afterward. The important thing is that the patient is awake and responsive enough to answer your questions. However, continue to monitor for: Airway issues Breathing problems Weak or rapid pulse Pale, clammy skin Pale and clammy skin are signs of shock. If you determine the patient to be in shock, that warrants an immediate 911 call and activation of EMS. As always, err on the side of patient welfare. Pro Tip #2: Just because the situation doesn't appear serious doesn't mean it can't suddenly become serious. If you don't have an AED already, it's a good idea to send someone at the scene to go find one. If, for instance, the fainting was caused by a serious heart dysrhythmia, an AED could be lifesaving. It's typical for fainting victims to begin to recover under their own powers. As they are coming around, gauge their mental alertness, ask again about the presence of pain, and of course, continue to assess for signs of something more serious: Decreased level of consciousness Airway, breathing, or circulation problems Signs of shock Long-bone fractures Varying degrees of responsiveness If you, at any point, notice any of the above, call 911 and activate EMS or call in a code if you're in a healthcare setting. Then treat the patient accordingly. A Word About Syncope and Presyncope Syncope, or fainting, is caused due to a temporary reduction in blood flow to the brain. Depriving the brain of its normal blood flow can cause it to momentarily shut down. When this happens, it triggers a fainting episode or syncope. But what specifically triggers fainting? There are a number of things that trigger it, including: Emotional shock Pain Certain medical conditions Overexertion In pregnant women and older people – getting up from a seated or lying position Syncope can occur without warning. Or there could be some early signs, such as dizziness, the feeling of being lightheaded, or feeling like your about to faint. Together, these symptoms have a name – presyncope. How to Prevent Someone in Presyncope from Fainting Help the patient lay down. Continue to monitor the patient's breathing and level of consciousness. Instruct and help the patient perform physical counter-pressure maneuvers (PCM). Three Examples of Physical Counter-Pressure Maneuvers Have the patient grip one hand at the fingers with the other and try to pull them apart without letting go. They should hold the grip for as long as they can or until their symptoms disappear. Have the patient hold a rubber ball or similar object in their dominant hand and then squeeze the object for as long as they can or until their symptoms disappear. Have the patient cross one leg over the other and squeeze them together tightly. Have them hold this position for as long as they can or until their symptoms disappear. Physical counter-pressure maneuvers help raise the patient's blood pressure through skeletal muscle contraction and, in many cases, will resolve symptoms of faintness. Let the patient know to avoid holding their breath while performing the maneuvers. An easy way to avoid this is to engage the patient and keep him or her talking. https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/training/first-aid/video/allergic-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2060.mp4 Allergic Reactions While there are only around 1500 deaths each year in the U.S. from severe allergic reactions, it is nonetheless frightening how quickly these allergic reactions can occur. Around 50 million Americans suffer from an allergy, and this is a number that's apparently on the rise. One theory as to why has to do with our too-sterile modern life. One that includes: Antibacterial soap Hand sanitizer Air-tight homes An increase in environmental pollutants It seems our body's immune systems aren't developing as effectively to fight germs and other foreign invaders like they were in the past. The most common causes of all allergic reactions are from foods (number one) and insects (number two). Children are most affected when it comes to food allergies. And while most kids outgrow their food allergies, according to the CDC, the number of children with food allergies rose by 18 percent in a 10-year span from 1997 to 2007. Pro Tip #1: While most kids outgrow most food allergies, there is one that cannot be outgrown – the peanut. Sadly, peanut allergies are for life. What Causes an Allergy? The job of your immune system is to protect your body from foreign invaders – various bacteria, germs, and viruses. A healthy immune system protects the body even in the presence of these invaders. However, when there is an allergy present, the immune system will mistakenly target and overreact to a threat that doesn't really exist. This results in your immune system attacking a harmless substance that has recently been eaten, inhaled, injected, or come into contact with the skin. And that substance is called an allergen. An allergen can be introduced to the body a number of times with no trouble. Then, for seemingly no reason, the body one day decides to flag that allergen as a foreign invader, which triggers the body to attack the allergen. And to further complicate matters, the body will remember the allergen and produce specific antibodies that will attack the allergen even more fiercely next time it's introduced into the body. Pro Tip #2: This is why allergic reactions are often more severe the second or third time – the build-up of antibodies and larger battles. When the immune system attacks the allergen, high quantities of histamine and other chemicals are released into the surrounding tissues. Depending on the part of the body affected, symptoms can include: Itching Hives and rash Sneezing Wheezing Swelling of the face Runny nose Nausea There is one particular kind of allergic reaction that can be especially life-threatening – anaphylaxis. Anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Warning: Anaphylaxis can cause the body's blood vessels to suddenly dilate – as in opening all the way up, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen-starved. Anaphylactic shock will cause death if not treated. One common and basic treatment for anaphylactic shock is epinephrine (or an epi-pen), as it constricts blood vessels and opens the airway, thereby reducing the effects of the allergen. The most common causes of anaphylaxis are bees and other stinging insects, latex, medications and the following foods: Nuts Fish Shellfish Eggs Milk The most common cause of severe, life-threatening allergic reactions is by far the peanut. How to Treat for Allergic Reactions As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first things you'll want to look for are the signs and symptoms of allergic reactions and anaphylactic shock: Trouble breathing Wheezing Tightness in the throat Itchiness on the tongue Swelling of the face Hives Pale skin Rapid heart rate Low blood pressure Nausea Vomiting Diarrhea Dizziness How children typically describe an allergic reaction may better help understand some of the signs: It feels like there's hair on your tongue You experience tingling Your mouth itches It feels like something is stuck in your throat Your lips feel tight Your body feels weird all over Warning: The key element with allergic reactions is time. Don't wait. Call 911 immediately. If available, use an epi-pen. But don't wait for symptoms to get better. The three steps to providing care for allergic reactions are: Recognize the signs early Call EMS or a code if in a healthcare setting Assist the patient with an epi-pen if needed Pro Tip #3: Keep the patient calm. Sit them down. Make sure they're comfortable. To make breathing easier, have the patient sit straight up and lean forward. If the patient is feeling faint or is losing consciousness, lie them down, elevate their legs, and keep them warm. Talk to them, reassure them, but be prepared to begin CPR if they suddenly stop breathing or become completely unresponsive. Warning: There is the possibility of a secondary reaction after the first. Which is why the patient should be monitored for four to six hours after the initial allergic reaction. A Word About how to Know if it's Anaphylaxis? Depending on the situation, there may be different things to watch out for as you put the puzzle pieces together. Here's a cheat sheet that may help. Situation #1: You know that the patient has been exposed to an allergen. What to Look For: Trouble breathing OR Signs and symptoms of shock Situation #2: You think the patient may have been exposed to an allergen. What to Look For: Any TWO of the following: A skin reaction Swelling of the face, neck, tongue, or lips Trouble breathing Signs and symptoms of shock Nausea, vomiting, cramping, or diarrhea Situation #3: You do not know if the patient has been exposed to an allergen. What to Look For: A skin reaction (such as hives, itchiness, or flushing) OR Swelling of the face, neck, tongue, or lips PLUS Trouble breathing OR Signs and symptoms of shock https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/training/first-aid/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/first-aid/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/first-aid/video/poison-control https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7190.mp4 Poison Control Some of the most dangerous areas of any home, especially for young, curious children, are the places where poisons are stored, such as cleaning products and medications. Limiting access to these areas will always be key to preventing catastrophe. Luckily, there are numerous procedures and products that can easily help secure cupboards, drawers, and cabinets that house these dangers. A couple simple ways to better secure household poisons include: Store all medications and dangerous chemicals up high, so they're out of reach for small children Purchase commercial made locks at the hardware store Warning: It's important to understand how a colorful liquid chemical looks to a child. Those bright colors probably look like Kool-Aid, fruit punch, or the latest soda, and appear more delicious than dangerous. Chemicals don't have to be in liquid form to be tempting to children. Another common threat lately are the dishwasher and laundry cleaning pods that children routinely mistake as candy. However, children consuming poisons is just part of the problem. Kids also don't know the difference between consuming a medication that will help them feel better when they're sick and over-consuming that same medication – something that could hurt them or even kill them. Then add to this the fact that these medications are often flavored to taste good so that children will take them. Which is why medicine cabinets deserve the same amount of precaution as those cabinets where poisons are stored. How to Treat for Poisoning Is you suspect poisoning, the first thing to do is look for clues to corroborate that suspicion, such as: Are there pills scattered about? Are there empty pill bottles or packages around? Does the victim have burns or redness around the lips and mouth? Does the victim have unusual stains or odors, particularly breath that smells like gasoline or paint thinner? Is the victim exhibiting signs of drowsiness or mental confusion? Is the victim having difficulty breathing? Has the victim vomited? Pro Tip #1: First aid treatments for poisoning have changed a lot over the years. Which is why if you suspect poisoning you should call the Poison Control Hotline at 1-800-222-1222. Keep this phone number in a prominent location for quick and easy access. Poison Control will work with you to first help identify the poison in question. And then will guide you in providing treatment for that poison. Pro Tip #2: You may have heard to induce vomiting for poisonings. This is rarely true. One more reason to call poison control and get the proper treatment advice based on the poison that was ingested. Warning: If at any point, the patient goes unconscious or stops showing signs of life (moving, breathing normally, etc.), call 911 immediately and activate EMS. A Word About How Poison Enters the Body There are four categories of poisons based on how they enter the body – ingestion, inhalation, absorption, and injection. Ingestion This category is for all the poisons that can be swallowed – common food poisoning culprits like mushrooms and shellfish, recreational drugs, medications, alcohol, and household items like cleaning supplies. Young children are most at risk, as everything they see looks like it should go into their mouths immediately and often does. Older adults are also more at risk, mostly due to medication errors. Inhalation Inhaled poisons are those gases and fumes that are poisonous. The most common inhaled poison is carbon monoxide, as it's odorless, colorless, and tasteless. To further complicate matters, exposure can lead to death in mere minutes. Carbon monoxide comes from car exhaust, tobacco smoke, fires, and defective gas cooking and heating equipment, like furnaces and hot water heaters. Other less common culprits in this category include carbon dioxide, chlorine gas, ammonia, sulfur dioxide, nitrous oxide, chloroform, dry cleaning solvents, fire extinguisher gases, industrial gases, and hydrogen sulfide. Absorption Absorbed poisons can enter the body through the skin or mucous membranes in the eyes, nose, and mouth. Plants are the biggest offenders when it comes to absorbed poisons, and most of us have probably had a run-in with poison ivy once or twice. Chemicals in fertilizers and pesticides are also commonly absorbed poisons, as are topically applied medications. Injection Injected poisons do include those administered by hypodermic needle, such as recreational and medicinal drugs. But more times than not, instances of poisoning by injection are perpetrated through bites and stings. Poisonous snakes, insects, spiders, and marine life are abundant in certain countries, like Australia, while others like their neighbor New Zealand, can boast a total of zero poisonous animals. https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/training/first-aid/video/cold-related-emergncies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7188.mp4 Cold-Related Emergencies Cold-related emergencies are typically the result of cold temperatures combined with a lack of insulation or protective clothing to deal with those temperatures. How We Lose Heat   Radiation is the most significant and it involves the emission of infrared waves from the skin to cooler surroundings, similar to heat radiating from a stove. Convection contributes the next most heat loss and occurs when warm air or water around the body is replaced by cooler air or water, carrying heat away.  Think of how nice a strong breeze is on a hot day. Conduction is when there is direct contact with other objects. This is often a smaller concern, however, if your skin is in contact with a surface that absorbs heat easily like water, metal or cemet, conduction becomes a much larger concern.  Evaporation is responsible for another large portion of heat loss under normal conditions and becomes the only effective cooling mechanism when the environment is warmer than the skin.  It includes sweat evaporation and moisture loss from the lungs during breathing.    Pro Tip #1:> Protecting yourself from as many of the methods of heat loss as possible will ensure you stay as warm as you can.   Hypothermia begins to set in around the time the patient begins to shiver. And once the core body temperature drops below 95 degrees Fahrenheit, serious side effects ensue, including: Dizziness Delirium/confusion Lethargy Fatigue and weakness Loss of consciousness How to Treat for a Cold-Related Emergency If at any point someone starts showing signs of hypothermia or frostbite, call 911 immediately to activate EMS. Attempt to find warm shelter to keep the patient as comfortable and as warm as possible until help arrives. Monitor for airway, breathing, and circulation issues. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally. Then begin CPR. Treatment for hypothermia is a simple concept of just keeping them warm. It can become difficult in different situations though. This following list includes our priorities, but the order of when we conduct them may change based on the circumstances. Insulate the patient's body as best you can until help arrives. Move the patient to a warmer environment if possible. Remove any wet clothing and cover with blankets. Pro Tip #2: One of your best tools for helping you achieve number one above is a mylar blanket. They're common in first aid and emergency kits, and for good reason. They work by reflecting the heat of the patient and are big enough to cover most adults from head to toe. Warning: Wrapping a patient in a mylar blanket should be done gently using the steps below. You want to make sure not to agitate any frost-bitten extremities. Plus, cardiac arrest is also a concern. Aggressive movements can put the heart into a fatal rhythm. Using a Mylar Blanket Unwrap the blanket and tuck it around the patient as much as possible as this can help with both convection and radiation heat losses. For smaller patients, blankets could be placed under the mylar so long as the blanket is dry and the mylar fits completely over the victim and blankets. Pro Tip #3: The patient may be in a fetal position to try and stay warm. This can help decrease heat loss from radiation, convection and conduction. Leave them in this position if they are comfortable and you can continue to assist them in staying warm such as covering them with blankets. Seal the blanket as best you can, but leave room for the patient to breathe, as mylar isn't breathable material. Put another blanket or coat over the patient. Cover the feet and tuck it in around the patient as best you can, including the top of the head. Pro Tip #4: We lose a ton of heat through our feet, hands, and head, so make sure these areas are covered. Top and sides of head, not the face. Warning: Don't forget to protect yourself. When dealing with cold-related emergencies, you're likely putting yourself in the same environment that felled the patient. And since you're likely kneeling on cold pavement, in snow, and may be working with your gloves off for reasons of manual dexterity, pay extra care that you don't also become a victim.> Rewarming Body Parts in the Field A clinical setting is the preferred location for rewarming, so don't worry about it, especially considering that frozen parts that have been warmed could re-freeze causing additional injury. However, it pays to know that you should only rewarm using water between 99 and 104 degrees Fahrenheit. Higher temperatures could burn the patient, not to mention the pain involved. Rewarming is very painful, as the nerve endings begin to come back and the patient begins feeling again. Which is why a setting that can offer analgesics is the best option. Also, rubbing or massaging the frostbitten portion could cause further injury, so it is best to let the body part warm up on its own. Recognizing Frost Nip and Frost Bite The most common body parts to freeze first are the nose, cheeks, ears, feet, hands, and especially the ends of fingers and toes. When frost bitten, these parts will appear white, hard to the touch, and numb or nearly numb to the patient. A Word About Cold-Related Contributing Factors When it comes to cold-related emergencies, there are several contributing factors to be aware of, including the environment and the age of the patient. Anyone can develop hypothermia; however, the risk factors below could put people at higher risk. A cold environment. Though, even if the ambient temperature isn't that low, it can quickly be made worse if the patient isn't properly protected from the cold, including the use of inappropriate clothing. A wet environment. The presence of moisture – perspiration, rain, snow, etc. – will increase the speed at which body heat is lost. Wind. Wind makes the environment a lot colder than the temperature indicates. The higher the wind chill effect, the lower the actual temperature. Age. The very young and very old usually have a harder time staying warm in cold conditions. Body mass, or lack thereof, is one concern, as is their ability to think clearly when it comes to removing themselves from that environment or better protecting themselves with proper clothing. And in older adults, impaired circulation may also be a concern. Medical conditions. People with certain medical conditions, such as hypoglycemia, shock, and head injury, may be at higher risk of developing hypothermia. Drugs and alcohol. Alcohol and certain types of drugs can reduce a person's ability to feel the cold, or can impair judgment and impede rational thought, preventing the patient from taking proper precautions to stay warm. Trauma. If a person is injured and they are facing issues with hypothermia, both conditions may worsen much quicker. Injured victims must be kept as warm as possible. https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/training/first-aid/video/eye-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7189.mp4 Eye Injuries Injuries to the eye can involve the eyeball, the bone, and the soft tissue surrounding the eye. Blunt objects, like a fist or a baseball, can injure the eye and/or the surrounding area. Or a smaller object could penetrate the eyeball. Care for open and closed wounds around the eye as you would for any other soft tissue injury. In this lesson, when we talk about treating an eye injury, assume we're referring to treating an injury from an object. Near the end we'll present some information on the other type of eye injury – chemical injuries.> How to Assess and Treat Eye Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Once you've ensured that the patient isn't suffering with airway, breathing, or circulation issues, the first thing you want to do is assess what type of eye injury you're dealing with – object or chemical? Both are serious! Pro Tip #1: Eye injuries are serious and always warrant a trip to the ER, whether by calling 911 and activating EMS or by private vehicle. Therefore, the job of the responder is to stabilize the wound, stop the damage, and ready the patient for safe transport. Sequence of Treatment for Eye Injuries Sit the patient down and facing you if possible. Place a small cup over the injured eye to eliminate any more damage or pressure. Ask the victim to hold the cup in place. Pro Tip #2: If you don't have a medical grade cup, a Dixie cup is a suitable alternative. And smaller is better as you'll have tape over it. Using a gauze bandage, begin wrapping over the cup and injured eye, while asking the patient to let go of the cup.  Cover the victim's head two to three times. Tuck or tape the end of the gauze to hold it in place. Pro Tip #3: The injured person has impaired eye sight with one eye covered. Be sure to be extra communicative and always talk to them as you're helping them. Having an eye covered can be disorienting. Make sure the victim's good eye is free and clear of the bandage to prevent even further impairement. Perform a secondary survey as you do the above. Assess the patient for secondary issues, from head to toe. And as always, continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. A Word About Chemical Eye Injuries This section will mirror the last lesson on the importance of, and strategies for, diluting chemical burns. Only with the eyes, and particularly the mucous membrane, damage can occur very quickly. Meaning your quick actions are essential. There are two types of chemical eye injuries – dry or wet. If you're dealing with dry chemicals, brush as much off the eye as you can before beginning to flush with a solution. If you're dealing with a wet chemical, go right into flushing the eye. Pro Tip #4: Ideally, you'll have a balanced pH solution for moments like this. Otherwise, use what you have access to – tap water, bottled water, etc. Flush the injured eye for at least 20 minutes. Your goal here is to stop the damage from the chemical. Warning: Always rinse from the inside of the eye to the outside of the eye. Flushing the eye the other way – from the outside in – could lead to cross-contamination of the other eye. While readying the patient for transport, and during your secondary survey, make sure the victim didn't get any chemicals into their mouth, nose, ears, etc. if they did, treat accordingly. Prevent Eye Injuries The single most effective measure for both chemical and foreign object injuries is wearing appropriate protective eyewear — ANSI-approved safety glasses or goggles have been shown to reduce workplace eye injuries by up to 90%. For environments involving chemicals, the CDC and OSHA recommend using sealed, indirect-vent goggles rather than standard safety glasses, since chemical splashes can travel around unprotected frames; additionally, knowing the location of the nearest eyewash station and flushing affected eyes with clean water for a minimum of 15–20 minutes is critical to minimizing damage after exposure. https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/training/first-aid/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/first-aid/video/spider-bites-tick-bites-and-scorpion-stings https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6491.mp4 Spider Bites, Tick Bites and Scorpion Stings This first aid lesson is for the treatment of spider bites, tick bites, and scorpion stings. While these encounters can be alarming and sometimes painful, knowing the proper first aid steps can help ensure a swift and effective response and recovery. It's important to keep in mind that millions of people are bitten or stung by spiders, ticks, and scorpions every year in the United States alone, and most of these are harmless. However, in this lesson, we’re going to focus on generalized treatment and what to watch for in more severe cases. Remember that the priority is always safety. Once you and the victim are out of harm's way, see if there is a way to identify what bit or stung you, as this can help identify appropriate treatment if needed. But only do this if it can be done safely. Since all of these bites or stings will have punctured the skin, gently washing with soap and water is always the recommended first step. If you notice any concerning reactions or symptoms, seek medical help immediately. In that case, watch for skin discoloration or blistering, nausea, abdominal pain, difficulty breathing, change in responsiveness, or significant pain. If there are no immediate health concerns, here are the steps to handle these bites or stings. First Aid Steps for Spider Bites If you're in a geographical area where there are venomous spiders, remove yourself from the vicinity to avoid further bites.> It's important to identify the spider responsible for the bite whenever safe and possible. Wash the bite area with mild soap and water. Elevate the bitten extremity and apply a cold compress or an ice pack wrapped in a thin cloth to the bite site. Elevating the bitten extremity will help reduce pain and swelling. Leave the compress or ice pack on the bite site for about 10-15 minutes each hour. Symptoms Associated with Spider Bites Symptoms associated with spider bites can vary from minor to severe. Although extremely rare, death can occur in the most severe cases. Possible symptoms resulting from a spider bite include the following: Itching or rash Pain radiating from the site of the bite Muscle pain or cramping Reddish to purplish color or blister Increased sweating Difficulty breathing Headache Nausea and vomiting Fever Chills Anxiety or restlessness High blood pressure Pro Tip #1: For suspected or confirmed bites from venomous spiders, such as black widows or brown recluse spiders, it's crucial to seek immediate medical attention. Call emergency services or visit the nearest hospital. First Aid Steps for Tick Bites The important thing to remember with tick bites is that the longer the tick is attached, the more likely it is to transmit diseases. So acting quickly is definitely in the victim's best interest. Remove the tick promptly using a pair of fine-tipped tweezers. Grasp the tick as close to the skin's surface as possible. Pull the tick away from the skin steadily and slowly with firmness, and try to avoid twisting or crushing the tick during this process. The skin will tent, and the tick will eventually let go. Clean the area with mild soap and water. Pro Tip #2: If you're concerned about tick-borne diseases, you can preserve the tick in a sealed container or a plastic bag. This may assist healthcare professionals in identifying the tick and determining the risk of disease transmission. Please note that if the head comes off and stays embedded in the skin, call emergency services or visit the nearest hospital. A Word of Caution Avoid folklore such as painting the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible – not waiting for it to detach. If you develop a rash or fever within several days to weeks after removing a tick, see your doctor. Tick Bite Bot: An Interactive Tool for Dealing with Tick Bites The CDC has an interactive tool that can assist you in the removal of attached ticks and also advise you on when to seek medical attention. This online mobile-friendly tool asks a series of questions covering topics such as tick attachment time and symptoms. Based on the user's responses, the tool will then provide information on first-aid treatment options. First Aid Steps for Scorpion Stings Like with spider bites, remember to first remove yourself from the area to prevent further stings. Clean the sting site with mild soap and water. Apply a cold compress or an ice pack wrapped in a cloth to the sting site to help with the pain. Pro Tip #3: While most scorpion stings are harmless, seeking medical attention is essential to be safe, as venomous species can be fatal to humans. Call emergency services or visit the nearest hospital immediately. When it comes to scorpions, prevention is key. Be proactive and take precautions by checking your clothing and inside your shoes before putting them on wherever these creatures are common. And remember that if you are stung, stay calm and follow the steps above. And as always, seek professional medical help whenever necessary. Symptoms Associated with Scorpion Stings Symptoms usually subside within 48 hours, although stings from a bark scorpion can be life-threatening. Symptoms of a scorpion sting may include: A stinging or burning sensation at the injection site Extreme pain when the sting site is tapped with a finger Restlessness Convulsions Roving eyes Staggering gait Thick tongue sensation Slurred speech Drooling Muscle twitches Abdominal pain and cramps Respiratory depression https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/training/first-aid/video/shock-lay-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7184.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. It is a serious and potentially life-threatening condition that requires immediate medical care as it is a multi-symptom and complex condition. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. There are several types of shock, including psychological shock – a psychological condition in which worry and concern send a person into shock, rather than a physical condition. While this shock lesson is in the bleeding control section, it's important to understand that any first aid emergency could send a person into shock. Pro Tip #1: The important thing to remember with shock is that the symptoms are the same regardless of what contributes to it. It's a serious condition that warrants rapid treatment and an immediate 911 call. Besides psychological shock, there are four main types. The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #2: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue mask with a one-way valve available if necessary. Warning: If at any point the victim stops breathing normally or becomes unresponsive, begin CPR (or rescue breathing) immediately and continue until medical professionals arrive. Pro Tip #3: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #4: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. A Few Common Shock Questions Are there any tests I can perform on the victim to better help identify shock? If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail bed. If it's more than a few seconds – or the time it takes to say capillary refill – your victim is likely in shock. How do I know when to call 911? It's always better to be safe than sorry, so call 911 any time it's an actual emergency or if you're unsure what to do or overwhelmed, and how exactly that's defined will vary from rescuer to rescuer. However, as it pertains to this lesson, always call 911 immediately as soon as you suspect shock or as soon as the victim loses consciousness or begins having breathing issues. In other words, err on the side of victim safety. https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/training/first-aid/video/2025-guidelines-update-for-cpr-and-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7289.mp4 2025 Guidelines Update for CPR and First Aid for All Ages In this lesson, we're going to summarize the latest information from the 2025 American Heart Association Emergency Cardiovascular Care guidelines as they relate to lay rescuer CPR. The goal of these guideline changes is simple: improve survival by improving early recognition, high-quality CPR, and early defibrillation. For out-of-hospital cardiac arrest, survival rates depend heavily on what happens in the first few minutes. The 2025 ECC updates continue to emphasize that early action by lay rescuers is what saves lives. Many of the changes you'll see focus on improving CPR quality, reducing delays, and removing the barriers that prevent people from stepping in to help. Initiation of Resuscitation for Adults The ECC continues to reinforce the importance of CPR with breaths in adult cardiac arrest. For trained rescuers who are able to provide ventilations safely, compressions and breaths should be delivered together. If a rescuer is not trained or does not have the ability to give breaths, hands-only CPR can be used, as providing compressions alone is far better than doing nothing at all. Whenever feasible, and without delaying chest compressions, CPR should be performed where the person is found, as long as high-quality CPR can be delivered safely and effectively. It's preferred that the patient be on their back, on a firm surface, since firm surfaces improve compression depth and effectiveness. Delays caused by unnecessary movement of the patient are associated with worse outcomes. When possible, chest compressions should be performed with the patient's torso positioned approximately at the level of the rescuer's knees to allow better body mechanics and improved compression depth. Rescuers may also consider placing their dominant hand on the sternum when performing compressions, which may further improve overall CPR quality. Pro Tip #1: The key takeaway is this: don't delay chest compressions. If high-quality CPR can be delivered safely where the patient is found, begin it immediately. This was re-emphasized to include the giving of breaths for high-quality CPR. AED Use and Patient Dignity AEDs have become more widely available and continue to prove their effectiveness everyday. However, statistically, women have a much lower rate of AED use than men. So while the 2025 guidelines address the importance of early AED use, the emphasis was particularly for women. Evidence suggests that the need to expose the chest may contribute to lower rates of AED use in female patients. While proper pad placement is always preferred, current evidence shows that successful defibrillation can still occur even when pad placement is not perfect. What this means is rather than the need to remove all clothing from the chest, it's reasonable to just adjust the clothing and apply AED pads under clothing, directly to the skin.> Pro Tip #2: If needed, rather than removing all clothing from the chest, simply adjust clothing, including bras, to have appropriate pad placement on the skin. This has been shown to be safe and effective Foreign Body Airway Obstruction In conscious adults and children with severe foreign body airway obstruction, rescuers should perform repeated cycles of 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unresponsive. Ironically, the back blows are something that was taught years ago. However, this sequence reflects evidence suggesting that back blows may be more effective and cause fewer injuries than abdominal thrusts alone. Remember, for patients in late-stage pregnancy or the rescuer cannot reach their arms around the victim’s waist, chest thrusts should be used instead.  Pro Tip #3: A key update in 2025 is that chest thrusts for infants should now be performed using the heel of one hand, placed in the center of the chest, rather than the previously recommended two-finger technique. This change is based on evidence showing improved compression depth and effectiveness during severe airway obstruction.   Cardiac Arrest Following Drowning When an adult or child is rescued from the water and unconscious and not breathing, CPR with breaths should be started before AED application. Further, if you are in a position that full CPR cannot be started, just performing breaths can still be helpful. This is due to drowning-related cardiac arrest being caused by low oxygen levels. So the idea here is that If we apply the AED immediately without providing ventilations, we still have not addressed the cause of the cardiac arrest. If we delay the application of the AED for a short amount of time, we can provide the needed oxygen back into the victim to stabilize the underlying issue in the first place. Then, when applying and using an AED, resetting the heart should be more effective. Eye Injuries with an Embedded Foreign Object A small but important update: when caring for a person with a foreign object embedded in the eye, rescuers should now cover only the affected eye rather than both eyes. This change is intended to reduce anxiety in the patient by allowing them to maintain vision in the unaffected eye. The previous concept was that if you covered both eyes, then that would reduce the movement of the good and the injured eye. Data is showing that with the increased anxiety and potential for further injury caused by the temporary blindness, it would be safe to just bandage the injured eye.  ProTip #4: Our goal is to prevent any further injury to the eyes. Protect the injured eye(s) from any excessive pressure with a shield or cup and seek immediate medical attention. Managing Shock When caring for a person showing signs of shock who remains alert, it is reasonable to place or maintain them on their back. If the person is at risk for airway obstruction — such as decreased alertness or active vomiting — or if they cannot be continuously monitored, it is reasonable to place them in the recovery position, on their side. While elevating the feet has been shown occasionally to help the patient, the effects are often short lasting only a few minutes. Pro Tip #5: In situations where there is no evidence of trauma or injury, such as fainting or dehydration, some studies suggest that raising the feet approximately 6 to 12 inches may still be beneficial. Though our main focus is getting the patient safely to the ground, keeping them warm and monitoring them for airway concerns, such as vomiting, or the need for CPR. A Unified Chain of Survival The 2025 guidelines introduce a single, standardized Chain of Survival that now applies to infants, children, and adults. This unified approach emphasizes early recognition, early CPR, early defibrillation, advanced care, and recovery as a continuous process across all age groups. CPR in Infants and Children In infants and children, studies consistently show that CPR with both compressions and breaths provides the best chance of survival. However, if a lay rescuer is unable or unwilling to provide breaths to an infant or child in cardiac arrest, compression-only CPR is still reasonable. Large observational studies show that compression-only CPR is far better than providing no CPR at all, and significantly improves survival outcomes compared to no bystander intervention. Lastly, further evidence shows that using 2 fingers for infant chest compressions or chest thrusts are minimally effective. Therefore, the ECC has eliminated the use of two-fingers and recommends using a two-thumb hand encircling technique or the heel of one hand. You will see further demonstrations of both techniques throughout the course. Closing Thoughts The 2025 ECC CPR guideline updates continue to reinforce a simple but powerful message: early recognition, early CPR, and early defibrillation save lives. These updates are designed to improve CPR quality, reduce delays, and remove the barriers that prevent rescuers from acting — whether that rescuer is a parent, a bystander, or a trained professional. Guidelines will continue to evolve as new science emerges, but the mission remains the same: recognize the emergency, take action, and do the best you can. CPR doesn't need to be perfect to save a life. Doing something is always better than doing nothing, and confident, informed rescuers make a measurable difference. https://d3imrogdy81qei.cloudfront.net/video_images/13120/2025-guidelines-update-for-cpr-and-first-aid.jpg Yes 458 https://www.procpr.org/training/first-aid/video/burns-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7186.mp4 Burns Burns are a complex injury, as there are varying degrees of burns, different sizes, and different locations that can present unique challenges. And there are also different types of burns – thermal, chemical, and electrical. In this lesson, when we talk overall about burns, then how to treat them, starting with thermal burns. Then, we'll discuss some information on chemical and electrical burns. How to Assess and Treat a Burn Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first thing you want to do is assess how bad the burn is. To determine the degree of burn, look for the following signs: 1st degree (superficial) – usually presents itself as a pink outer ring; characterized by redness and pain 2nd degree (partial-thickness) – will present itself with blistering skin and is usually very painful 3rd degree (full-thickness) – dark, charred areas; can include life-threatening complications Warning:  The following burns should be seen immediately at a hospital for treatment: Large 2nd burns that involve the face, hands, feet, or genitalia All 3rd degree burns Any burn that has concern for inhalation injury (soot around the nose or mouth, difficulty breathing)  The concerning part about burns is that you may not see the full extent or concern of the injury until hours later. After the burning process has ended, the injured skin starts the healing process. This involves the moving of fluid to the injured area causing swelling, pain, dehydration/shock and other potentially life threatening conditions. Minor seeming injuries may be far more serious if not evaluated or treated by professionals. Sequence of Treatment for Burn Victims Remove the body from the burn. This can mean a few different things – like the presence of smoldering clothing or a victim who's laying in burning embers. Cool the burn. Pour cool clean water over the burn for five to 20 minutes. Your goal is to remove residual heat from the burned tissue. This will stop the burning process. Even room temperature water is appropriate as that is still over 20 degrees cooler than normal body temperature and can remove heat from the skin. Apply loose, dry, sterile dressing over the wound. Begin wrapping above the burn and wrap particularly lightly over the burn. During 3rd degree burns, the nerve endings become damaged, so there is less pain. However, 1st and 2nd degree burns can be quite painful. Pro Tip #1: Observe the patient for signs of shock or dizziness. If they are losing their balance, help them into a seated or lying position, whichever is more comfortable. At the first sign of shock, call 911 and activate EMS immediately. Look for inhalation burns. Is the victim wheezing? Is there some swelling or burns around the face? Have the eyebrows been burned? Is there soot on the inside of the victim's mouth or nose? All of these could signal possible future complications in the form of respiratory issues. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Pro Tip #2: Skin is the major organ that controls your body temperature. If we damage it from a burn, then pour cold or cool water over the body (burned area), the victim could become cold and start to shiver, hypothermia has now set in. Once the burn is cooled, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. Chemical Burns You're likely going to encounter two types of chemical burns – those from dry chemicals and those from wet. When you're dealing with dry chemicals, you first want to brush off as much of the loose, dry chemical as you safely can. Safety is key. You don't want to become the next victim. After brushing off the loose chemical, rinse the burn for a minimum of 15 minutes, again using cool clean water. When dealing with wet chemicals, go right into rinsing them off using cool, clean water. Pro Tip #3: Dilution is the solution to pollution. When dealing with chemical burns, rinsing them off with cool, clean water will have a weakening effect, as the chemicals are diluted again and again with every dousing of clean water. Electrical Burns Electrical burn situations require an extra level of safety. Before anything, make sure the energy source has been removed before coming into contact with the patient. This could mean removing the patient from the energy source, cutting the power, or something else. You cannot risk becoming another patient at the scene. Pro Tip #4: There is a significant difference between electrical entry burn wounds and electrical exit burn wounds. Entry wounds look like typical thermal burns. But exit wounds may look more like shotgun exit wounds – huge, explosive, and damaging. Manage the entry wound the same as you would a thermal burn. Manage the exit wound as the situation requires, which will likely include treatment options for tissue damage and excessive bleeding. Warning: As electricity travels through the body it can affect the conductivity of the heart, which could potentially damage the conduction points in the heart and contribute to secondary cardiac issues. With electrical burns, monitoring for heart dysrhythmias for 24 to 72 hours in hospital might be necessary. A Word About Burn Victim Pediatric Considerations It's important to note that children have greater surface areas relative to their weights than adults. This can become a major factor when it comes to staying warm and hydrated. Victims with severe burns tend to lose a lot of water through evaporation and leaking from the burned area. This increases our concerns as it can lead to hypothermia and shock. Monitor the victim for signs of dehyration, shock or hypothermia. Immediately seek advanced medical intervention if any of these are seen. After Burn Care If the burn is minor, and the burning has been completely stopped, at-home treatment might be appropriate. The 2024 ECC Guidelines suggest petrolatum (with or without topical antibiotics such as polymyxin), honey, and aloe have been shown to improve healing time in certain burns. Over the counter pain medications may help with pain when used correctly. All treatment should be under the direction of your physician. https://d3imrogdy81qei.cloudfront.net/video_images/13032/burns-2025.jpg Yes 413 https://www.procpr.org/training/first-aid/video/conscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7180.mp4 Conscious Child Choking This conscious child choking lesson is for situations where you can see that a child is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. Remember to only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing the victim. How to Provide Care The first thing you want to do is face the child and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the child. "Are you choking?" The child will probably nod yes. "May I help you?" You'll likely get another nod. Don't wait too long to receive permission, as children may be a little more flustered than adults. Pro Tip #1: With children, they may not have the same level of awareness as adults. If they're only nodding or making gagging, high-pitched squeaking sounds, these are good indications that the airway is fully obstructed. Pro Tip #2: If the child can respond verbally, that means that they are able to move enough air past the larynx to speak. This is a good indication that something may be stuck but that the airway isn't obstructed. Or it could indicate a partial obstruction of the airway. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Blows Technique for Children Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. You may kneel if needed. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts.   Abdominal Thrust Technique for Children Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. Warning: It's important that when helping a choking victim who's shorter than yourself, that you lower yourself to their height. This will limit unnecessary pressure on the rib cage and prevent broken ribs or other possible harm while you perform the abdominal thrusts. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Remember to stay below the bottom tip of the rib cage (xyphoid process) and above the belly button. This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Lower yourself to the height of the child. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your hands upward as you perform each thrust. Perform five abdominal thrusts unless the object comes out or the child becomes unresponsive. Remember to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. If after the five abdominal thrusts, the object is still not out, alternate between 5 back blows and 5 abdominal thrusts. Once the object comes out, the child will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the child know that he or she is OK now and have them sit down if necessary. Children may experience more confusion and fear than adults, so letting them know that they'll be fine is important. If you called 911, let them come anyway, so the child can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there are no interal injuries. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the child into an urgent care center, hospital, or to see their physician. With children, don't leave it up to them to determine if more care is necessary. If you weren't able to remove the obstruction using the abdominal thrust technique, the child will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious child choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/training/first-aid/video/conscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7181.mp4 Conscious Infant Choking This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak or babble or make any noise Their lips are beginning to show signs of circumoral cyanosis – a blue ring around the lips that indicates early signs of oxygen starvation Signs that the infant is conscious include: The baby is still moving around The baby's eyes are open Remember to activate EMS as soon as possible so long as it doesn’t delay care. If possible, have another person nearby call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant. How to Provide Care Helping a conscious choking infant isn’t significantly different than helping a child or an adult. You'll still be performing a combination of back slaps and thrusts to try and dislodge the airway obstruction. The biggest difference between infants when compared to adults or children, rather than performing abdominal thrusts, for infants we need to make sure we are performing chest thrusts rather than abdominal thrusts. Warning: Due to the fragile nature of infants performing abdominal thrusts on them could cause severe internal injuries. Chest thrusts should be used for conscious choking infants. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Rest your forearm on your leg for additional support. Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Place the heel of your hand on the sternum in the center of the infant's chest. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is extremely effective if you perform the back slaps and chest thrusts properly. If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. A Word About Pediatric Considerations Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children. The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children: Hot dogs Nuts and seeds Chunks of meat or cheese Whole grapes Hard, gooey or sticky candy Popcorn Chunks of peanut butter Raw vegetables Raisins Chewing gum According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy. It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.  https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/es/training/first-aid/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/first-aid/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/first-aid/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/first-aid/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/first-aid/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/first-aid/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/first-aid/video/amputacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2047.mp4 Amputación https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/es/training/first-aid/video/agentes-hemostaticos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2049.mp4 Agentes hemostáticos https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/es/training/first-aid/video/valoracion-secundaria-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2051.mp4 Valoración secundaria https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/es/training/first-aid/video/lesiones-musculoesqueleticas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2053.mp4 Lesiones musculoesqueléticas https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/es/training/first-aid/video/posicion-lateral-seguridad-recuperacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2063.mp4 Posición lateral de seguridad https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/es/training/first-aid/video/emergencias-relacionadas-calor-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2064.mp4 Emergencias relacionadas con el calor https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/es/training/first-aid/video/introduccion-solo-pro-primeros-auxilios https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2110.mp4 Introducción a primeros auxilios solamente https://d3imrogdy81qei.cloudfront.net/video_images/3779/profirstaid-only-intro-2015.jpg Yes 47 https://www.procpr.org/es/training/first-aid/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/first-aid/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/first-aid/video/mordeduras-serpiente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2059.mp4 Mordeduras de serpiente https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/es/training/first-aid/video/conmocion-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2038.mp4 Conmoción cerebral https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/es/training/first-aid/video/mordeduras-animales-y-humanos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2370.mp4 Mordeduras de animales y humanos https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/es/training/first-aid/video/hemorragias-nasales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6487.mp4 Hemorragias nasales https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/es/training/first-aid/video/lesiones-dentales-y-bucales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6489.mp4 Lesiones dentales y bucales https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/es/training/first-aid/video/traumatismos-penetrantes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6490.mp4 Traumatismos penetrantes https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/es/training/first-aid/video/lesiones-cabeza-cuello-espalda https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2098.mp4 Lesiones de cabeza, cuello y espalda https://d3imrogdy81qei.cloudfront.net/video_images/3755/head-neck-and-back-injuries-2015.jpg Yes 229 https://www.procpr.org/es/training/first-aid/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/first-aid/video/asma-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2062.mp4 Asma https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/es/training/first-aid/video/lesiones-del-oido https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6488.mp4 Lesiones del oído https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/es/training/first-aid/video/mecanismo-lesion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2050.mp4 Mecanismo de lesión https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/es/training/first-aid/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/first-aid/video/torniquetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2048.mp4 Cómo aplicar un torniquete https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/es/training/first-aid/video/diabetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2100.mp4 Diabetes https://d3imrogdy81qei.cloudfront.net/video_images/3759/diabetes-2015.jpg Yes 500 https://www.procpr.org/es/training/first-aid/video/como-usar-epipen https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2102.mp4 Cómo usar un Epipen https://d3imrogdy81qei.cloudfront.net/video_images/3763/how-to-use-an-epipen-2015.jpg Yes 140 https://www.procpr.org/es/training/first-aid/video/convulsiones https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2101.mp4 Convulsiones https://d3imrogdy81qei.cloudfront.net/video_images/3761/seizure-2015.jpg Yes 246 https://www.procpr.org/es/training/first-aid/video/control-hemorragia-sangrado-venoso https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2095.mp4 Sangrado venoso https://d3imrogdy81qei.cloudfront.net/video_images/3749/bleeding-control-venous-bleeding-2015.jpg Yes 214 https://www.procpr.org/es/training/first-aid/video/es-control-hemorragia-sangrado-arterial https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2094.mp4 Sangrado arterial https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/es/training/first-aid/video/es-control-hemorragia-sangrado-capilar https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2096.mp4 Sangrado capilar https://d3imrogdy81qei.cloudfront.net/video_images/3751/bleeding-control-capillary-bleeding-2015.jpg Yes 235 https://www.procpr.org/es/training/first-aid/video/desvanecimiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2056.mp4 Desvanecimiento https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/es/training/first-aid/video/reacciones-alergicas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2060.mp4 Reacciones alérgicas https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/es/training/first-aid/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/first-aid/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/first-aid/video/control-envenenamiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7190.mp4 Control de envenenamiento https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/es/training/first-aid/video/emergencias-relacionadas-frio-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7188.mp4 Emergencias relacionadas con el frío https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/es/training/first-aid/video/lesiones-oculares-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7189.mp4 Lesiones oculares https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/es/training/first-aid/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/first-aid/video/picaduras-de-escorpiones-garrapatas-y-aranas https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6491.mp4 Picaduras de escorpiones, garrapatas y arañas Ahora discutiremos el tratamiento de primeros auxilios para picaduras de arañas, picaduras de garrapatas y picaduras de escorpiones. Estos encuentros pueden ser alarmantes, pero conocer los pasos adecuados puede ayudar a garantizar una respuesta rápida y efectiva. Primero, sepa que millones de personas son mordidas o picadas cada año solo en los Estados Unidos. y la mayoría de estas son inofensivas. Queremos enfocarnos en el tratamiento generalizado y en qué observar en casos más graves. La prioridad siempre es la seguridad. Una vez que usted y la víctima estén a salvo, vea si hay una forma de identificar qué lo mordió o picó, ya que esto puede ayudar a identificar el tratamiento adecuado si es necesario. Dado que todas estas mordeduras o picaduras habrán perforado la piel, se recomienda siempre lavar suavemente con jabón y agua. Si se notan picaduras o signos o síntomas preocupantes, busque ayuda médica de inmediato. En ese caso, observe si hay decoloración o ampollas en la piel, náuseas, dolor abdominal, dificultad para respirar, cambio en la capacidad de respuesta, o dolor significativo. Si no hay preocupaciones inmediatas, aquí es cómo podemos manejar estos casos de manera independiente siempre y cuando no se noten síntomas preocupantes. Para las arañas: Si se encuentra en un área conocida por las arañas venenosas, aléjese del lugar para evitar más mordeduras. Es importante identificar la araña responsable de la mordedura. Luego, lávese con jabón suave y agua. Para reducir el dolor y la hinchazón, eleve la extremidad mordida y aplique una compresa fría o una bolsa de hielo envuelta en un paño delgado en el lugar de la mordedura. Déjelo actuar durante unos 10-15 minutos cada hora. Para mordeduras sospechosas o confirmadas de arañas venenosas como las viudas negras o las arañas reclusas pardas, es crucial buscar atención médica inmediata. Llame a los servicios de emergencia o diríjase al hospital más cercano. Ahora hablemos de las garrapatas. Si encuentra una garrapata adherida a su piel, retírela rápidamente ya que cuanto más tiempo estén adheridas, más probable es que transmitan enfermedades. Use unas pinzas de punta fina para agarrar la garrapata lo más cerca posible de la superficie de la piel. Tire de ella alejándola de la piel de manera constante y lenta con firmeza, evitando torcer o aplastar la garrapata. La piel se tensará y la garrapata finalmente se soltará. Limpie el área con agua y jabón suave. Si está preocupado por las enfermedades transmitidas por garrapatas, puede conservar la garrapata en un recipiente sellado o una bolsa de plástico. Esto puede ayudar a los profesionales de la salud a identificar la garrapata y determinar el riesgo de transmisión de enfermedades. Tenga en cuenta que si la cabeza se desprende y queda incrustada en la piel, esto es una llamada al profesional médico para pedir ayuda. Ahora hablemos de los escorpiones. Aléjese del área para prevenir más picaduras. Limpie el sitio de la picadura con jabón suave y agua, similar a las mordeduras de araña, y aplique una compresa fría o una bolsa de hielo envuelta en un paño en el sitio de la picadura para ayudar con el dolor. Aunque la mayoría de las picaduras de escorpión son inofensivas, buscar atención médica es esencial para estar seguro, ya que las especies venenosas pueden ser mortales para los humanos. Llame a los servicios de emergencia o diríjase el hospital más cercano inmediatamente. Recuerde, la prevención es clave, así que tome precauciones revisando su ropa y vistiendo la indumentaria adecuada siempre que estas criaturas sean comunes. Mantenga la calma y siga estos pasos si se encuentra con una mordedura o picadura. Y siempre busque ayuda médica profesional cuando sea necesario. https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/es/training/first-aid/video/conmocion-rescatista-lego-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7184.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/es/training/first-aid/video/2025-guidelines-update-for-cpr-and-first-aid-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7289.mp4 Actualización de las Guías 2025 - RCP y primeros auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13120/2025-guidelines-update-for-cpr-and-first-aid.jpg Yes 458 https://www.procpr.org/es/training/first-aid/video/quemaduras-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7186.mp4 Quemaduras https://d3imrogdy81qei.cloudfront.net/video_images/13032/burns-2025.jpg Yes 413 https://www.procpr.org/es/training/first-aid/video/asfixia-nino-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7180.mp4 Asfixia en niño consciente https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/es/training/first-aid/video/asfixia-bebe-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7181.mp4 Asfixia en bebé consciente https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/training/adult-cpr/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/adult-cpr/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/adult-cpr/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/adult-cpr/video/when-cpr-doesnt-work https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2041.mp4 When CPR Doesn't Work This is the last lesson in the cardiac arrest section, and a difficult topic to tackle for most. Whether you're a licensed paramedic, family member, neighbor, or stranger, the question remains the same for many people: Why didn't CPR work? That's a fair question. Even when you do everything perfectly, the desired outcome often isn't what you expected or hoped for. However, some of that hope and desire can be rooted in a misunderstanding of what CPR really is, which is the point of this lesson. CPR was designed to buy time, and nothing more. During cardiac arrest the heart is either in a fibrillatory state, meaning it's wiggling around in a disordered fashion, or it's completely asystolic, meaning it's not contracting at all. When a heart is healthy and operating as it should, it beats from top to bottom in a very organized way utilizing one-way valves. It works perfectly to circulate oxygenated blood throughout the entire body, and it does so efficiently. However, during cardiac arrest, regardless of what caused it, the heart is unable to circulate blood and oxygen and the body begins to die. The patient isn't breathing. There's no pulse. At this point, that person is clinically dead. Now, it doesn't mean that person will remain that way, as there is a difference between clinical death and biological death. What CPR aims to do, specifically the compressions, is to make up for the circulation that isn't happening naturally. The reality, though, is that even when CPR is performed perfectly, it's delivering only a small percentage of what the body needs to survive. It wasn't designed to be equal to artificial life support. Remember, it's simply a way to buy time. People have this idea that if they perform chest compressions on an unresponsive person, the body will remain alive. And he or she will remain alive so long as the chest compressions continue. But this isn't the case. CPR doesn't stop the dying process. It slows down biological death a little. But that's all it does. The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives – an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. – and the underlying cause of the cardiac arrest can be addressed. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival. CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology. The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are. If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact – by performing high quality CPR, you gave the patient the best possible chance of survival. Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way. That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. Now, you may be asking yourself, if CPR rarely works, is it even worth trying? EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying. And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember – we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them. The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough (even strangers) to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live. Isn't that the greatest gift we can give to another? This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. If you've ever performed CPR on a cardiac arrest victim, but the patient still remained dead, hopefully this greater understanding of what CPR really is has brought some peace to you, as the pain, agony, and guilt can be immense. Go forth and rescue confidently! And be at peace with yourself when you do. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/training/adult-cpr/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/adult-cpr/video/procpr-basic-introduction https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2108.mp4 ProCPR Basic Introduction Welcome to ProCPR Basic. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. And at the end, we'll share with you some important information about why learning high-quality CPR is so vital. Your instructor for the duration of your ProCPR Basic course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and also a co-founder of ProTrainings. In other words, you're in good hands. We created ProCPR Basic to be both efficient and effective, and we developed it with you in mind. Your schedule is probably hectic, which is why ProCPR is available whenever you are, 24 hours a day, seven days a week, as opposed to when an instructor is available. You can squeeze in a quick lesson whenever you have a few minutes to spare. The list of occupations that can benefit from the ProCPR Basic course is long and includes: Construction Workers Manufacturing Forestry Transportation Workplace Emergency Response Team Electricians Security Personnel Adult Foster Care Restaurant Staff Home Health Care Aids Hotel Staff CNAs High School Teachers High School Coaches The total course time includes 1 hour and 27 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual here: Student Manual. What You Will Learn in this Course Your ProCPR Basic course curriculum is quite substantial. Some of the important things you'll be learning are: Introductory CPR Training• The Five Fears of CPR Rescue Medical Emergencies• Stroke• Heart Attacks• Shock Cardiac Arrest Training• Adult CPR• AED• Hands-Only CPR Choking• Adult Choking- Conscious and Unconscious Bloodborne Pathogens• Reducing Your Risk• Glove Removal• Hand Hygiene If you require first aid as part of your certification, check out our Adult CPR & First Aid course. Our Adult CPR course is a 2-year certification. If you are currently certified with Red Cross, AHA, National Safety Council, ASHI, or Medic First Aid, you are welcome to re-certify with this course. Individuals are free to train, refresh, and test at no charge any time 24/7! This course is nationally accredited and follows the latest American Heart Association, ECC/ILCOR guidelines. Those of you old enough to remember may recall that McDonald's signs used to include a running total of the number of hamburgers sold until that number outgrew the sign. Nearly 47,000 satisfied professionals just like yourself have completed this ProCPR Basic course. And although our numbers aren't growing as quickly as McDonald's, we do sincerely hope that you'll be the next person who has a satisfying experience. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Why Learning High-Quality CPR is Important ProCPR Basic is different from the typical CPR course you're probably accustomed to taking. We believe that high-quality CPR training is something everyone should be able to access, for free. So, rather than paying simply to learn CPR, the payment is at the very end, only for those who need a certification card for work. We also believe that the problem with CPR isn't that everyone is doing CPR incorrectly. The bigger problem is that people aren't doing CPR at all. That's why we start with the "why." Why are people afraid to rescue? What happens when CPR doesn't work? These are just a few of the parts of the training that will make even the most seasoned professional walk away from the course learning something new or thinking about CPR differently. Gaining confidence in your skills is a big part of performing high-quality CPR. Remembering that as you progress through each lesson will serve you well. Welcome again to ProCPR Basic. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3775/procpr-basic-introduction-2015.jpg Yes 41 https://www.procpr.org/training/adult-cpr/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/adult-cpr/video/unconscious-adult-choking-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2118.mp4 Practice: Unconscious Adult Choking Learn how to give CPR to an adult who is unconscious and choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/training/adult-cpr/video/adult-aed-workplace-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2138.mp4 Practice: Adult AED Learn how to give CPR with an AED to an adult who is unconscious and not breathing by watching the procedure performed on a manikin. https://d3imrogdy81qei.cloudfront.net/video_images/3835/adult-aed-workplace-practice-2015.jpg Yes 276 https://www.procpr.org/training/adult-cpr/video/adult-cpr-workplace-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2139.mp4 Practice: Adult CPR Learn how to give CPR to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3837/adult-cpr-workplace-practice-2015.jpg Yes 96 https://www.procpr.org/training/adult-cpr/video/adult-aed-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2107.mp4 Adult AED If the patient is a witnessed cardiac arrest, first check to assure the scene is safe. Check for patient responsiveness, contact emergency services. Turn on the AED if the patient is not breathing. Attach the AED pads to the patient, and do not touch the patient while the AED analyzes. After a shock is delivered, begin CPR for about 5 cycles or two minutes. The AED will interrupt after two minutes and reanalyze the patient. Continue to follow the AED's instructions until advanced life support arrives. https://d3imrogdy81qei.cloudfront.net/video_images/3773/adult-aed-profa-2015.jpg Yes 214 https://www.procpr.org/training/adult-cpr/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/adult-cpr/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/adult-cpr/video/adult-cpr-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2106.mp4 Adult CPR Adult CPR is performed by first contacting emergency services. Next, if the patient is not breathing, begin chest compressions followed by two rescue breaths. Perform 30 compressions at a rate of 100-120 per minute and a depth of 2-2.4 inches in the center of the chest. These 30 compressions should be followed by two rescue breaths, and repeat the cycle until an AED or emergency services arrives. https://d3imrogdy81qei.cloudfront.net/video_images/3771/adult-cpr-profa-2015.jpg Yes 158 https://www.procpr.org/training/adult-cpr/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/adult-cpr/video/unconscious-adult-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2033.mp4 Unconscious Adult Choking In this lesson, we'll cover how to help an adult choking victim who is unconscious. In our fictional scenario, the adult victim went unconscious while you were trying to help them. The method of care will closely resemble performing CPR, which you recently learned, however, there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy. Help lower the victim to the ground or floor, so they don't fall and injure themselves. Pay extra attention to supporting their head and neck. Call 911 and activate EMS if you haven't already done so. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient. Lift the victim's chin and tilt his or her head back. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness. Pro Tip #3: Let's assume your compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compressions to two rescue breaths. Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. How You can Increase the Effectiveness of CPR It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. With that in mind, here are two lists (cheat sheets) to use when practicing CPR – one list of what to do and what of what NOT to do. What is High-Quality CPR? Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 (for adults) Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the victim's chest to rise What is Low-Quality CPR? Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/training/adult-cpr/video/agonal-respiration-not-breathing-normally https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2022.mp4 Agonal Respiration (Not Breathing Normally) Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations. Agonal respiration is one sign of respiratory and cardiac arrest. Historically, this type of breathing has been difficult to identify and describe, especially for lay people, which can slow or hinder care and response times for cardiac arrest victims. A Word About Cardiac Arrest Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate blood to vital organs, including the brain. When heartbeats are weak, irregular, or uncoordinated, blood can't flow through the arteries to the rest of the body. If circulation is hampered or halted in any way, the body's organs cannot receive the oxygen they need to function normally. As a result, organ failure can occur. Brain damage sets in between 4-6 minutes, and after 8-10 minutes, this damage will likely be irreversible. Cardiovascular disease is the leading cause of death in the world and in the U.S., where it accounts for approximately 1 in 3 deaths. Cardiovascular disease is also the primary cause of cardiac arrest, but there are others, including: Drowning Choking Drug overdose Severe injury Brain damage Electrocution Warning: As more than 300,000 out-of-hospital cardiac arrests occur each year in the U.S., it's vital that lay rescuers and EMS professionals understand that early recognition – which is more difficult with agonal respiration – and quick action can have a tremendous impact on survival rates. Cardiac Chain of Survival To effectively respond to cardiac emergencies, it helps to understand the Cardiac Chain of Survival. Following the links in these chains – adult and pediatric – will give patients the best chance of survival. Warning: For each minute that CPR and/or defibrillation are delayed, the chance of survival is reduced by 7-10 percent. Adult Cardiac Chain of Survival Recognize the emergency and call 911 – the sooner medical personnel are called the sooner EMS can provide care for the patient. Early CPR – supplying blood and oxygen to vital organs can prevent brain damage and death. Early defibrillation – this electrical shock may restore an effective heart rhythm and increase the victim's chance of survival. Advanced life support – Medical personnel can help provide the proper equipment and medication needed to continue lifesaving care. Integrated post-cardiac arrest care – Integrated care can optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. Pediatric Cardiac Chain of Survival Injury prevention and safety – ways to prevent cardiac arrest in children. Early CPR Early Emergency Care – Rapid activation of the EMS system or response team to get help on the way quickly. Pediatric advanced life support Integrated post-cardiac arrest care Agonal Respiration Continued Agonal respiration is characterized by abnormal breathing attempts in which the patient appears to be gasping or gulping. (Think of a fish as it tries to breathe out of the water to get an idea of what agonal respiration looks like.) These respiratory attempts originate from the lower brain stem neurons as higher, more complex neurons become increasingly hypoxic – lacking in oxygen. Agonal Respiration occurs in around 40 percent of early cardiac arrest victims. Aggressive CPR attempts are often hindered or slowed due to misinterpretation or misunderstanding of this serious condition. Pro Tip #1: It's important to remember that, when it comes to agonal respiration, these attempts from the body to breathe are routinely misinterpreted as normal breathing. However, even though it may appear the victim is breathing, he or she is not exchanging air well and will require immediate assistance to increase his or her survival rate. While lay rescuers describe agonal respiration in a number of ways, the good news is that 911 dispatchers have become better equipped to recognize all the ways in which people describe it, leading to better assistance and improved response times. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/training/adult-cpr/video/bleeding-control-arterial-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2094.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care A person who is the victim of arterial bleeding will instinctively grab and cover the wound to reduce the amount of blood flow, if that person is conscious and able to. To best assist in treating the wound, you should: Make sure the scene is safe. Put on latex-free gloves if available. If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer. Find the source of the bleeding; you may have to remove clothing over the wound. Make the switch from the victim's hand to a dressing pad or a clean cloth. Apply pressure. The wound will be pulsating, and it will likely take several dressing pads to control the bleeding. If the victim is conscious and can assist, this will help. Ask the victim to maintain pressure over the dressing pad or cloth. The blood will probably soak through, so apply a second pad on top of the first, rather than removing it. Continue to apply firm, direct pressure over the wound. If the victim is becoming light-headed from the blood loss, have them sit or lie down. The goal is to control the bleeding to the point where the wound is not leaking through each new dressing pad. If blood continues to leak through, continue to apply another pad or piece of cloth until it stops. Consider using a tourniquet if – you cannot control the bleeding with dressing pads and the blood loss is extreme. This is a life-threatening situation and last resort. In most cases, even arterial bleeding can be controlled using pressure plus dressing and bandages. Once you have the bleeding controlled, it's time to wrap the wound. Using an ACE roller bandage like you find in most first aid kits, start from the end of the extremity where the injury is located. If the wound is on the wrist, began wrapping from the hand. Pro Tip #1: it's important to extend the bandage several inches beyond the wound on both sides. This will help keep the wound clean and limit the chances of infection. When wrapping the wound, if extra pressure is required, twist the bandage once over the wound and continue wrapping. Repeat as often as necessary. To finish, tuck the end of the bandage into the wrap to hold it in place. Pro Tip #2: While pressure is important to control the bleeding, you don't want to cut off circulation to the extremity on which the wound occurred. Pinch a nail and the fleshy underside between two of your fingers (if the wound occurred on an arm or a leg). The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. At this point, you'll want to decide whether to call 911 for EMS services or transport the victim to the emergency room by private vehicle. Call 911 if: The victim has lost consciousness or is showing signs of losing consciousness The victim is exhibiting signs of shock – pale, cold, sweaty skin You cannot stop the bleeding A Word About Dressings and Bandages Dressings are sterile pads used to absorb blood and other fluids, help promote clotting, and prevent infection. Gauze pads are most common. Most dressing pads are porous, which allows air to circulate to the wound and promote healing. Common sizes range from 2-4-inch squares. Universal or trauma dressings are larger in size and used for larger wounds. Occlusive dressings are not porous, which means no air or fluids can pass through, and typically used for abdominal wounds. Bandages are strips of material used to hold the dressing in place, maintain pressure over the wound, control bleeding, and protect from dirt and infection. The most common type of bandage is the roller bandage that is usually made of gauze and comes in assorted widths and lengths. These are the type of bandages you find in most first aid kits. However, there are other types of bandages including: Pressure bandage – for more pressure and a snugger fit Bandage compress – thick gauze dressing attached to a gauze bandage Elastic bandage – type of roller bandage typically used for muscles, bones, and joints Triangular bandage – large bandage that can folded and used as a sling As arterial bleeding is the most severe type of bleeding, it's important to properly assess the situation quickly as a rapid response is vital for a positive outcome. If you feel like the situation is too serious to handle yourself, it's important that you or someone else at the scene call 911 immediately. https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/training/adult-cpr/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/adult-cpr/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/adult-cpr/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/adult-cpr/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/adult-cpr/video/2025-guidelines-update-for-cpr-and-first-aid-adults https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7288.mp4 2025 Guidelines Update for CPR and First Aid for Adults In this lesson, we'll go over the most important updates from the 2025 American Heart Association Emergency Cardiovascular Care guidelines for lay rescuers — that means everyday people like you who may need to help in an emergency. The goal of these updates is simple: help more people survive cardiac arrest by acting fast. When someone's heart stops, every second counts. The 2025 guidelines focus on making CPR easier to do, reducing delays, and encouraging more people to step in and help. Starting CPR in Adults When an adult collapses and is unresponsive, the most important thing you can do is start CPR right away. If you know how to give rescue breaths, you should give both compressions and breaths. But if you're not comfortable giving breaths, don't let that stop you — hands-only CPR is still much better than doing nothing at all. Start CPR where the person is. Moving them wastes valuable time. Lay them on their back on a hard, flat surface — a firm surface helps your compressions work better. Try to kneel beside them so their chest is about level with your knees, as this helps you push down with the right amount of force. You can also try placing the hand closest to their head on the center of their chest first, as this may help improve the quality of your compressions. Pro Tip #1:Don't wait. Don't move them unless you absolutely have to. Just get down and start compressions as soon as possible. Using an AED on Female Patients An AED, or automated external defibrillator, is a device that can reset the heart with an electric shock. One barrier that has been identified is that people sometimes hesitate to use an AED on a woman because they feel uncomfortable exposing her chest. The 2025 guidelines want to clear this up: you do not need to fully remove clothing to use an AED. Simply move clothing or undergarments aside to place the pads directly on the skin. The pads don't have to be in the perfect spot to work. Getting the AED on quickly and delivering a shock is what matters most. Always prioritize speed while being respectful of the patient's dignity. Helping Someone Who Is Choking If an adult is conscious and choking — meaning something is stuck in their airway and they cannot breathe, cough, or speak — here is what to do. Give 5 firm back blows between the shoulder blades, then follow with 5 abdominal thrusts. Keep repeating this cycle until the object comes out or the person goes unconscious. Research shows that back blows can be more effective and safer than abdominal thrusts alone, which is why this combination approach is now recommended. If the person is pregnant or if abdominal thrusts are not possible for any reason, use chest thrusts instead. Cardiac Arrest After Drowning If someone has gone into cardiac arrest after drowning, start CPR with breaths before reaching for an AED. Drowning cuts off oxygen to the body, so getting air into the lungs is the first priority. An AED is less likely to help initially in these cases because the heart rhythm involved in drowning emergencies is usually not one that can be shocked back to normal. Eye Injuries with an Embedded Object If something is stuck in a person's eye, cover only the injured eye — not both. Covering both eyes can make the person feel panicked and disoriented. Keeping the uninjured eye uncovered helps them stay calm and aware of what's happening around them, while still preventing further injury to the injured eye. Caring for Someone in Shock If someone is showing signs of shock — such as pale or clammy skin, weakness, or dizziness — but is still awake and alert, have them lie flat on their back. If they seem drowsy, are vomiting, or you can't keep a close eye on them, roll them onto their side instead. This is called the recovery position, and it helps keep their airway clear. Pro Tip #2: If the person fainted or is dehydrated but has no injuries, some studies suggest that gently raising their feet 6 to 12 inches may help in the short term to improve blood flow. This is not always recommended, but it may be worth trying in the right situation. Just keep in mind that our priority should be keeping them warm, on the ground and making sure to keep their airway clear and monitor for CPR if needed. A Unified Chain of Survival The 2025 guidelines now use one Chain of Survival for everyone — infants, children, and adults. Think of it as a step-by-step path to survival: recognize the emergency, call for help, start CPR, use an AED, and keep going until professional help arrives. Each link in that chain matters, and you are one of those links. Closing Thoughts The message behind all of these updates is simple: act fast, do your best, and don't be afraid to help. You don't have to be a medical professional to save a life. CPR doesn't have to be perfect — it just has to happen. The more confident and informed you are, the more of a difference you can make. https://d3imrogdy81qei.cloudfront.net/video_images/13118/2025-guidelines-update-for-cpr.jpg Yes 356 https://www.procpr.org/training/adult-cpr/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/adult-cpr/video/shock-lay-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7184.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. It is a serious and potentially life-threatening condition that requires immediate medical care as it is a multi-symptom and complex condition. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. There are several types of shock, including psychological shock – a psychological condition in which worry and concern send a person into shock, rather than a physical condition. While this shock lesson is in the bleeding control section, it's important to understand that any first aid emergency could send a person into shock. Pro Tip #1: The important thing to remember with shock is that the symptoms are the same regardless of what contributes to it. It's a serious condition that warrants rapid treatment and an immediate 911 call. Besides psychological shock, there are four main types. The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #2: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue mask with a one-way valve available if necessary. Warning: If at any point the victim stops breathing normally or becomes unresponsive, begin CPR (or rescue breathing) immediately and continue until medical professionals arrive. Pro Tip #3: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #4: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. A Few Common Shock Questions Are there any tests I can perform on the victim to better help identify shock? If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail bed. If it's more than a few seconds – or the time it takes to say capillary refill – your victim is likely in shock. How do I know when to call 911? It's always better to be safe than sorry, so call 911 any time it's an actual emergency or if you're unsure what to do or overwhelmed, and how exactly that's defined will vary from rescuer to rescuer. However, as it pertains to this lesson, always call 911 immediately as soon as you suspect shock or as soon as the victim loses consciousness or begins having breathing issues. In other words, err on the side of victim safety. https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/es/training/adult-cpr/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/adult-cpr/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/adult-cpr/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/adult-cpr/video/cuando-rcp-no-funciona-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2041.mp4 Cuando la RCP no funciona La RCP es un intento de compensar la circulación en el corazón que no está sucediendo normalmente. La RCP no detiene el proceso de morir; Simplemente disminuye la muerte celular biológica. La esperanza es que este procedimiento puede comprar tiempo para que el ccsme llegue a probar otros métodos de restaurar la circulación apropiada de la sangre oxigenada por todo el cuerpo para comprar aún más tiempo de modo que la razón subyacente por la cual la persona entró en paro cardiaco en el primer lugar puede ser Explorado Si la RCP no funciona, recuerde que le dio a esa persona la mejor oportunidad de sobrevivir. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/es/training/adult-cpr/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/adult-cpr/video/introduccion-pro-rcp-basico https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2108.mp4 Introducción a ProRCP básico https://d3imrogdy81qei.cloudfront.net/video_images/3775/procpr-basic-introduction-2015.jpg Yes 41 https://www.procpr.org/es/training/adult-cpr/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/adult-cpr/video/asfixia-adulto-inconsciente-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2118.mp4 Práctica: Asfixia en adulto inconsciente Aprenda a dar RCP a un adulto que está inconsciente y ahogándose observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/es/training/adult-cpr/video/dea-adulto-lugar-de-trabajo-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2138.mp4 Práctica: DEA en adulto https://d3imrogdy81qei.cloudfront.net/video_images/3835/adult-aed-workplace-practice-2015.jpg Yes 276 https://www.procpr.org/es/training/adult-cpr/video/rcp-adulto-lugar-de-trabajo-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2139.mp4 Práctica: RCP en adulto https://d3imrogdy81qei.cloudfront.net/video_images/3837/adult-cpr-workplace-practice-2015.jpg Yes 96 https://www.procpr.org/es/training/adult-cpr/video/dea-adultos-pro-primeros-auxilios https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2107.mp4 DEA en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3773/adult-aed-profa-2015.jpg Yes 214 https://www.procpr.org/es/training/adult-cpr/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/adult-cpr/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/adult-cpr/video/rcp-adultos-pro-primeros-auxilios https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2106.mp4 RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3771/adult-cpr-profa-2015.jpg Yes 158 https://www.procpr.org/es/training/adult-cpr/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/adult-cpr/video/asfixia-adulto-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2033.mp4 Asfixia en adulto inconsciente Una vez que una víctima de asfixia se convierte en inconsciente, asegúrese de que EMS se ha activado. Dar 30 compresiones torácicas. Compruebe el objeto en la boca del paciente y barrerlo si es posible. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Si todavía no entra aire, realice 30 compresiones torácicas, revise el objeto nuevamente y, si es posible, retírelo. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Continúe este proceso hasta que la vía aérea esté abierta y el aire entre en los pulmones. https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/es/training/adult-cpr/video/respiracion-agonica-no-respirar-normalmente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2022.mp4 Respiración agónica (no respirar normalmente) Un signo de parada cardiaca se describe como respiración agonal. Esto ocurre cuando una persona está haciendo un jadeo o tragarse el movimiento y no está respirando normalmente. La respiración agónica ocurre en el 40% de los paros cardiacos tempranos. Saber cuándo una persona es respiratoria agonal puede prevenir intentos agresivos de RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/es/training/adult-cpr/video/es-control-hemorragia-sangrado-arterial https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2094.mp4 Sangrado arterial https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/es/training/adult-cpr/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/adult-cpr/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/adult-cpr/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/adult-cpr/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/adult-cpr/video/2025-guidelines-update-for-cpr-and-first-aid-adults-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7288.mp4 Actualizaciones de las Guías 2025: RCP en Adultos y Primeros Auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13118/2025-guidelines-update-for-cpr.jpg Yes 356 https://www.procpr.org/es/training/adult-cpr/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/adult-cpr/video/conmocion-rescatista-lego-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7184.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/training/cpr/video/arterial-bleeding-child https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2036.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding injury. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. Pro Tip #1: The most important thing with an arterial bleeding wound is to apply pressure and stop the bleeding. Apply pressure. Stop the bleeding. Keep these in mind as you progress through this lesson. Find the source of the bleeding. You may have to remove or cut away clothing to reveal the wound. Pro Tip #2: An arterial bleed can be a frightening situation. Reassure the victim and let them know that you'll stay with them until additional help arrives and that you'll take good care of them while you wait. Cover the wound as long as no impaled objects are protruding from it. Ideally, a sterile pad or bandage would work best, but use whatever you have available, so long as it's clean. Apply direct and constant pressure to the wound. If the victim is conscious and can assist, this will help. Warning: Remember, arterial wounds will be pulsating or spurting, and it will likely take several dressing pads to control the bleeding. So, don't be surprised by the amount of blood or the difficulty you may experience in controlling it. Apply new pressure pads or bandages as needed, if blood begins to soak through the one(s) already applied. DO NOT remove the old bandage or pad, as this can strip the wound of blood trying to clot and only delay your ability to control the bleeding. After bleeding is controlled, you can begin to wrap the wound using an elastic bandage. Start at the furthest point from the body and wrap over any and all dressing pads you placed over the wound. (If the wound is on the arm, begin wrapping at the end where the fingers are.) Wrap around the wound at least an inch on each side and overlap the bandage as you wrap. Go down the arm, up the arm, and repeat as many times as necessary. Pro Tip #3: To apply even more pressure to a difficult wound, twist the bandage one time directly over the wound and repeat as necessary. This will tighten-up the pressure where pressure is most needed. When done wrapping, cut the end of the bandage and either tape it down or tuck it into the wrap to hold it in place. An arterial bleed is an automatic 911 call. It's always a good idea to activate EMS in an emergency. You can always cancel the call or send them away once they arrive. But if the situation suddenly turns dire, you'll be glad knowing they're on the way. Warning: Watch for signs of shock. Does the victim appear pale, sweaty, or cold? (Shock is very dangerous and something we'll get into more in a subsequent lesson.) Also monitor the victim for difficulties breathing, circulation problems, or other injuries you may not have noticed earlier. At this point, the victim should be stabilized and the bleeding under control. If you activated EMS, simply wait for them to arrive. If EMS is not on the way, you can find another way to get the victim to the next level of medical care, most likely an emergency room. A Few Common Arterial Bleeding Questions Should I elevate the wound above the heart? No, not anymore. While this was once the protocol for dealing with a bleeding wound, we're no longer doing this. Should I apply a tourniquet if I cannot control the bleeding? Yes, but only if you can't stop the bleeding and it's a matter of life and death. Cutting off circulation to any part of the body is a serious event and best left to professionals. Can I let the victim drive himself or herself to the hospital? No, especially not in this case, as blood loss from an arterial wound can be severe and cause reactions that don't mix well with operating a moving vehicle. However, in general, this should be avoided. There may be a chance that the victim has difficulty seeing his or her own blood, which could cause psychogenic shock. It's always better if the victim is a passenger rather than the driver. How do I know if I wrapped the wound too tightly? This can be a real concern and one reason we only use tourniquets in serious situations, as you don't want to cut off blood supply to ANY part of the body for too long. Look at the fingers or toes or whatever extremities are closest to the wound. Are the nail beds still pink or are they beginning to turn blue? Pinch a nail and the fleshy underside between two of your fingers. The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. https://d3imrogdy81qei.cloudfront.net/video_images/3631/arterial-bleeding-child-2015.jpg Yes 236 https://www.procpr.org/training/cpr/video/unconscious-adult-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2033.mp4 Unconscious Adult Choking In this lesson, we'll cover how to help an adult choking victim who is unconscious. In our fictional scenario, the adult victim went unconscious while you were trying to help them. The method of care will closely resemble performing CPR, which you recently learned, however, there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy. Help lower the victim to the ground or floor, so they don't fall and injure themselves. Pay extra attention to supporting their head and neck. Call 911 and activate EMS if you haven't already done so. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient. Lift the victim's chin and tilt his or her head back. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness. Pro Tip #3: Let's assume your compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compressions to two rescue breaths. Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. How You can Increase the Effectiveness of CPR It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. With that in mind, here are two lists (cheat sheets) to use when practicing CPR – one list of what to do and what of what NOT to do. What is High-Quality CPR? Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 (for adults) Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the victim's chest to rise What is Low-Quality CPR? Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/training/cpr/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/cpr/video/adult-cpr-lay-rescuer-community https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2023.mp4 Adult CPR In this lesson, we'll cover how to administer CPR on an adult victim. In situations where CPR is needed, you personally may have witnessed the victim exhibit symptoms and go unresponsive. Others may have witnessed the incident. Or no one was around to see what really happened. If someone was there to witness the incident, what they likely would have noticed is a victim who: Loses their balance Clutches their chest Collapses to the ground or floor If you arrive on the scene after this happens, in cardiac arrest emergencies, the victim will usually also be unresponsive and not breathing normally, if at all. Let's assume for this lesson that that's how you found the victim. And that CPR is required. CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped. Oxygen is vital for life and it's only a matter of minutes before the brain begins to be negatively impacted. How to Provide Care Warning: Don't let the repetition of this next paragraph lull you into overlooking or dismissing the importance of scene safety. What if you show up to the scene and there's a live electrical wire, or poisonous gases in the air, and this is why the victim collapsed? Don't make assumptions, and don't become another victim. Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue shield available and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Pro Tip #1: As long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation. If you've determined at this point that the victim is unresponsive and not breathing normally continue immediately with CPR, beginning with chest compressions. Pro Tip #2: Chest compression landmarks: Aim for the center of the chest, between the nipples and on the lower one-third of the sternum. Hand placement: Place your first palm on that landmark and interlock the fingers on your top hand over your first. Lean over the victim, position your hands as indicated above, and in the video, and lock your elbows. Use your upper body weight to supply the force needed for chest compressions and compress at a depth between 2 – 2.4 inches. Perform 30 chest compressions at a rate between 100 – 120 compressions per minute, which amounts to around two compression every second. Make sure you allow the victim's chest to come all the way back up before performing your next compression. Pro Tip #3: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Lift the victim's chin and tilt his or her head back. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver two breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Pro Tip #4: Don't forget to watch the victim's chest when providing breaths. If the chest doesn't rise, then you might be dealing with another problem and one that likely includes an obstructed airway. Go right back into 30 chest compressions followed again by two breaths. Continue to perform 30 chest compressions to two breaths until EMS arrives, an AED is located, someone equally trained can relieve you, or the victim becomes responsive and begins breathing normally again. A Few Common Questions About Adult CPR Why is it important to use your upper body weight when performing chest compressions? If you need to perform CPR for a longer period of time, using only your upper body strength will begin to fatigue you. As you become fatigued, your compression rate and depth may falter, as would the quality of CPR and the victim's chances of recovering. Can I stop doing CPR once I've started? Once you begin CPR, it's important not to stop. If you must stop, do so for no longer than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life and the patient breathing normally again, an AED being available and ready to use, or being too exhausted to continue. Is there anything else I can do to help a cardiac arrest victim? The best thing you can do in these situations is to provide high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. So, what constitutes high-quality CPR? High-Quality CPR Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise Pro Tip #5: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Low-Quality CPR Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force https://d3imrogdy81qei.cloudfront.net/video_images/3605/adult-cpr-lay-rescuer-community-2015.jpg Yes 216 https://www.procpr.org/training/cpr/video/agonal-respiration-not-breathing-normally https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2022.mp4 Agonal Respiration (Not Breathing Normally) Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations. Agonal respiration is one sign of respiratory and cardiac arrest. Historically, this type of breathing has been difficult to identify and describe, especially for lay people, which can slow or hinder care and response times for cardiac arrest victims. A Word About Cardiac Arrest Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate blood to vital organs, including the brain. When heartbeats are weak, irregular, or uncoordinated, blood can't flow through the arteries to the rest of the body. If circulation is hampered or halted in any way, the body's organs cannot receive the oxygen they need to function normally. As a result, organ failure can occur. Brain damage sets in between 4-6 minutes, and after 8-10 minutes, this damage will likely be irreversible. Cardiovascular disease is the leading cause of death in the world and in the U.S., where it accounts for approximately 1 in 3 deaths. Cardiovascular disease is also the primary cause of cardiac arrest, but there are others, including: Drowning Choking Drug overdose Severe injury Brain damage Electrocution Warning: As more than 300,000 out-of-hospital cardiac arrests occur each year in the U.S., it's vital that lay rescuers and EMS professionals understand that early recognition – which is more difficult with agonal respiration – and quick action can have a tremendous impact on survival rates. Cardiac Chain of Survival To effectively respond to cardiac emergencies, it helps to understand the Cardiac Chain of Survival. Following the links in these chains – adult and pediatric – will give patients the best chance of survival. Warning: For each minute that CPR and/or defibrillation are delayed, the chance of survival is reduced by 7-10 percent. Adult Cardiac Chain of Survival Recognize the emergency and call 911 – the sooner medical personnel are called the sooner EMS can provide care for the patient. Early CPR – supplying blood and oxygen to vital organs can prevent brain damage and death. Early defibrillation – this electrical shock may restore an effective heart rhythm and increase the victim's chance of survival. Advanced life support – Medical personnel can help provide the proper equipment and medication needed to continue lifesaving care. Integrated post-cardiac arrest care – Integrated care can optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. Pediatric Cardiac Chain of Survival Injury prevention and safety – ways to prevent cardiac arrest in children. Early CPR Early Emergency Care – Rapid activation of the EMS system or response team to get help on the way quickly. Pediatric advanced life support Integrated post-cardiac arrest care Agonal Respiration Continued Agonal respiration is characterized by abnormal breathing attempts in which the patient appears to be gasping or gulping. (Think of a fish as it tries to breathe out of the water to get an idea of what agonal respiration looks like.) These respiratory attempts originate from the lower brain stem neurons as higher, more complex neurons become increasingly hypoxic – lacking in oxygen. Agonal Respiration occurs in around 40 percent of early cardiac arrest victims. Aggressive CPR attempts are often hindered or slowed due to misinterpretation or misunderstanding of this serious condition. Pro Tip #1: It's important to remember that, when it comes to agonal respiration, these attempts from the body to breathe are routinely misinterpreted as normal breathing. However, even though it may appear the victim is breathing, he or she is not exchanging air well and will require immediate assistance to increase his or her survival rate. While lay rescuers describe agonal respiration in a number of ways, the good news is that 911 dispatchers have become better equipped to recognize all the ways in which people describe it, leading to better assistance and improved response times. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/training/cpr/video/adult-aed-lay-rescuer-community https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2026.mp4 Adult AED In this lesson, we'll cover how to use an AED on an adult victim. An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm. Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the rescuer, or someone else, that could result in electrocution? Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient. If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if it is a concern, you can disconnect it and remove it from the pathway to the heart. Necklaces should be moved to the side. Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads. Piercings shouldn't cause any problems. It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it. There are no special considerations for pregnant women. Pro Tip #2: It's OK to be just as aggressive with a pregnant woman as you would any other victim. The primary focus should be on the mother, as saving her will also help save the baby. The care you provide to the mother won't put the baby in any more jeopardy. How to Provide Care Let's assume a few things: The scene is safe, and your gloves are on You or a bystander called 911 You have an AED, whether you found one or had it with you The victim is unresponsive and not breathing normally CPR is already in progress Remember, as long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation. However, when it comes to AEDs, they supply their own instructions. Well, at least after the first step below. AED Technique for Adults Pro Tip #3: This is really the anti Pro Tip, as you don't need to be a pro to execute it. The AED will tell you what to do and what it's doing, like "remove clothing" or "analyzing rhythm." All you have to do is follow along. Turn on the AED. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. (AEDs will typically include a pair of scissors somewhere on the unit.) Attach the AED pads to the victim's chest. The pads should have a diagram on placement if you need help. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side of the victim's side, under the left breast. Make sure they adhere well. Plug the cable into the AED and be sure no one is touching the victim. The AED should now be charging and analyzing the rhythm of the victim's heart. If the scene is clear and no one is touching the victim, push the discharge button to deliver a shock. Then go right back into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Perform 30 chest compressions. Grab the rescue shield and place it over the victim's mouth and nose. Lift the victim's chin and tilt his or her head back. Deliver two rescue breaths. Continue with CPR until the AED interrupts you. At some point, it will reanalyze the victim's heart rhythm and again advise you on what to do next. If the AED advises a shock, do that. If it advises you to NOT shock the victim, continue with CPR only, again over the pads. (The AED will continue to reanalyze.) Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until EMS arrives, the patient is responsive and breathing normally, or someone who's equally trained or better can relieve you. A Couple Special AED Considerations There could be special situations that go beyond what you found in the list that opened this lesson. These include using an AED on a victim who's wearing an implantable device and a victim with an excessive amount of chest hair. Implantable Devices Implantable devices, like pacemakers, are sometimes located below one of the collarbones in the area where one of the AED pads should go. This can be problematic as the device could interfere with shock delivery. An ICD (Implantable Cardioverter-Defibrillator) is another common implantable device you may encounter. It's sort of like a mini version of an AED, as it detects abnormal heart rhythms and restores them to normal. If one of these devices is visible – a small lump can sometimes be seen or felt – or if you know the victim has one in a specific location, do not place the AED pad on top of it. Instead, adjust the placement of the pad to avoid the device. Excessive Chest Hair Chest hair rarely interferes with AED pad adhesion, but it is nonetheless a possibility. If the victim has excessive chest hair, press firmly on the pads when placing them on the victim's chest. If you get an error message, like check pads, or something similar, remove them and replace with new pads. Some of the victim's chest hair will likely come off with the old pads, which may solve the problem. However, if the AED still refuses to work, you'll have to shave the victim's chest (or cut some of the hair) before applying a third round of pads. https://d3imrogdy81qei.cloudfront.net/video_images/3611/adult-aed-lay-rescuer-community-2015.jpg Yes 244 https://www.procpr.org/training/cpr/video/child-cpr-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2024.mp4 Child CPR In this lesson, we'll cover how to perform CPR on a child. Much of the process will look the same as adult CPR, but there are some subtle yet crucial differences to take note of. Like in the last lesson, we'll assume that in this scenario, a child has suddenly collapsed and you don't know why. Pro Tip #1: The victim could be in this condition for any number of reasons and it's not a bad idea to consider some of these when you're doing your assessment of the scene and the victim. Is there a live electrical wire nearby? Could the victim have been bitten by a snake? (Incidentally, these two fictional scenarios also drive home the point of scene safety.) Regardless of what led to the child's condition, all you know for sure is that the victim is unresponsive and not breathing normally, if at all. And that CPR is required. What is a Child? According to guidelines, a child is anyone from one-year to the first signs of puberty. And if you just wondered about ambiguity, you'd be correct to be concerned. Let's say puberty begins around age 14. This can still be problematic since some 14-year olds are tiny, while others are bigger than many adults. Which is why it's a better idea to judge the victim by size rather than by age. This should also help reduce wasted time. Instead of having to think about it, just look, decide, and begin. Pro Tip #2: To complicate matters further, the size of your hands also matters. You see, the size of the patient determines whether you use two hands during chest compressions or just one, which means it's much more a matter of ratio (your hand size to their chest size), than it is their size alone. So, perhaps a better way of deciding whether the victim is "adult-size" or "child-size," is to see how your hands fit over their compression point. Depth Compression Matters The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. Pro Tip #3: While two inches may represent an average chest compression depth for children, it's best not to use a fixed depth. Instead, compress to a depth 1/3 the depth of the chest when performing CPR. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue shield available and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Remember, as long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation. If you've determined at this point that the victim is unresponsive and not breathing normally continue immediately with CPR, beginning with chest compressions. Remember your landmarks, which don't change when performing CPR on children: Aim for the center of the chest, between the nipples and on the lower one-third of the sternum. Hand placement: If you've determined that you should use two hands, based on the size of the victim, place your first palm on that landmark, just as you would for adults, and interlock the fingers on your top hand over your first. One-Hand placement: Place your first palm on the same landmark … and that's it. Lean over the victim, position your hand(s) as indicated above, and in the video, and lock your elbows. Use your upper body weight to supply the force needed for chest compressions and compress at a depth equal to 1/3 the depth of the child's chest. Perform 30 chest compressions at a rate between 100 – 120 compressions per minute, which amounts to around two compressions every second. Remember to allow the child's chest to come all the way back up before performing your next compression. Remember, to maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Lift the child's chin and tilt his or her head back slightly. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the child's nose and open their mouth. Deliver two rescue breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Don't forget to watch the victim's chest when performing chest compressions. If the chest doesn't rise, then you might be dealing with another problem and one that likely includes an obstructed airway. Go right back into 30 chest compressions followed again by two rescue breaths. Continue to perform 30 chest compressions to two rescue breaths until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. https://d3imrogdy81qei.cloudfront.net/video_images/3607/child-cpr-profa-2015.jpg Yes 222 https://www.procpr.org/training/cpr/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/cpr/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/cpr/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/cpr/video/when-cpr-doesnt-work https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2041.mp4 When CPR Doesn't Work This is the last lesson in the cardiac arrest section, and a difficult topic to tackle for most. Whether you're a licensed paramedic, family member, neighbor, or stranger, the question remains the same for many people: Why didn't CPR work? That's a fair question. Even when you do everything perfectly, the desired outcome often isn't what you expected or hoped for. However, some of that hope and desire can be rooted in a misunderstanding of what CPR really is, which is the point of this lesson. CPR was designed to buy time, and nothing more. During cardiac arrest the heart is either in a fibrillatory state, meaning it's wiggling around in a disordered fashion, or it's completely asystolic, meaning it's not contracting at all. When a heart is healthy and operating as it should, it beats from top to bottom in a very organized way utilizing one-way valves. It works perfectly to circulate oxygenated blood throughout the entire body, and it does so efficiently. However, during cardiac arrest, regardless of what caused it, the heart is unable to circulate blood and oxygen and the body begins to die. The patient isn't breathing. There's no pulse. At this point, that person is clinically dead. Now, it doesn't mean that person will remain that way, as there is a difference between clinical death and biological death. What CPR aims to do, specifically the compressions, is to make up for the circulation that isn't happening naturally. The reality, though, is that even when CPR is performed perfectly, it's delivering only a small percentage of what the body needs to survive. It wasn't designed to be equal to artificial life support. Remember, it's simply a way to buy time. People have this idea that if they perform chest compressions on an unresponsive person, the body will remain alive. And he or she will remain alive so long as the chest compressions continue. But this isn't the case. CPR doesn't stop the dying process. It slows down biological death a little. But that's all it does. The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives – an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. – and the underlying cause of the cardiac arrest can be addressed. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival. CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology. The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are. If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact – by performing high quality CPR, you gave the patient the best possible chance of survival. Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way. That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. Now, you may be asking yourself, if CPR rarely works, is it even worth trying? EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying. And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember – we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them. The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough (even strangers) to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live. Isn't that the greatest gift we can give to another? This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. If you've ever performed CPR on a cardiac arrest victim, but the patient still remained dead, hopefully this greater understanding of what CPR really is has brought some peace to you, as the pain, agony, and guilt can be immense. Go forth and rescue confidently! And be at peace with yourself when you do. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/training/cpr/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/cpr/video/community-cpr-introduction https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2109.mp4 Community CPR Introduction Welcome to the ProTrainings' Community CPR. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. And at the end, we'll give you a little information on why learning CPR is so important. Your instructor for the duration of your Community CPR course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and is also a co-founder of ProTrainings. In other words, you're in good hands. We created Community CPR with you in mind. In our busy modern world, it's hard to imagine fitting anything else into our already jam-packed schedules and especially several hours' worth of CPR training. Since your schedule is already hectic, we created Community CPR to be available whenever you are, 24 hours a day, seven days a week. You can squeeze in a quick lesson whenever you have a few minutes to spare, whether it's day or night, weekend or workday. It's there when you need it. Furthermore, you'll be able to absorb the vital skills associated with infant, child, and adult CPR over time by opting in to our email reminder system. Over the next couple of years, you'll continue to receive these refresher video lessons to keep your skills sharp should you ever need them; important skills that you can use in the workplace, and also at home. The list of people that can benefit from the Community CPR course are: Middle and High School Students Parents  People that need CPR but not First Aid certification The total course time includes 2 hours and 2 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual here: Student Manual. What You Will Learn in this Course Your Community CPR course curriculum is quite substantial. The lessons you're about to dive into are as follows: Introductory CPR Training• Welcome to Community CPR• 2015 Guidelines Update - CPR• The Five Fears of CPR Rescue• How to Access EMS Through Technology Medical Emergencies• Heart Attacks• Stroke Universal Precautions• Universal Precautions in the Workplace• Handwashing Cardiac Arrest• Agonal Respiration (Not Breathing Normally)• Adult, Child, Infant CPR• Adult, Child, Infant AED• Hands-Only CPR• When CPR Doesn't Work Choking• Adult, Child, Infant Choking (Conscious)• Adult, Child, Infant Choking (Unconscious) Bleeding Control• Arterial Bleeding• Shock Conclusion• Special Considerations for CPR, AED, & Choking• Conclusion Community CPR certification includes adult, child, and infant CPR. Individuals are free to train, refresh, and test at no charge any time 24/7! The Community CPR certification is nationally accredited and follows the latest American Heart Association, ECC/ILCOR guidelines. This course is great for people who do not need a first-aid certification. Generally, people who need to be certified for daycare or the general workplace (OSHA Compliance) should take our ProFirstAid certification instead, as it includes adult, child, and infant CPR with a first aid component. Those of you old enough to remember may recall that McDonald's signs used to include a running total of the number of hamburgers sold until that number outgrew the sign. When you combine all of the ProTrainings courses, several hundred thousand satisfied people just like yourself have completed one of our courses. And although our numbers aren't growing as quickly as McDonald's, we do sincerely hope that you'll be the next person who has a satisfying experience. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Why Learning High-Quality CPR is Important Community CPR is different from typical CPR courses. We believe that high-quality CPR and first aid training is something everyone should be able to access, for free. So, rather than paying simply to learn CPR, the payment is at the very end and only for those who need a certification card. We also believe that the problem with CPR isn't that everyone is doing CPR incorrectly. The bigger problem is that people aren't doing CPR at all. That's why we start with the "why." Why are people afraid to rescue? What happens when CPR doesn't work? These are just a few of the parts of the training that will make even the most seasoned professional walk away from the course learning something new or thinking about CPR. Gaining confidence in your skills is a big part of performing high-quality CPR. Remembering that as you progress through each lesson will serve you well. Welcome again to Community CPR. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3777/community-cpr-introduction-2015.jpg Yes 48 https://www.procpr.org/training/cpr/video/adult-cpr-community-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2111.mp4 Practice: Adult CPR Learn how to give CPR to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3781/adult-cpr-community-lay-rescuer-practice-2015.jpg Yes 118 https://www.procpr.org/training/cpr/video/child-cpr-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2112.mp4 Practice: Child CPR Learn how to give CPR to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3783/child-cpr-lay-rescuer-practice-2015.jpg Yes 80 https://www.procpr.org/training/cpr/video/unconscious-adult-choking-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2118.mp4 Practice: Unconscious Adult Choking Learn how to give CPR to an adult who is unconscious and choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/training/cpr/video/unconscious-child-choking-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2119.mp4 Practice: Unconscious Child Choking Learn how to give CPR with an AED to a child who is unconscious and choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3797/unconscious-child-choking-lay-rescuer-practice-2015.jpg Yes 112 https://www.procpr.org/training/cpr/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/cpr/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/cpr/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/cpr/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/cpr/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/cpr/video/child-aed-fa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2027.mp4 Child AED AED pads come in an adult size and a pediatric size, for patients less than 8 years old or 55 pounds - roughly 25 kilograms. However, remember, if you do not have pediatric pads and the patient is less than 8 years old or less than 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. If placing the pads on the chest, pads cannot touch. If using adult size pads on a child, you may place them one on the center of the chest and the other on the center of the back to avoid touching, like you would for an infant. Also, remember that when using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? If for some reason the scene isn't safe enough to use an AED, move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. And one last reminder: It's OK if the victim or the victim's clothing is wet, as long as the area where pads will be placed is dry and you or the victim aren't submerged in water or connected by it. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? (With children, shouting their name may help.) If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS.. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. If you've determined at this point that the victim is unresponsive, not breathing normally, continue immediately with your AED. AED Technique for Children Turn on the AED. Remove the patient's clothing to reveal a bare chest. There are two pad placement options for children based on their size. The pads should have a diagram on placement if you need a reminder. Determining the size for pad location can be as simple as if the pads look like they will touch each other on the chest, then use the front and back locations. For small children, attach one AED pad to the center of the child’s chest, roll the child onto his or her side, and attach the second pad to the center of the back, between the shoulder blades.  For larger children placement is the same as an adult. One on the upper right chest, just below the collar bone. The other pad is placed on the lower left side of the chest, mid axillary line, below the breast. Plug the cable into the AED and be sure no one is touching the patient, including yourself. Some AEDs will have the cable already plugged into the device. The AED should now be analyzing the heart rhythm.  The AED will find one of two options, either a shockable rhythm or a non-shockable rhythm. For a shockable rhythm, the AED will charge itself to deliver the shock. If the scene is clear and no one is touching the patient, push the flashing shock button. Some AEDs will shock automatically, so be sure to listen to the directions of the AED. For a non-shockable rhythm or after the AED does shock, we immediately go right back into CPR starting with compressions. It's OK to perform CPR over the pads, so don't worry about moving them. Perform 30 compressions that go about 2 inches deep, or 1/3 the depth of the chest, and at a rate of between 100 and 120 compressions per minute, which amounts to almost two compressions per second. Grab the appropriately-sized rescue mask or face shield and seal it over the victim's face and nose and tilt back the head to open the airway. Breathe into the rescue mask or face shield and wait for the chest to rise and fall before administering the second breath. Continue with 30 compressions to 2 breaths. Every 2 minutes of CPR, the AED will analyze the heart again. Follow the directions and go right back into CPR. Continue this cycle until help arrives, the patient is responsive and breathing normally, the scene becomes unsafe for you, or the next level of care takes over. A Word About AED Precautions When using an AED, there are several precautions to keep in mind. Some of these may be obvious (and a repeat of what you've already learned in this course), while others may not be. Since alcohol is flammable, do not use anything with alcohol on it to wipe the patient's chest or back dry. While it's OK to use adult pads on a child, the reverse isn't entirely true, as pediatric pads may not deliver enough energy to defibrillate the adult patient. Do not touch the patient while the AED is conducting an analysis, as this may affect the analyzation process. Before delivering an AED shock, make sure no one is touching the patient or any of the resuscitation equipment. Do not use an AED if there are flammable or combustible materials or gases present. Do not operate an AED inside a moving vehicle, as the movement can affect the analysis and shock incorrectly. Do not use an AED if the victim is in contact with free-standing water or in the rain. Move the patient first. Do not place AED pads on top of any patches or implantable devices. Remove patches first and adjust the pads as necessary to avoid devices like a pacemaker.   https://d3imrogdy81qei.cloudfront.net/video_images/3613/child-aed-fa-2015.jpg Yes 250 https://www.procpr.org/training/cpr/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/cpr/video/infant-aed-fa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7176.mp4 Infant AED In this lesson, you'll learn how to use an AED on an infant who's gone into cardiac arrest. The methods of defibrillating an infant differ a little from adults and children, so be sure and make note of those differences. As you know, AED pads come in two sizes – adult and pediatric. Pediatric pads are for patients less than 8 years old or 55 pounds or roughly 25 kilograms, while adult pads are for anyone 8 years and older or weighing more than 55 pounds. So, since we are talking about infants, we will always opt for the pediatric pads. However, if you do not have pediatric pads available, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. Studies have shown using adult pads to be safe and effective based on the limited data available. Pro Tip #1: Some AEDs have a key or button that can be used for switching to pediatric energy levels. Be sure to use pediatric settings or pads when possible. Infant-related cardiac arrests are typically the result of: Drowning Choking/airway obstruction Electrocution This is important for reasons of scene safety. If the infant was pulled from a pool, is he or she laying in too much water to safely use an AED? If the infant was electrocuted, is the source of that electricity still a threat? It's always important to make sure the scene is safe before helping another person, but it's especially important when using an AED, where one spark can cause a lot of problems in the wrong situation. (And why we often mention combustible gases and flammable liquids in our scene safety warnings.) How to Provide Care Just like the last two AED lessons, we're going to assume a few things: The scene is safe, and your gloves are on You or someone else has called 911 You have an AED that's ready to use The infant is already in cardiac arrest (not breathing, not conscious, not moving) CPR is already in progress AED Technique for Infants Turn on the AED. Remove the infant's clothing to reveal a bare chest and dry the chest off if it's wet. Since one pad will go on the infant's back, be sure that area is also accessible and dry. Attach one AED pad to the infant's chest, roll the baby over onto his or her side carefully while supporting the head and neck, and attach the second pad to the center of the infant's back between the shoulder blades. Pro Tip #2: The AED should include a diagram on pad placement if you ever need help. And make sure they adhere well and aren't peeling off, as this will affect the AED's effectiveness. Plug the cable into the AED and be sure no one is touching the victim. The AED should now be analyzing the rhythm of the infant's heart. The AED will automatically charge if the AED finds a shockable rhythm. If the scene is clear and no one is touching the victim, push the discharge button to deliver a shock. Then go right back into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Remember, you want to minimize compression interruptions. Don't delay or interrupt compressions any longer than absolutely necessary and this includes after a shock is delivered. Go right back into your compressions. Perform 30 chest compressions. Grab the rescue shield and place it over the victim's mouth and nose. Seal your mouth over the infant's mouth and nose. Deliver two rescue breaths – Breathe into the rescue mask slowly (over one second) and watch for the chest to rise, then stop. Wait for the chest to fall before administering the next breath, this is about two seconds between breaths. Continue with CPR until the AED interrupts you. At some point, it will reanalyze the victim's heart rhythm and again advise you on what to do next. If the AED advises a shock, do that. If it advises you to NOT shock the victim, continue with CPR only, again over the pads. (The AED will continue to reanalyze.) Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until EMS arrives, the patient is responsive and breathing normally, or someone who's equally trained or better can relieve you. A Few Common Questions About AED Use Why is it so important to not disrupt or delay CPR compressions? Current research suggests that minimizing all delays is important for victim recovery, including that first compression after an AED shock. Compressions immediately help get the victim's pulse pressures back up and oxygenated blood circulating again. Will a wet diaper cause a problem with an AED? No. As wetness concerns AED use, as long as the victim isn't submerged in a pool or puddle of water, you should be fine. Keep in mind that the only areas that need to be dry are those where the pads will go. Can I remove the pads if the victim begins breathing normally again? No. Keep the pads on until EMS or other advanced medical personnel take over. The AED will continue monitoring the victim and will advise you again should problems arise, so keep the pads on and the AED turned on. https://d3imrogdy81qei.cloudfront.net/video_images/13012/infant-aed-2025.jpg Yes 329 https://www.procpr.org/training/cpr/video/infant-cpr-profa https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7172.mp4 Infant CPR Infant-related cardiac arrests are typically the result of: Drowning Choking/airway obstruction Electrocution Just as with child CPR, due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the infant is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on his or her forehead and tap on the bottom of the baby's feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check the infant for breathing - you don’t see any. If you've determined at this point that the victim is unresponsive and not breathing normally, continue immediately with CPR. CPR Technique for Infants Place two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should wrap around the chest. Alternatively, you can give compressions using the heel of 1 hand in the center of the chest. Conduct 30 compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face.  Place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About CPR Compression Rate and Depth Performing proper chest compressions is essential for providing high-quality CPR, which greatly improves the patient's chances for a successful outcome. Chest compressions put pressure on the heart to send oxygenated blood through the arteries to the brain and other vital organs. Chest compressions also increase the likelihood of a successful AED shock for the patient, particularly if several minutes have elapsed since the patient collapsed or suffered an incident leading to respiratory distress. Chest compression effectiveness is reduced if: Compressions are too shallow The compression rate is too fast or too slow There isn't a full recoil of the chest cavity There are interruptions during CPR The patient isn't laying on a firm, flat surface Warning: Compression rates that exceed 120 per minute tend to have a negative impact on compression depth, perhaps due to responders rushing through them. Regardless, if the compression rate exceeds 120 per minute, you are less likely to compress the full 1/3 of the chest for infants and children, thereby reducing the effectiveness of CPR. If you are unsure if you're compressing at the correct depth, a feedback device might be helpful. https://d3imrogdy81qei.cloudfront.net/video_images/13004/infant-cpr-2025.jpg Yes 357 https://www.procpr.org/training/cpr/video/adult-aed-community-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2115.mp4 Practice: Adult AED Learn how to give CPR with an AED to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3789/adult-aed-community-lay-rescuer-practice-2015.jpg Yes 220 https://www.procpr.org/training/cpr/video/child-aed-lay-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2116.mp4 Practice: Child AED Learn how to give CPR with an AED to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3791/child-aed-lay-rescuer-practice-2015.jpg Yes 211 https://www.procpr.org/training/cpr/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/cpr/video/conscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7180.mp4 Conscious Child Choking This conscious child choking lesson is for situations where you can see that a child is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. Remember to only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing the victim. How to Provide Care The first thing you want to do is face the child and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the child. "Are you choking?" The child will probably nod yes. "May I help you?" You'll likely get another nod. Don't wait too long to receive permission, as children may be a little more flustered than adults. Pro Tip #1: With children, they may not have the same level of awareness as adults. If they're only nodding or making gagging, high-pitched squeaking sounds, these are good indications that the airway is fully obstructed. Pro Tip #2: If the child can respond verbally, that means that they are able to move enough air past the larynx to speak. This is a good indication that something may be stuck but that the airway isn't obstructed. Or it could indicate a partial obstruction of the airway. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Blows Technique for Children Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. You may kneel if needed. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts.   Abdominal Thrust Technique for Children Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. Warning: It's important that when helping a choking victim who's shorter than yourself, that you lower yourself to their height. This will limit unnecessary pressure on the rib cage and prevent broken ribs or other possible harm while you perform the abdominal thrusts. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Remember to stay below the bottom tip of the rib cage (xyphoid process) and above the belly button. This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Lower yourself to the height of the child. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your hands upward as you perform each thrust. Perform five abdominal thrusts unless the object comes out or the child becomes unresponsive. Remember to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. If after the five abdominal thrusts, the object is still not out, alternate between 5 back blows and 5 abdominal thrusts. Once the object comes out, the child will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the child know that he or she is OK now and have them sit down if necessary. Children may experience more confusion and fear than adults, so letting them know that they'll be fine is important. If you called 911, let them come anyway, so the child can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there are no interal injuries. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the child into an urgent care center, hospital, or to see their physician. With children, don't leave it up to them to determine if more care is necessary. If you weren't able to remove the obstruction using the abdominal thrust technique, the child will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious child choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/training/cpr/video/conscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7181.mp4 Conscious Infant Choking This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak or babble or make any noise Their lips are beginning to show signs of circumoral cyanosis – a blue ring around the lips that indicates early signs of oxygen starvation Signs that the infant is conscious include: The baby is still moving around The baby's eyes are open Remember to activate EMS as soon as possible so long as it doesn’t delay care. If possible, have another person nearby call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant. How to Provide Care Helping a conscious choking infant isn’t significantly different than helping a child or an adult. You'll still be performing a combination of back slaps and thrusts to try and dislodge the airway obstruction. The biggest difference between infants when compared to adults or children, rather than performing abdominal thrusts, for infants we need to make sure we are performing chest thrusts rather than abdominal thrusts. Warning: Due to the fragile nature of infants performing abdominal thrusts on them could cause severe internal injuries. Chest thrusts should be used for conscious choking infants. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Rest your forearm on your leg for additional support. Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Place the heel of your hand on the sternum in the center of the infant's chest. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is extremely effective if you perform the back slaps and chest thrusts properly. If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. A Word About Pediatric Considerations Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children. The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children: Hot dogs Nuts and seeds Chunks of meat or cheese Whole grapes Hard, gooey or sticky candy Popcorn Chunks of peanut butter Raw vegetables Raisins Chewing gum According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy. It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.  https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/training/cpr/video/unconscious-child-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2034.mp4 Unconscious Child Choking In this lesson, you'll learn how to help a choking victim who is an unconscious child. Just as with our last fictional choking scenario, this victim went unconscious while you were trying to help them. Much of this lesson will look exactly like the unconscious adult choking lesson that you just finished. However, keep in mind that we learn through repetition and you can always expect a nugget or two (or seven) that wasn't in the last lesson. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy. Help lower the child to the ground or floor, so they don't sustain a trauma from a hard fall. Pay extra attention to supporting their head and neck. Call 911 and activate EMS if you haven't already done so. Enlist the help of a bystander if one is available. Locate the area over the heart to begin chest compressions. Pro Tip #1: While likely a refresher, it's important to remember your CPR compressions landmark – center of the chest on the lower third of the sternum. And don't forget, that to maximize cardiac output, position yourself directly over the victim's chest and not off to one side. If you're not directly over the heart, you may not adequately compress it. Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Remember, once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Lift the victim's chin and tilt his or her head back slightly. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Grab the rescue shield and place it over the victim's mouth and nose. Pinch the victim's nose and open their mouth. Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness. Remember, we're assuming your chest compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compression to two rescue breaths. Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again. A Few Common Random Questions that (may) Pertain to Choking Victims What are the differences between child CPR and adult CPR? There are three distinct differences to be aware of. Opening the Airway While the same head tilt maneuver is applied to children as it is for adults, make sure there is less hypertension in a child's neck compared to adults. To do that, simply tilt the head back only slightly past neutral. Your goal is a chin angle that's less pronounced and more perpendicular to the ground. Remember, with infants, that tilt is even less pronounced, as in neutral or slightly sniffing. With infants, it's more about distancing the chin from the chest, due to a neck that's still in the stubby stage. Performing Compressions The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. And in very small children, it's better to perform compressions using just one hand. But since human beings tend to come in many different sizes, stick to your 1/3 the depth of the chest and you'll never be wrong. Using AEDs As you recently learned, AEDs work the same regardless of age. However, the pads themselves, as well as pad placement, will vary based on the size of the victim. If your cardiac arrest victim weighs more than 55 pounds, continue using the adult AED pads. If the victim weighs less than 55 pounds, use pediatric AED pads if available. And yes, you'll have to guess when it comes to their weight. How well do compressions work for dislodging an obstruction? Just because your choking victim went unconscious, there's no reason to panic, as chest compressions work surprisingly well for removing airway obstructions. Performing those compression perfectly will also help. If the victim begins breathing again but it's not “normal breathing”, what are some signs I can look for? Just as there are many reasons why a person would experience respiratory or airway issues, there are also numerous signs and symptoms that can alert you to a problem, including: The person is unable to speak, can only speak a few words, or has a hoarse-sounding voice excessive use of abdominal muscles to breathe muscles between the ribs pull in on inhalation pursed lips breathing nasal flaring fatigue Adequate breathing means that respiratory rate – 12-20 for adults, 15-30 for children, 25-50 for infants – depth and effort are all normal. https://d3imrogdy81qei.cloudfront.net/video_images/3627/unconscious-child-choking-first-aid-2015.jpg Yes 190 https://www.procpr.org/training/cpr/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/cpr/video/unconscious-infant-choking-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7182.mp4 Unconscious Infant Choking This unconscious infant choking lesson is for situations where you find an infant who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the infant isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction. In this scenario, you would treat this patient as an unconscious infant choking victim. The method of care will closely resemble performing CPR on an infant, however there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the infant to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Pro Tip #1: While repetitive and maybe not necessary, it bears repeating: The prevalence of technology has reached a point where everyone has a cell phone or mobile device. And those devices tend to have speakers making them hands-free. Also remember that in an emergency your adrenaline will likely be spiked and your brain mildly dazed and confused. If you're having trouble remembering your rescue skills, dispatch can help. Draw an imaginary line across the infant's nipples and place your two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should be wrapping around the infant’s chest. Alternatively, you may also use the heel of one hand in the center of the chest. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, and count as you perform them. Conduct 30 chest compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #2: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face. If you have an infant mask, use that.  If you can, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Here’s the difference between CPR and unconscious choking - open the airway and look for the object before giving your two breaths. If you see the object, use your pinky finger to sweep out the object. Never do a finger sweep unless you see the object. Place the rescue mask and breathe into the mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. Pro Tip #3: Because infants' mouths are small, it's best to use your pinky finger combined with a hooking motion to sweep out obstructions. If the rescue breaths go in this time – causing the chest to rise and fall – check for breathing. If after no more than 10 seconds, you do not see, hear, or feel breathing, start CPR. >Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. https://d3imrogdy81qei.cloudfront.net/video_images/13024/unconscious-infant-choking-2025.jpg Yes 217 https://www.procpr.org/training/cpr/video/shock-lay-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7184.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. It is a serious and potentially life-threatening condition that requires immediate medical care as it is a multi-symptom and complex condition. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. There are several types of shock, including psychological shock – a psychological condition in which worry and concern send a person into shock, rather than a physical condition. While this shock lesson is in the bleeding control section, it's important to understand that any first aid emergency could send a person into shock. Pro Tip #1: The important thing to remember with shock is that the symptoms are the same regardless of what contributes to it. It's a serious condition that warrants rapid treatment and an immediate 911 call. Besides psychological shock, there are four main types. The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #2: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue mask with a one-way valve available if necessary. Warning: If at any point the victim stops breathing normally or becomes unresponsive, begin CPR (or rescue breathing) immediately and continue until medical professionals arrive. Pro Tip #3: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #4: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. A Few Common Shock Questions Are there any tests I can perform on the victim to better help identify shock? If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail bed. If it's more than a few seconds – or the time it takes to say capillary refill – your victim is likely in shock. How do I know when to call 911? It's always better to be safe than sorry, so call 911 any time it's an actual emergency or if you're unsure what to do or overwhelmed, and how exactly that's defined will vary from rescuer to rescuer. However, as it pertains to this lesson, always call 911 immediately as soon as you suspect shock or as soon as the victim loses consciousness or begins having breathing issues. In other words, err on the side of victim safety. https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/training/cpr/video/2025-guidelines-update-for-cpr-and-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7289.mp4 2025 Guidelines Update for CPR and First Aid for All Ages In this lesson, we're going to summarize the latest information from the 2025 American Heart Association Emergency Cardiovascular Care guidelines as they relate to lay rescuer CPR. The goal of these guideline changes is simple: improve survival by improving early recognition, high-quality CPR, and early defibrillation. For out-of-hospital cardiac arrest, survival rates depend heavily on what happens in the first few minutes. The 2025 ECC updates continue to emphasize that early action by lay rescuers is what saves lives. Many of the changes you'll see focus on improving CPR quality, reducing delays, and removing the barriers that prevent people from stepping in to help. Initiation of Resuscitation for Adults The ECC continues to reinforce the importance of CPR with breaths in adult cardiac arrest. For trained rescuers who are able to provide ventilations safely, compressions and breaths should be delivered together. If a rescuer is not trained or does not have the ability to give breaths, hands-only CPR can be used, as providing compressions alone is far better than doing nothing at all. Whenever feasible, and without delaying chest compressions, CPR should be performed where the person is found, as long as high-quality CPR can be delivered safely and effectively. It's preferred that the patient be on their back, on a firm surface, since firm surfaces improve compression depth and effectiveness. Delays caused by unnecessary movement of the patient are associated with worse outcomes. When possible, chest compressions should be performed with the patient's torso positioned approximately at the level of the rescuer's knees to allow better body mechanics and improved compression depth. Rescuers may also consider placing their dominant hand on the sternum when performing compressions, which may further improve overall CPR quality. Pro Tip #1: The key takeaway is this: don't delay chest compressions. If high-quality CPR can be delivered safely where the patient is found, begin it immediately. This was re-emphasized to include the giving of breaths for high-quality CPR. AED Use and Patient Dignity AEDs have become more widely available and continue to prove their effectiveness everyday. However, statistically, women have a much lower rate of AED use than men. So while the 2025 guidelines address the importance of early AED use, the emphasis was particularly for women. Evidence suggests that the need to expose the chest may contribute to lower rates of AED use in female patients. While proper pad placement is always preferred, current evidence shows that successful defibrillation can still occur even when pad placement is not perfect. What this means is rather than the need to remove all clothing from the chest, it's reasonable to just adjust the clothing and apply AED pads under clothing, directly to the skin.> Pro Tip #2: If needed, rather than removing all clothing from the chest, simply adjust clothing, including bras, to have appropriate pad placement on the skin. This has been shown to be safe and effective Foreign Body Airway Obstruction In conscious adults and children with severe foreign body airway obstruction, rescuers should perform repeated cycles of 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unresponsive. Ironically, the back blows are something that was taught years ago. However, this sequence reflects evidence suggesting that back blows may be more effective and cause fewer injuries than abdominal thrusts alone. Remember, for patients in late-stage pregnancy or the rescuer cannot reach their arms around the victim’s waist, chest thrusts should be used instead.  Pro Tip #3: A key update in 2025 is that chest thrusts for infants should now be performed using the heel of one hand, placed in the center of the chest, rather than the previously recommended two-finger technique. This change is based on evidence showing improved compression depth and effectiveness during severe airway obstruction.   Cardiac Arrest Following Drowning When an adult or child is rescued from the water and unconscious and not breathing, CPR with breaths should be started before AED application. Further, if you are in a position that full CPR cannot be started, just performing breaths can still be helpful. This is due to drowning-related cardiac arrest being caused by low oxygen levels. So the idea here is that If we apply the AED immediately without providing ventilations, we still have not addressed the cause of the cardiac arrest. If we delay the application of the AED for a short amount of time, we can provide the needed oxygen back into the victim to stabilize the underlying issue in the first place. Then, when applying and using an AED, resetting the heart should be more effective. Eye Injuries with an Embedded Foreign Object A small but important update: when caring for a person with a foreign object embedded in the eye, rescuers should now cover only the affected eye rather than both eyes. This change is intended to reduce anxiety in the patient by allowing them to maintain vision in the unaffected eye. The previous concept was that if you covered both eyes, then that would reduce the movement of the good and the injured eye. Data is showing that with the increased anxiety and potential for further injury caused by the temporary blindness, it would be safe to just bandage the injured eye.  ProTip #4: Our goal is to prevent any further injury to the eyes. Protect the injured eye(s) from any excessive pressure with a shield or cup and seek immediate medical attention. Managing Shock When caring for a person showing signs of shock who remains alert, it is reasonable to place or maintain them on their back. If the person is at risk for airway obstruction — such as decreased alertness or active vomiting — or if they cannot be continuously monitored, it is reasonable to place them in the recovery position, on their side. While elevating the feet has been shown occasionally to help the patient, the effects are often short lasting only a few minutes. Pro Tip #5: In situations where there is no evidence of trauma or injury, such as fainting or dehydration, some studies suggest that raising the feet approximately 6 to 12 inches may still be beneficial. Though our main focus is getting the patient safely to the ground, keeping them warm and monitoring them for airway concerns, such as vomiting, or the need for CPR. A Unified Chain of Survival The 2025 guidelines introduce a single, standardized Chain of Survival that now applies to infants, children, and adults. This unified approach emphasizes early recognition, early CPR, early defibrillation, advanced care, and recovery as a continuous process across all age groups. CPR in Infants and Children In infants and children, studies consistently show that CPR with both compressions and breaths provides the best chance of survival. However, if a lay rescuer is unable or unwilling to provide breaths to an infant or child in cardiac arrest, compression-only CPR is still reasonable. Large observational studies show that compression-only CPR is far better than providing no CPR at all, and significantly improves survival outcomes compared to no bystander intervention. Lastly, further evidence shows that using 2 fingers for infant chest compressions or chest thrusts are minimally effective. Therefore, the ECC has eliminated the use of two-fingers and recommends using a two-thumb hand encircling technique or the heel of one hand. You will see further demonstrations of both techniques throughout the course. Closing Thoughts The 2025 ECC CPR guideline updates continue to reinforce a simple but powerful message: early recognition, early CPR, and early defibrillation save lives. These updates are designed to improve CPR quality, reduce delays, and remove the barriers that prevent rescuers from acting — whether that rescuer is a parent, a bystander, or a trained professional. Guidelines will continue to evolve as new science emerges, but the mission remains the same: recognize the emergency, take action, and do the best you can. CPR doesn't need to be perfect to save a life. Doing something is always better than doing nothing, and confident, informed rescuers make a measurable difference. https://d3imrogdy81qei.cloudfront.net/video_images/13120/2025-guidelines-update-for-cpr-and-first-aid.jpg Yes 458 https://www.procpr.org/es/training/cpr/video/sangrado-arterial-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2036.mp4 Sangrado arterial El sangrado arterial se caracteriza por una sangre roja más brillante que puede palpitar o chorro. Aplique presión directa con un vendaje. Si hay fugas de sangre, aplique más apósitos en la parte superior. Nunca quite un vendaje. Una vez que el sangrado está bajo control, use gasa de rodillo para asegurar el vendaje, comenzando en el extremo distal y trabajando hacia el corazón. Usted puede girar la gasa para aplicar más presión. Asegúrese de que la sangre no esté goteando y que el vendaje no tenga efecto de torniquete. Eleve la herida y llame a EMS o lleve al paciente al hospital más cercano. https://d3imrogdy81qei.cloudfront.net/video_images/3631/arterial-bleeding-child-2015.jpg Yes 236 https://www.procpr.org/es/training/cpr/video/asfixia-adulto-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2033.mp4 Asfixia en adulto inconsciente Una vez que una víctima de asfixia se convierte en inconsciente, asegúrese de que EMS se ha activado. Dar 30 compresiones torácicas. Compruebe el objeto en la boca del paciente y barrerlo si es posible. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Si todavía no entra aire, realice 30 compresiones torácicas, revise el objeto nuevamente y, si es posible, retírelo. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Continúe este proceso hasta que la vía aérea esté abierta y el aire entre en los pulmones. https://d3imrogdy81qei.cloudfront.net/video_images/3625/unconscious-adult-choking-first-aid-2015.jpg Yes 160 https://www.procpr.org/es/training/cpr/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/cpr/video/adulto-rcp-rescatista-lego-comunidad-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2023.mp4 RCP en adultos La RCP para adultos se realiza comprobando la capacidad de respuesta del paciente, la respiración anormal y el contacto con los servicios de emergencia. A continuación, compruebe si hay un pulso durante 10 segundos como máximo y comience la RCP si el paciente no tiene pulso. Realice 30 compresiones a una velocidad de 100-120 por minuto ya una profundidad de 2-2.4 pulgadas en el centro del pecho. Estas 30 compresiones deben ser seguidas de dos respiraciones de rescate, y repetir el ciclo hasta que llegue un DEA o servicios de emergencia. https://d3imrogdy81qei.cloudfront.net/video_images/3605/adult-cpr-lay-rescuer-community-2015.jpg Yes 216 https://www.procpr.org/es/training/cpr/video/respiracion-agonica-no-respirar-normalmente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2022.mp4 Respiración agónica (no respirar normalmente) Un signo de parada cardiaca se describe como respiración agonal. Esto ocurre cuando una persona está haciendo un jadeo o tragarse el movimiento y no está respirando normalmente. La respiración agónica ocurre en el 40% de los paros cardiacos tempranos. Saber cuándo una persona es respiratoria agonal puede prevenir intentos agresivos de RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/es/training/cpr/video/adulto-dea-rescatista-lego-comunidad-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2026.mp4 DEA en adultos Si el paciente es un paro cardiaco presenciado, compruebe primero para asegurar que la escena es segura. Compruebe la capacidad de respuesta del paciente y póngase en contacto con los servicios de emergencia. Compruebe si hay un pulso durante no más de 10 segundos. Encienda el DEA si el paciente no tiene pulso y no respira. Adjunte las almohadillas AED al paciente, y no toque al paciente mientras se analiza el DEA. Después de un choque se entrega, comenzar la RCP durante unos 5 ciclos o dos minutos. El DEA se interrumpirá después de dos minutos y volverá a analizar al paciente. Siga las instrucciones del AED hasta que llegue el soporte de vida avanzado. https://d3imrogdy81qei.cloudfront.net/video_images/3611/adult-aed-lay-rescuer-community-2015.jpg Yes 244 https://www.procpr.org/es/training/cpr/video/rcp-ninos-pro-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2024.mp4 RCP en niños Si un niño no responde y no está respirando, comience la RCP. Realizar compresiones torácicas con una mano en el centro del pecho durante treinta compresiones. Estas compresiones deben realizarse a una profundidad de por lo menos 1/3 de la profundidad del pecho. Dar dos respiraciones más, seguido por 30 compresiones, y repetir hasta que el niño revive o un DEA está disponible, o avanzado soporte de vida llega. https://d3imrogdy81qei.cloudfront.net/video_images/3607/child-cpr-profa-2015.jpg Yes 222 https://www.procpr.org/es/training/cpr/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/cpr/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/cpr/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/cpr/video/cuando-rcp-no-funciona-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2041.mp4 Cuando la RCP no funciona La RCP es un intento de compensar la circulación en el corazón que no está sucediendo normalmente. La RCP no detiene el proceso de morir; Simplemente disminuye la muerte celular biológica. La esperanza es que este procedimiento puede comprar tiempo para que el ccsme llegue a probar otros métodos de restaurar la circulación apropiada de la sangre oxigenada por todo el cuerpo para comprar aún más tiempo de modo que la razón subyacente por la cual la persona entró en paro cardiaco en el primer lugar puede ser Explorado Si la RCP no funciona, recuerde que le dio a esa persona la mejor oportunidad de sobrevivir. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/es/training/cpr/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/cpr/video/introduccion-rcp-comunidad https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2109.mp4 Introducción a RCP para la comunidad Bienvenido a ProTrainings Community CPR. Roy Shaw es un paramédico licenciado y su instructor para este curso. Aprenda a su propio ritmo y disfrute. https://d3imrogdy81qei.cloudfront.net/video_images/3777/community-cpr-introduction-2015.jpg Yes 48 https://www.procpr.org/es/training/cpr/video/cpr-adulto-comunidad-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2111.mp4 Práctica: RCP en adultos Aprenda a dar CPR a un adulto que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3781/adult-cpr-community-lay-rescuer-practice-2015.jpg Yes 118 https://www.procpr.org/es/training/cpr/video/cpr-nino-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2112.mp4 Práctica: RCP en niños Aprenda a darle RCP a un niño que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3783/child-cpr-lay-rescuer-practice-2015.jpg Yes 80 https://www.procpr.org/es/training/cpr/video/asfixia-adulto-inconsciente-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2118.mp4 Práctica: Asfixia en adulto inconsciente Aprenda a dar RCP a un adulto que está inconsciente y ahogándose observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3795/unconscious-adult-choking-lay-rescuer-practice-2015.jpg Yes 95 https://www.procpr.org/es/training/cpr/video/asfixia-nino-inconsciente-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2119.mp4 Práctica: Asfixia en niño inconsciente Aprenda a dar RCP con un DEA a un niño que está inconsciente y ahogándose observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3797/unconscious-child-choking-lay-rescuer-practice-2015.jpg Yes 112 https://www.procpr.org/es/training/cpr/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/cpr/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/cpr/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/cpr/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/cpr/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/cpr/video/dea-nino-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2027.mp4 DEA en niños Compruebe la capacidad de respuesta del paciente, póngase en contacto con los servicios de emergencia y compruebe si hay un pulso. Encienda el DEA si el paciente no está respirando normalmente. Adjunte las almohadillas DEA al paciente, y no toque al paciente mientras se analiza el DEA. Después de un choque se entrega, comenzar la RCP durante unos 5 ciclos o dos minutos. El DEA se interrumpirá después de dos minutos y volverá a analizar al paciente. Siga las instrucciones del DEA hasta que llegue el soporte de vida avanzado. https://d3imrogdy81qei.cloudfront.net/video_images/3613/child-aed-fa-2015.jpg Yes 250 https://www.procpr.org/es/training/cpr/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/cpr/video/dea-bebe-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7176.mp4 DEA en bebés https://d3imrogdy81qei.cloudfront.net/video_images/13012/infant-aed-2025.jpg Yes 329 https://www.procpr.org/es/training/cpr/video/rcp-bebe-pro-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7172.mp4 RCP en bebés https://d3imrogdy81qei.cloudfront.net/video_images/13004/infant-cpr-2025.jpg Yes 357 https://www.procpr.org/es/training/cpr/video/dea-adulto-comunidad-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2115.mp4 Práctica: DEA en adultos Aprenda a dar RCP con un DEA a un adulto que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3789/adult-aed-community-lay-rescuer-practice-2015.jpg Yes 220 https://www.procpr.org/es/training/cpr/video/dea-nino-rescatista-lego-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2116.mp4 Práctica: DEA en niños Aprenda a dar CPR con un DEA a un niño que está inconsciente y no respira observando el procedimiento realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3791/child-aed-lay-rescuer-practice-2015.jpg Yes 211 https://www.procpr.org/es/training/cpr/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/cpr/video/asfixia-nino-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7180.mp4 Asfixia en niño consciente https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/es/training/cpr/video/asfixia-bebe-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7181.mp4 Asfixia en bebé consciente https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/es/training/cpr/video/asfixia-nino-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2034.mp4 Asfixia en niño inconsciente Una vez que un niño asfixia víctima se convierte en inconsciente, asegúrese de que EMS se ha activado. Dar 30 compresiones torácicas. Compruebe el objeto en la boca del paciente y barrerlo si es posible. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Si todavía no entra aire, realice 30 compresiones torácicas, revise el objeto nuevamente y, si es posible, retírelo. Intente respirar. Si no hay aumento de pecho y caída, reposicione la vía aérea e intente otra respiración. Continúe este proceso hasta que la vía aérea esté abierta y el aire entre en los pulmones. https://d3imrogdy81qei.cloudfront.net/video_images/3627/unconscious-child-choking-first-aid-2015.jpg Yes 190 https://www.procpr.org/es/training/cpr/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/cpr/video/asfixia-bebe-inconsciente-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7182.mp4 Asfixia en bebé inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/13024/unconscious-infant-choking-2025.jpg Yes 217 https://www.procpr.org/es/training/cpr/video/conmocion-rescatista-lego-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7184.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13028/shock-2025.jpg Yes 143 https://www.procpr.org/es/training/cpr/video/2025-guidelines-update-for-cpr-and-first-aid-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7289.mp4 Actualización de las Guías 2025 - RCP y primeros auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13120/2025-guidelines-update-for-cpr-and-first-aid.jpg Yes 458 https://www.procpr.org/training/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/video/agonal-respiration-not-breathing-normally https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2022.mp4 Agonal Respiration (Not Breathing Normally) Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations. Agonal respiration is one sign of respiratory and cardiac arrest. Historically, this type of breathing has been difficult to identify and describe, especially for lay people, which can slow or hinder care and response times for cardiac arrest victims. A Word About Cardiac Arrest Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate blood to vital organs, including the brain. When heartbeats are weak, irregular, or uncoordinated, blood can't flow through the arteries to the rest of the body. If circulation is hampered or halted in any way, the body's organs cannot receive the oxygen they need to function normally. As a result, organ failure can occur. Brain damage sets in between 4-6 minutes, and after 8-10 minutes, this damage will likely be irreversible. Cardiovascular disease is the leading cause of death in the world and in the U.S., where it accounts for approximately 1 in 3 deaths. Cardiovascular disease is also the primary cause of cardiac arrest, but there are others, including: Drowning Choking Drug overdose Severe injury Brain damage Electrocution Warning: As more than 300,000 out-of-hospital cardiac arrests occur each year in the U.S., it's vital that lay rescuers and EMS professionals understand that early recognition – which is more difficult with agonal respiration – and quick action can have a tremendous impact on survival rates. Cardiac Chain of Survival To effectively respond to cardiac emergencies, it helps to understand the Cardiac Chain of Survival. Following the links in these chains – adult and pediatric – will give patients the best chance of survival. Warning: For each minute that CPR and/or defibrillation are delayed, the chance of survival is reduced by 7-10 percent. Adult Cardiac Chain of Survival Recognize the emergency and call 911 – the sooner medical personnel are called the sooner EMS can provide care for the patient. Early CPR – supplying blood and oxygen to vital organs can prevent brain damage and death. Early defibrillation – this electrical shock may restore an effective heart rhythm and increase the victim's chance of survival. Advanced life support – Medical personnel can help provide the proper equipment and medication needed to continue lifesaving care. Integrated post-cardiac arrest care – Integrated care can optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. Pediatric Cardiac Chain of Survival Injury prevention and safety – ways to prevent cardiac arrest in children. Early CPR Early Emergency Care – Rapid activation of the EMS system or response team to get help on the way quickly. Pediatric advanced life support Integrated post-cardiac arrest care Agonal Respiration Continued Agonal respiration is characterized by abnormal breathing attempts in which the patient appears to be gasping or gulping. (Think of a fish as it tries to breathe out of the water to get an idea of what agonal respiration looks like.) These respiratory attempts originate from the lower brain stem neurons as higher, more complex neurons become increasingly hypoxic – lacking in oxygen. Agonal Respiration occurs in around 40 percent of early cardiac arrest victims. Aggressive CPR attempts are often hindered or slowed due to misinterpretation or misunderstanding of this serious condition. Pro Tip #1: It's important to remember that, when it comes to agonal respiration, these attempts from the body to breathe are routinely misinterpreted as normal breathing. However, even though it may appear the victim is breathing, he or she is not exchanging air well and will require immediate assistance to increase his or her survival rate. While lay rescuers describe agonal respiration in a number of ways, the good news is that 911 dispatchers have become better equipped to recognize all the ways in which people describe it, leading to better assistance and improved response times. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/training/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/video/adult-cpr-team-approach https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2090.mp4 Adult CPR Team Approach This lesson focuses on the team approach to CPR when three or more responders or healthcare professionals are involved. There are three main takeaways from this section: It's important to establish who the team leader is in any team approach to life support. The team leader is the orchestrator for everyone else in the rescue process and directs all the action. It's important for all involved to communicate effectively, and to use what's known as closed-loop communication. Closed-loop communication refers to a command (from the team leader) that has been heard by the team member executing that command and repeated back. This establishes that each command is understood and about to be executed. It's also important to take notes and log times. This includes all facets of the rescue attempt – when chest compressions begin, when the first shock is executed, what drugs are being administered and when, etc. The Role of Team Leader The team leader is orchestrating the actions of the other team members – who is doing what and when – but also monitoring the others for quality assurance. If the team leader sees that something is being done incorrectly or could be improved upon, it's his or her job to point out the intended improvement or change in rescue care and encourage that team member through positive reinforcement. A Typical Division of Duties in a Three-Team-Member Approach Responder one: Begins performing the correct number of chest compressions based on the size of the patient and counting out loud. Responder two: Takes a position at the victim's head and readies the bag valve mask for use, performing two rescue breaths after a round of compressions have been completed and making sure that the chest rises and falls each time. Responder three: Takes notes of responder one and two's actions and times of each action. Responder three will also assist in some other aspect of care, if needed, including getting the AED ready. Responder three is also ready to jump in elsewhere when the switch occurs – when the compressor's two minutes are up and responder one switches places with responder two or three. All three responders are communicating all vital information to the rest of the team while they work. The team leader will indicate when a switch is about to occur, who is taking over for whom, if an IV should be established, what drugs will go into the IV, as well as dosages, and other important information and directives. A good team approach is vital in a rescue situation. It ensures that everyone is doing his or her job to the highest standards of care. In short, good practices and habits in a team approach leads to more saved lives. A Word About Advanced Airways If a patient has an advanced airway such as a supraglottic airway device or an endotracheal tube, CPR will be performed a little differently. A supraglottic airway device, which allows for improved ventilation, is an advanced airway that does not enter and directly protect the trachea like an endotracheal tube. When using a supraglottic airway device, like a laryngeal mask airway, a minimum of two responders must be present. Responder one provides one ventilation every six seconds, which is about 10 ventilations per minute. At the same time, responder two is performing compressions at the normal rate of between 100 and 120 compressions per minute. It's important to note that there is no pause between compressions or ventilations, and responders do not use the standard 30:2 compressions to ventilations ratio. Advanced airway devices provide a continuous delivery of compressions and ventilations without any interruptions. https://d3imrogdy81qei.cloudfront.net/video_images/3739/adult-cpr-team-approach-2015.jpg Yes 448 https://www.procpr.org/training/video/neonatal-bls https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2080.mp4 Neonatal BLS Neonates are newborns who are less than a month old. It's important to note that there are some significant differences between resuscitating neonates compared to infants. As with infants, it's most common for the respiratory drive or lack of oxygen to contribute to the neonate's unresponsiveness versus a cardiac-driven event. This is important as it reflects how we perform rescue breaths and CPR. The following CPR instructions are for respiratory distress. Pro Tip #1: The rescue mask for neonates is extremely small. It's important to have rescue masks to fit every size patient, as an adult mask could prove useless when trying to resuscitate a newborn. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin to assess whether or not the newborn is responsive. If you don't get an initial response and you can see that the infant still isn't breathing normally, place your hand on his or her forehead and tap on the bottom of the newborn's feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. Pro Tip #2: If the newborn's pulse is 100 beats per minute or less but not less than 60, perform rescue breathing – one rescue breath every two to three seconds. If the newborn's pulse is less than 60, begin to perform full neonatal CPR – three chest compressions followed by one rescue breath. CPR Technique for Neonates Just as you would for infants (the landmarks are the same), draw an imaginary line across the newborn's nipples and place two fingers on the lower part of the sternum in the center of the infant's chest. Your fingers should be perpendicular to the baby's chest, meaning your knuckles are directly above your fingers during compressions. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on neonates, use only your fingers to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go to a depth of 1/3 of the newborn's chest cavity, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform three chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Breathe once into the rescue mask and wait for the chest to rise and fall. Continue to perform three chest compressions to one rescue breath for two minutes then reassess for vital signs. If the neonate's pulse is still slow or there is no pulse, continue CPR until help arrives, an AED arrives, or the victim is responding positively and breathing normally. Pro Tip #3: Although most situations involving an unresponsive neonate will be due to a respiratory problem, remember that there is a difference in how we resuscitate an unresponsive newborn who has had a cardiac-related event that led to their current condition. If their condition was due to a congenital heart defect or cardiac arrest, perform 15 compressions to two rescue breaths and repeat. Performing Neonate CPR in a Two-Responder Setting This two-responder scenario is more likely to be found in a clinical or professional health setting. It allows the responders to incorporate things like high-flow oxygen with a bag valve mask and the use of circumferential thumb compressions. This is much more efficient when performing just three compressions to every breath, as one responder can handle the bag while the other performs the compressions. A Word About Vital Signs (By Age) Assessing a patient's vital signs is a crucial first step in providing care. Therefore, it's important to know what range is normal when it comes to pulse rates and respirations. For Adults (12 years and older) Pulse rate – 60 to 100 beats per minuteRespirations – 12 to 20 breaths per minute For Children (1 year to 12 years old) Pulse rate – 80 to 100 beats per minuteRespirations – 15 to 30 breaths per minute For Infants (1 month to 12 months old) Pulse rate – 100 to 140 beats per minuteRespirations – 25 to 50 breaths per minute For Neonates (full term to 30 days) Pulse rate – 120 to 160 beats per minuteRespirations – 40 to 60 breaths per minute https://d3imrogdy81qei.cloudfront.net/video_images/3719/neonatal-bls-2015.jpg Yes 376 https://www.procpr.org/training/video/adult-aed https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2081.mp4 Adult AED An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm. Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from any water first, then use the AED. These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient. If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if it is a concern, you can disconnect it and remove it from the pathway to the heart. Necklaces should be moved to the side Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads Piercings shouldn't cause any problems It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it There are no special considerations for pregnant women Pro Tip #2: It's OK to be just as aggressive with a pregnant woman as you would any other patient. The primary focus should be on the mother, as saving her will also help save the baby. The care you provide to the mother won't put the baby in any more jeopardy. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with your AED. AED Technique for Adults Turn on the AED. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. Attach the AED pads to the patient's chest. The pads should have a diagram on placement if you need a reminder. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side mid axillary, under the left breast. Make sure they adhere well. Plug the cable into the AED and be sure no one is touching the patient, including yourself. The AED should now be charging and analyzing the rhythm of the patient's heart. If the scene is clear and no one is touching the patient, push the flashing shock button. Then go right into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. After one round of CPR, let the AED analyze the patient again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button. Go right back into CPR. Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About Abnormal Heart Rhythms The most common abnormal heart rhythm that causes cardiac arrest is known as ventricular fibrillation, or V-fib, for short. When in V-fib, the patient's heart ventricles fibrillate, or quiver, without any organized rhythm. Electrical impulses fire randomly, which prevents the heart from pumping and circulating blood. Another less common and less life-threatening abnormal heart rhythm is called ventricular tachycardia, or V-tach, for short. In V-tach, the heart is controlled by an abnormal electrical impulse that fires too fast for the heart's chambers to completely fill, which disrupts the heart's ability to pump and circulate blood. Both V-fib and V-tach typically result in no pulse and no normal breathing. https://d3imrogdy81qei.cloudfront.net/video_images/3721/adult-aed-2015.jpg Yes 353 https://www.procpr.org/training/video/unconscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2091.mp4 Unconscious Adult Choking This unconscious adult choking lesson is for situations where you find a person who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the patient has a pulse but isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction. In this scenario, you would treat this patient as an unconscious adult choking victim. The method of care will closely resemble performing CPR, however there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the patient to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient. Lift the victim's chin and tilt his or her head back slightly. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Breathe into the rescue mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – check for a carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you detect a pulse but there are still no signs of normal breathing, continue to perform one rescue breath every five seconds for two minutes. After two minutes, reassess for a pulse and check again for normal breathing. If you still detect a pulse and the patient still isn't breathing normally, continue with one rescue breath every five seconds for two minutes. If you do not detect a pulse, go into full CPR – 30 chest compressions followed by two rescue breaths. Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About High Quality CPR It's important to understand what constitutes high quality CPR, as performing CPR correctly will give the victim the best chance of survival. High Quality CPR Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise Low Quality CPR Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force Warning: Once you begin CPR, it's important not to stop. If you must stop, do so for no more than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life and the patient breathing normally again, an AED being available and ready to use, or being too exhausted to continue. https://d3imrogdy81qei.cloudfront.net/video_images/3741/unconscious-adult-choking-2015.jpg Yes 216 https://www.procpr.org/training/video/child-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2077.mp4 Child CPR Much of what was covered in the last section – Adult CPR – will apply in this section – Child CPR. There will, however, be some subtle but crucial differences that will be highlighted. But first, let's recap the five links in the Child Cardiac Chain of Survival: Injury prevention and safety Early CPR Early Emergency Care Pediatric advanced life support Integrated post-cardiac arrest care Child-related cardiac arrests are typically the result of a hypoxic event, such as: Drowning Choking/airway obstruction Exacerbation of asthma Due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation. Warning: Laryngeal spasms (sudden spasm of the vocal cords) may occur in these situations, making passive ventilation during chest compressions minimal or nonexistent. Administering high-quality CPR can help overcome this oxygenation problem. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the child is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. CPR Technique for Children Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go roughly 2 inches deep, or 1/3 the depth of the child's chest, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Grab the appropriately-sized rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly – just past perpendicular. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About the Differences Between Child CPR and Adult CPR This section began by mentioning a few subtle differences between adult CPR and child CPR. There are four distinct differences to be aware of. Opening the Airway While the same head tilt maneuver is applied to children as it is for adults, make sure there is less hyperextension in a child's neck compared to adults. To do that, simply tilt the head back only slightly past neutral. Your goal is a chin angle that's less pronounced and more perpendicular to the ground. Performing Compressions The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. And in very small children, it's better to perform compressions at 1/3 of the child's chest and using just one hand. Compressions to Ventilations Ratio If there is only a single responder, continue using the 30 compressions to two ventilations ratio. However, if there are two responders, that ratio changes to 15 compressions to two ventilations. Using AEDs AEDs work the same regardless of age. However, the pads themselves, as well as pad placement, will vary based on the size of the child. If the child weighs more than 55 pounds, continue using the adult AED pads. If the child weighs less than 55 pounds, use pediatric AED pads if available. Warning: It's vitally important that the AED pads do not touch each other. If the child is too small for adult pads, and you do not have pediatric pads, place one on the center of the sternum and the other on the child's back between the scapulae. https://d3imrogdy81qei.cloudfront.net/video_images/3713/child-cpr-2015.jpg Yes 112 https://www.procpr.org/training/video/adult-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2076.mp4 Adult CPR A patient who is unconscious, not breathing normally, and has no pulse is in cardiac arrest and needs CPR. CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped. Remember the five links in the Adult Cardiac Chain of Survival: Recognize the cardiac emergency and call 911 Early CPR Early defibrillation Advanced life support Integrated, post-cardiac arrest care How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally (as you now know, agonal respiration is not breathing normally and should be considered the same as NO respirations), and has no pulse, continue immediately with CPR. CPR Technique for Adults Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About High-Quality CPR It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. High-Quality CPR Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise Low-Quality CPR Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force Warning: Once you begin CPR, it's important not to stop. If you must stop, do so for no more than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life with the patient breathing normally again, an AED becomes available and ready to use or you getting too exhausted to continue. https://d3imrogdy81qei.cloudfront.net/video_images/3711/adult-cpr-2015.jpg Yes 243 https://www.procpr.org/training/video/unconscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2092.mp4 Unconscious Child Choking This unconscious child choking lesson is for situations where you find a child who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the child has a pulse but isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction. In this scenario, you would treat this patient as an unconscious child choking victim. The method of care will closely resemble performing CPR on a child, however there are subtle differences to pay attention to. Pro Tip #1: There is also one important distinction when performing rescue breaths on a child who has a pulse but isn't breathing normally versus an adult – one rescue breath every three seconds for two minutes, which has been highlighted in the steps below to help you remember. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the patient to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Remember that to maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Conduct compressions that go about 2 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Remember to allow for full recoil of the chest cavity after performing each chest compression. You want to allow the chest to come all the way back to the neutral position before performing another compression. Lift the victim's chin and tilt his or her head back slightly – just past perpendicular. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Breathe into the rescue mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – check for a carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you detect a pulse but there are still no signs of normal breathing, continue to perform one rescue breath every three seconds for two minutes. After two minutes, reassess for a pulse and check again for normal breathing. If you still detect a pulse and the patient still isn't breathing normally, continue with one rescue breath every three seconds for two minutes. If you do not detect a pulse, go into full CPR – 30 chest compressions followed by two rescue breaths. Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About the Differences Between Child CPR and Adult CPR There are four distinct differences to be aware of. Opening the Airway While the same head tilt maneuver is applied to children as it is for adults, make sure there is less hypertension in a child's neck compared to adults. To do that, simply tilt the head back only slightly past neutral. Your goal is a chin angle that's less pronounced and more perpendicular to the ground. Performing Compressions The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. And in very small children, it's better to perform compressions using just one hand. Compressions to Ventilations Ratio If there is only a single responder, continue using the 30 compressions to two ventilations ratio. However, if there are two responders, that ratio changes to 15 compressions to two ventilations. Using AEDs AEDs work the same regardless of age. However, the pads themselves, as well as pad placement, will vary based on the size of the child. If the child weighs more than 55 pounds, continue using the adult AED pads. If the child weighs less than 55 pounds, use pediatric AED pads if available. Warning: It's vitally important that the AED pads do not touch each other. If the child is too small for adult pads, and you do not have pediatric pads, place one on the center of the sternum and the other on the child's back between the scapulae. https://d3imrogdy81qei.cloudfront.net/video_images/3743/unconscious-child-choking-2015.jpg Yes 180 https://www.procpr.org/training/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/video/spinal-injury---jaw-thrust https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2084.mp4 Spinal Injury - Jaw Thrust This section is about providing care for someone who has taken a fall or sustained a physical injury that may appear to include the spine, and how you should proceed in these situations. Before we get into the jaw thrust CPR technique, there are some other things to keep in mind first. When you encounter a victim who appears to be immobile and in pain, you want to minimize their movement as much as possible, as you inquire more about what happened, how the patient is feeling, and whether or not you need to activate EMS. If the victim is conscious, let them know who you are and that you're there to help. Instruct the patient to not move and avoid nodding, and to answer your questions verbally, as you continue to assess his or her condition. Look specifically for head wounds and bleeding – from the head, nose, and ears. Check to see if the person has any broken teeth and if their pupils are responsive to light. Pro Tip #1: To check for responsiveness to light, simply place one hand over the patient's eyes and then remove it. Do the pupils react? If not, the victim could have a possible concussion and swelling of the brain. If you suspect this to be the case, call 911 immediately. Otherwise, if the victim is conscious, has a heartbeat, and is breathing normally, you may not have to call 911, at least while you continue to assess the situation. Some questions you should ask include: Do you remember what happened? Did you hit your head? Can you tell me what hurts? Can you move your arms, legs, fingers, toes? Do you know what day it is? Do you know what year it is? Should the victim answer one of those last two questions incorrectly, you may be dealing with someone who may have an altered mental state, likely due to a head injury. Remember, if you suspect a head injury at any point during your evaluation, call 911 immediately. Warning: If the patient is showing signs of paralysis, this could potentially lead to spinal shock. You may recall learning about the signs of shock in the bleeding control course material – pale, cold, sweaty, etc. If the patient does go into shock, this could lead to the patient becoming unresponsive and requiring CPR. Pro Tip #2: If you see signs of shock, cover the patient with a blanket or coat. It's important to keep them warm while you continue to reassess for airway or circulation problems. Should the patient become unresponsive or begin having trouble breathing normally, or go into full cardiac arrest, proceed with CPR using the jaw thrust technique to avoid any potential and/or further spinal injuries. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the patient's forehead and tap on his or her collarbone, while also reminding yourself not to move the neck or head. If you still do not get a response, proceed with CPR as you normally would. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse (or brachial pulse in infants), located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Jaw thrust Technique when Performing CPR The purpose of the jaw thrust technique is to minimize cervical spine movement. It requires two responders. One should be positioned at the head of the patient, while the other begins chest compressions as you normally would. When you get to the point of delivering two breaths into the rescue mask, proceed with the following steps: Place the apex of your rescue mask over the bridge of the victim's nose. Seal the bell part of the mask just below the patient's bottom lip and above the chin. Place both of your thumbs on top of the mask, as your fingers fan out and over the sides of the patient's face. As you push down on the mask with your thumbs, use your fingers to grab the mandible, or jaw, and pull it up into the mask. Pro Tip #3: The jaw line goes down then hooks at the back of the jaw, providing the leverage points you'll be using to pull the jaw upward, into the mask. Warning: Remember that you do not want to perform a normal head tilt, chin lift on a patient who you suspect may have a spinal injury. The only scenario when you would use the normal maneuver is if you are the lone responder and you have no choice. As you pull the jaw up into the mask, give one rescue breath, wait for the chest to rise and fall, and give one more rescue breath in the same manner. Continue with CPR – chest compressions followed by jaw thrust rescue breaths – until help arrives, an AED arrives, or the patient is responsive and breathing normally. A Word About Two-Responder CPR When two responders are available, responder one should size up the scene and make sure it's safe, begin the primary patient assessment, and then begin chest compressions. Responder two should call for help, get/find an AED, or prepare its readiness if you have one, while responder one continues with 30 chest compressions followed by two rescue breaths. Continue this way until responder two is ready to jump in and take over or until the AED is ready to use. When the AED is ready, responder one should move to the patient's head while responder two gets into a hovering position to perform chest compressions. Switch positions when the responder performing chest compressions becomes fatigued. Pro Tip #4: The best time to switch positions is while the AED is analyzing the patient. Use an agreed upon term like switch, and make sure the responder doing the chest compressions is counting out loud so the other responder can anticipate the switch. https://d3imrogdy81qei.cloudfront.net/video_images/3727/spinal-injury---jaw-thrust-2015.jpg Yes 386 https://www.procpr.org/training/video/adult-rescue-breathing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2072.mp4 Adult Rescue Breathing In this lesson, we're going to look at how and when to use rescue breathing on an unconscious adult patient. The main factor when it comes to rescue breathing is whether or not you can find a pulse. As you know, if the patient isn't breathing normally and doesn't have a pulse, you go immediately into CPR. However, if when assessing the patient, you do find a pulse and are confident that it is a pulse, that's when you'll use rescue breathing. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. Look one more time for signs the patient is breathing normally. If you've determined at this point that the victim is unresponsive, not breathing normally (as you now know from previous lessons, agonal respiration is not breathing normally and should be considered the same as NO respirations), but does have a pulse, continue immediately with rescue breathing. Rescue Breathing Technique for Adults Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. Breathe into the rescue mask and count out loud – one one-thousand, two one-thousand, three one-thousand, four one-thousand, five one-thousand … On six one-thousand, breathe into the rescue mask again. Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse. Pro Tip #1: You're going to continue to perform one rescue breath every six seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every six seconds for two more minutes. And so on. Pro Tip #2: Make sure the patient's chest rises as you perform your rescue breaths. If it doesn't, this could indicate an airway obstruction. Warning: If at any point you discover that the patient's pulse is gone, go immediately into full CPR and use an AED if you have one available. A Word About the Respiratory System The respiratory system is divided into two parts – the upper airway tracts and the lower airway tracts. The lower airway tracts access the respiratory system through the nose and mouth. As air is inhaled through the nose, it's warmed and humidified. Air inhaled through the mouth goes over the tongue and into the pharynx. The pharynx is divided into three parts – the nasopharynx, the oropharynx, and the laryngopharynx. The nasopharynx lies behind the nasal cavity. The oropharynx is located behind the oral cavity and is the shared passageway for both food and air. The laryngopharynx is the lowest part of the throat and divides into two passageways. The back portion is the entrance to the esophagus, which is the passageway for food. The front portion is the larynx, which is the continuation of the respiratory system. Above the larynx is the epiglottis – a flap of cartilage that folds down over the larynx to close it off to the trachea during swallowing, so that food doesn't enter. Incidentally, this only works if the person is conscious. After air travels through the pharynx, it then passes through the larynx. At the top of this structure is the hyoid bone (a horseshoe-shaped bone that helps support the structure of the larynx), made mostly of cartilage, muscle, and membranes. Below the hyoid bone are the thyroid and cricoid cartilages, which form the larynx. The lower airway tract begins below the vocal cords and consists of the trachea, bronchi, and lungs. The trachea is a hollow tube that's supported by rings of cartilage. It extends downward until it divides into two branches called bronchi, that connect with each lung. The two bronchi are also hollow tubes and supported by cartilage. And they, too, divide – into lower airways called bronchioles. Bronchioles are thin hollow tubes that remain open and lead to the alveoli. The alveoli – small sacs that form the end of the airway – number in the millions. Each alveolus shares a wall with capillary blood vessels. This point, where the walls of the alveoli and the walls of the capillaries come into contact, is where external respiration takes place – that all-important exchange of oxygen and carbon dioxide between the respiratory and circulatory systems. https://d3imrogdy81qei.cloudfront.net/video_images/3703/adult-rescue-breathing-2015.jpg Yes 144 https://www.procpr.org/training/video/infant-rescue-breathing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2074.mp4 Infant Rescue Breathing This lesson focuses on how to perform rescue breathing on an unconscious infant for the healthcare provider. And there are a few differences between adult/child rescue breathing and delivering rescue breaths to an infant that we'll highlight below. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your infant-sized rescue mask with a one-way valve handy and begin calling out to the infant to assess whether or not he or she is responsive. Are you OK? Can you hear me? (With infants, shouting their name, if you know it, may help.) If you don't get an initial response and you can see that the infant still isn't breathing normally, place your hand on his or her forehead and tap on the bottom of the baby's feet, shoulder, or rub their belly. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. Look one more time for signs the infant is breathing normally. If you've determined at this point that the infant is unresponsive, not breathing normally but does have a pulse above 60 beats per minute, continue immediately with rescue breathing. Pro Tip #1: Notice that with infants, we check for a pulse using the brachial artery rather than the carotid artery. Also, keep in mind that a weak pulse can be considered the same as no pulse in infants. The dividing line is 60 beats per minute. If lower, begin CPR immediately. If above, establish that the infant isn't breathing normally, then begin rescue breathing. Rescue Breathing Technique for Infants Grab a small-sized rescue mask and seal it over the infant's face and nose. Place something firm under the infant's shoulders (if possible) to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and count out loud – one one-thousand, two one-thousand … On three one-thousand, breathe into the rescue mask again. Pro Tip #2: What does slightly sniffing look like? Imagine you've just walked into a kitchen and caught the whiff of a freshly baked apple pie. You turn your head upward ever so slightly to catch a better smell. Ever so slightly, or neutral, is our goal when delivering rescue breaths to infants. The sequence for infants is the same as the sequence for children – one rescue breath every two to three seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every two to three seconds for two more minutes. And so on. Warning: As an infant's lungs are considerably smaller than the lungs of adults and even children, be careful not to force air in beyond the full point. To do this, watch closely as you deliver rescue breaths and stop when the chest reaches its apex. Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse. Pro Tip #3: As adults don't normally breathe one breath every two to three seconds, there's a chance you may become hyperventilated while doing rescue breathing. To combat this, take in a deep breath, hold it, and use that air to deliver a few rescue breaths. This is especially important if you feel like you're about to begin hyperventilating. Remember, if at any point you discover that the patient's pulse has disappeared, go immediately into full CPR and use an AED if you have one available. A Word About Pediatric Considerations and Respiratory Emergencies It's really important to quickly recognize breathing emergencies in children and infants and to provide treatment before their hearts stop beating. In adults, when their hearts stop beating, it's typically because of a disease. However, in children and infants, their hearts are usually healthy. Which is why when a child's or an infant's heart stops beating, it's usually the result of a breathing emergency. When helping a child with respiratory problems, keep in mind that a lower airway disease may be caused by birth problems or infections such as bronchiolitis, bronchospasms, pneumonia, or croup. Several of the illnesses and diseases that affect respiratory systems in infants and children are preventable through vaccines. These include: Diphtheria Measles, mumps, and rubella Whooping cough Pneumococcal disease Mycoplasma pneumonia Chickenpox Some diseases that may not have respiratory symptoms might still be spread through respiratory transmissions, such as mumps and severe diarrhea. https://d3imrogdy81qei.cloudfront.net/video_images/3707/infant-rescue-breathing-2015.jpg Yes 132 https://www.procpr.org/training/video/procpr-introduction https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2103.mp4 Welcome to ProCPR Welcome to your ProCPR BLS course designed for healthcare professionals. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. Your instructor for the duration of your ProCPR course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and also a co-founder of ProTrainings. In other words, you're in good hands. We created ProCPR with you in mind, the busy healthcare professional. In our modern world, it's hard to imagine fitting anything else into our already jam-packed schedules and especially several hours' worth of CPR training. Since your schedule is already hectic, we created ProCPR to be available whenever you are, 24 hours a day, seven days a week. You can squeeze in a quick lesson whenever you have a few minutes to spare, whether it's day or night, weekend or workday. It's there when you need it. The list of occupations that can benefit from the ProCPR course is long and includes: Physicians Physician Assistants Nurse Practitioners Nurses EMTs Paramedics Firefighters Lifeguards Physical Therapists Respiratory Therapists X-Ray Technologists Pharmacists Dentists Personal Trainers Other Health Care Professionals The total course time includes 3 hours and 9 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual here: Student Manual. What You Will Learn in this Course Your ProCPR course curriculum is quite substantial. Some of the important things you'll be learning are: Introductory CPR Training• Latest Updates• The Five Fears of CPR Rescue• Accessing EMS with Technology Medical Emergencies• Stroke• Heart Attacks Universal Precautions Respiratory Arrest Training• Adult, Child, Infant Rescue Breathing• Opioid Overdose Cardiac Arrest Training• Adult, Child, Infant, Neonatal CPR• Hands-Only CPR• AED Training• Spinal Injury Multiple Rescuer Skills• Bag Valve Mask• 2-Rescuer CPR & AED• CPR Team Approach Choking Training• Adult, Child, Infant Choking (Conscious)• Adult, Child, Infant Choking (Unconscious) Bleeding Control• Arterial Bleeding• Shock If you need first aid as well, you can take our ProFirstAid Advanced course that covers BLS & First Aid. The curriculum for this course was based on the latest American Heart Association and ECC/ILCOR guidelines for CPR and BLS. The ProCPR curriculum has also been submitted to and approved by hundreds of state and national boards and third-party accrediting organizations since 2005. Those of you old enough to remember may recall that McDonald's signs used to include a running total of the number of hamburgers sold until that number outgrew the sign. Nearly 230,000 satisfied professionals just like yourself have completed this ProCPR course. And although our numbers aren't growing as quickly as McDonald's, we do sincerely hope that you'll be the next healthcare provider who has a satisfying experience. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Welcome again to ProCPR. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3765/procpr-introduction-2015.jpg Yes 48 https://www.procpr.org/training/video/adult-rescue-breathing-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2121.mp4 Practice: Adult Rescue Breathing Learn how to perform rescue breathing on an unconscious adult who is not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3801/adult-rescue-breathing-practice-2015.jpg Yes 82 https://www.procpr.org/training/video/child-rescue-breathing-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2122.mp4 Practice: Child Rescue Breathing Learn how to perform rescue breathing on an unconscious child who is not breathing by watching the procedure performed on a manikin. https://d3imrogdy81qei.cloudfront.net/video_images/3803/child-rescue-breathing-practice-2015.jpg Yes 64 https://www.procpr.org/training/video/infant-rescue-breathing-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2123.mp4 Practice: Infant Rescue Breathing Learn how to perform rescue breathing on an unconscious infant who is not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3805/infant-rescue-breathing-practice-2015.jpg Yes 68 https://www.procpr.org/training/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/video/adult-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2124.mp4 Practice: Adult CPR Learn how to give CPR to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3807/adult-cpr-practice-2015.jpg Yes 92 https://www.procpr.org/training/video/child-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2125.mp4 Practice: Child CPR Learn how to give CPR to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3809/child-cpr-practice-2015.jpg Yes 104 https://www.procpr.org/training/video/two-person-aed-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2130.mp4 Practice: Two Person AED Watch how to two people can work together to give CPR with an AED to an unconscious adult who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3819/two-person-aed-practice-2015.jpg Yes 247 https://www.procpr.org/training/video/adult-cpr-two-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2131.mp4 Practice: Adult CPR Two Rescuer Watch how to two people can work together to give CPR to an unconscious adult who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3821/adult-cpr-two-rescuer-practice-2015.jpg Yes 188 https://www.procpr.org/training/video/child-cpr-two-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2132.mp4 Practice: Child CPR Two Rescuer Watch how two people can work together to give CPR to an unconscious child who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3823/child-cpr-two-rescuer-practice-2015.jpg Yes 141 https://www.procpr.org/training/video/infant-cpr-two-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2133.mp4 Practice: Infant CPR Two Rescuer Watch how two people can work together to give CPR to an unconscious infant who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3825/infant-cpr-two-rescuer-practice-2015.jpg Yes 148 https://www.procpr.org/training/video/unconscious-adult-choking-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2135.mp4 Practice: Unconscious Adult Choking (Healthcare Provider) Learn how to rescue an unconscious adult that is choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3829/unconscious-adult-choking-practice-2015.jpg Yes 102 https://www.procpr.org/training/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/video/unconscious-child-choking-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2136.mp4 Practice: Unconscious Child Choking Learn how to rescue an unconscious child that is choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3831/unconscious-child-choking-practice-2015.jpg Yes 97 https://www.procpr.org/training/video/pool-safety https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2069.mp4 Pool Safety Every year numerous lives are needlessly lost to drowning incidents, and many of those lost are young children. In this lesson, you'll learn how to recognize a drowning victim and how to help them to safety. Many times, a person who is a true drowning victim behaves differently than we might expect. They're likely not yelling for help, as they could be taking in water and unable to speak. It's important to understand what a drowning victim looks like. Signs of a potential drowning victim include: Exaggerated movements Head bobbing up and down at water line Arms flailing Making little noise beyond sounds of splashing How to Safely Rescue a Potentially Drowning Victim Once you've identified a potential drowning victim, use the following methods to rescue them and help them safely out of the pool. Pro Tip #1: The protocol for rescuing a drowning victim can be summed as such: Reach. Throw. Don't go. DO NOT swim out to get them unless you're a trained and certified lifeguard. Otherwise, you could end up a second drowning victim. Try to reach the victim from the side of the pool. If the victim is close enough, make sure you stay low to the ground and maintain a low center of gravity, while reaching out to them with your hand. Pull them out of the pool or assist them in getting to the nearest ladder and then out. Turn a towel into a rope. If you can't reach the victim with a hand, grab a towel and coil it up into a makeshift rope. Swing one end out to the drowning victim while you hang onto the other end. Drag the towel in with the victim in tow and help them out of the water. Use a pole or leaf skimmer. A swimming pool usually has these sorts of poles laying around, either for rescue purposes or cleaning and maintenance. And they often can telescope in and out, making them ideal to aid a drowning victim who is further away from the side of the pool. Pro Tip #2: If using a pole to assist a drowning victim, make sure you're standing with your forward-leading foot out in front of you. Lean back and use your weight as a counterbalance. Extend the pole and lower it down beside the victim. Once they grab it, lean back and pull them to safety. Use a life jacket or floatation device. If the victim is too far out to reach any other way, see if there are some floatation devices, like pool noodles or life jackets that you can toss out to them. Once the victim has the floatation device, instruct them to kick their feet and encourage them to keep coming, as they're likely exhausted and scared. Pull them to safety once they reach the side of the pool. If you called 911 and activated EMS, it's a good idea to keep them coming, especially if the victim took in some water. There could be some potential breathing issues or an aspirational pneumonia developing. Warning: If the victim is unresponsive when pulled from the water, begin CPR immediately. And always call 911 as soon as you think there's an emergency. If it turns out there isn't an emergency, you can always cancel the 911 call. But if turns out to be a real emergency, you'll be glad you activated EMS. A Word About Drowning When it comes to drowning, there are several critical facts and statistics to be aware of. Some important statistics. Drowning is the fifth most common cause of death from accidental injury in the United States for all ages, and it rises to the second leading cause of death for children ages 1 to 14. And males are more than three times more likely to drown than females. On the threat of drowning. Younger children can drown at any moment, even in as little as an inch of water. Young children commonly drown in home pools. Children with seizure disorders are 13 times more likely to drown than those without such disorders. Early recognition is key. Most people who are drowning spend their energy trying to keep their mouth and nose above water. As you learned earlier, recognizing someone who seems to be having trouble in the water, but is not calling out for help, may help save their life. There are three types of water-related victims: A distressed swimmer who is too tired to continue but afloat. A drowning victim who is active and vertical but not moving forward. A drowning victim who is passive, floating, or submerged and not moving. Don't become a victim yourself. Only those trained in swimming rescues should enter the water to assist with drowning emergencies. For your safety, look for a lifeguard before attempting a rescue, have the appropriate safety equipment, call for additional resources immediately if you do not have that equipment, and only swim out if you have the proper training, skills, and equipment. https://d3imrogdy81qei.cloudfront.net/video_images/3697/pool-safety-2015.jpg Yes 340 https://www.procpr.org/training/video/when-cpr-doesnt-work https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2041.mp4 When CPR Doesn't Work This is the last lesson in the cardiac arrest section, and a difficult topic to tackle for most. Whether you're a licensed paramedic, family member, neighbor, or stranger, the question remains the same for many people: Why didn't CPR work? That's a fair question. Even when you do everything perfectly, the desired outcome often isn't what you expected or hoped for. However, some of that hope and desire can be rooted in a misunderstanding of what CPR really is, which is the point of this lesson. CPR was designed to buy time, and nothing more. During cardiac arrest the heart is either in a fibrillatory state, meaning it's wiggling around in a disordered fashion, or it's completely asystolic, meaning it's not contracting at all. When a heart is healthy and operating as it should, it beats from top to bottom in a very organized way utilizing one-way valves. It works perfectly to circulate oxygenated blood throughout the entire body, and it does so efficiently. However, during cardiac arrest, regardless of what caused it, the heart is unable to circulate blood and oxygen and the body begins to die. The patient isn't breathing. There's no pulse. At this point, that person is clinically dead. Now, it doesn't mean that person will remain that way, as there is a difference between clinical death and biological death. What CPR aims to do, specifically the compressions, is to make up for the circulation that isn't happening naturally. The reality, though, is that even when CPR is performed perfectly, it's delivering only a small percentage of what the body needs to survive. It wasn't designed to be equal to artificial life support. Remember, it's simply a way to buy time. People have this idea that if they perform chest compressions on an unresponsive person, the body will remain alive. And he or she will remain alive so long as the chest compressions continue. But this isn't the case. CPR doesn't stop the dying process. It slows down biological death a little. But that's all it does. The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives – an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. – and the underlying cause of the cardiac arrest can be addressed. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival. CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology. The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are. If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact – by performing high quality CPR, you gave the patient the best possible chance of survival. Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way. That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. Now, you may be asking yourself, if CPR rarely works, is it even worth trying? EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying. And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember – we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them. The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough (even strangers) to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live. Isn't that the greatest gift we can give to another? This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. If you've ever performed CPR on a cardiac arrest victim, but the patient still remained dead, hopefully this greater understanding of what CPR really is has brought some peace to you, as the pain, agony, and guilt can be immense. Go forth and rescue confidently! And be at peace with yourself when you do. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/training/video/adult-cpr-2-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2086.mp4 Adult CPR 2 Rescuer In this section, we're going to cover two-responder adult CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.) The advantage of having a second, fully-trained and experienced rescuer is that the two of you can share in tasks and responsibilities. Rather than one of you having to do it all on your own. The type of rescue mask you're using doesn't change the two-responder technique when it comes to the sharing of duties; neither does the presence or absence of supplemental oxygen. Pro Tip #1: The advantage of two -responder CPR is the alleviation of rescuer fatigue. Performing the compressions and rescue breaths yourself will begin to tire you over time and perhaps diminish the quality of CPR being administered. The assessment phase is similar to one-responder situations, however, while one of you is assessing the scene and patient, the other can get the equipment ready to perform CPR, try to locate an AED if one isn't present, call 911 or a code, etc. Once chest compressions begin, that's when the efforts of each responder will begin to coordinate, including the important switch at the two-minute mark. Warning: The point of two-responder CPR is to limit fatigue and maintain the delivery of high-quality CPR. So, don't negate this benefit. Be sure to coordinate a switch at the two-minute mark so neither of you are performing chest compressions for longer than two minutes without a rest. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your bag valve mask, or rescue mask with a one-way valve (or bag valve mask when there are two responders), handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Two-Responder CPR Technique for Adults Responder one: Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Pro Tip #2: Counting with the correct cadence and out loud will help you maintain a consistent rhythm. However, when there are two responders, counting out loud is even more important. It allows the other responder to anticipate the delivery of rescue breaths and the all-important switching of duties. Responder two: Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. (When using the bag valve mask, remember not to push down on the mask, but rather, lift the mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do.) Compress the bag on the bag valve mask and wait for the chest to rise and fall before administering the next breath. Responder one: Go right back into your 30 chest compressions. Responder two: Go right back to delivering two rescue breaths. Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties. Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask. Continue to perform 30 chest compressions to two rescue breaths – while switching duties every two minutes – until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About Considerations for Older Adults In older adult patients, a general decrease in pain perception may cause a different reaction to a heart attack. Older adults often suffer what is known as a silent heart attack, meaning there is a lack of common symptoms we most often associate with heart attacks – chest pain or pressure, for instance. For these older adult patients, the symptoms of a heart attack mostly tend to include general weakness or fatigue, aches or pains in the shoulders, and indigestion and/or abdominal pain. https://d3imrogdy81qei.cloudfront.net/video_images/3731/adult-cpr-2-rescuer-2015.jpg Yes 237 https://www.procpr.org/training/video/child-rescue-breathing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2073.mp4 Child Rescue Breathing This lesson focuses on how to perform rescue breathing on an unconscious child for the healthcare provider. As you'll soon see, there's one important distinction compared with rescue breathing for adults. As you learned in the last lesson, what you find during your patient assessment will determine whether you'll perform full CPR or only rescue breathing. During your assessment, use your eyes and ears – is the chest rising and falling? Is the patient making any sounds that may indicate normal breathing? Is the patient showing signs of oxygen deprivation, like blue around the lips? How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? Pro Tip #1: There are two different sizes of rescue masks with one-way valves. There's an adult/child size and an infant size. You should always carry both, but if you don't and the mask you do have is too big, try turning it upside down. What you're aiming for is a good seal over both the nose and mouth. If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. Look one more time for signs the patient is breathing normally. If you've determined at this point that the child is unresponsive, not breathing normally but does have a pulse, continue immediately with rescue breathing. Pro Tip #2: So, you know that agonal respiration isn't normal breathing. But do you know what it looks like? Have you ever seen a fish out of water gasping for air? It's similar to that. However, the important thing to remember is that while it really does look like breathing, it really isn't. Rescue Breathing Technique for Children Grab an appropriately-sized rescue mask and seal it over the child's face and nose. Lift the victim's chin and tilt his or her head back slightly – just past perpendicular. Breathe into the rescue mask and count out loud – one one-thousand, two one-thousand … On two or three one-thousand, breathe into the rescue mask again. Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse. Pro Tip #3: The sequence has changed. With children, you're going to perform one rescue breath every two to three seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every two to three seconds for two more minutes. And so on. Remember to make sure the patient's chest rises as you perform your rescue breaths. If it doesn't, this could indicate an airway obstruction. Remember, if at any point you discover that the patient's pulse is gone, go immediately into full CPR and use an AED if you have one available. A Word About Respiratory Emergencies Identifying a respiratory emergency quickly and providing high-quality care is essential, as we humans cannot survive long without oxygen. The human brain is quick to be impacted by oxygen deprivation. After 4-6 minutes, brain damage is possible. Between 6-10 minutes, brain damage is likely. And after 10 minutes, it's all but certain. Reasons for breathing difficulties are numerous and include: An obstruction Low oxygen environment The presence of poisonous gases Infection Trauma Poor circulation Other health issues There are two types of respiratory emergencies – respiratory distress and respiratory arrest. During respiratory distress, breathing is difficult, labored, and/or restricted in some way. During respiratory arrest, breathing stops entirely. Respiratory distress is often a sign of more serious health conditions and should be taken seriously. As for the causes of respiratory distress, they include: A partially obstructed airway Illness Chronic conditions such as asthma Electrocution, including lightning strikes Heart attack Injury to the head, chest, lungs, or abdomen Allergic reactions Drugs Poisoning Emotional distress When assessing a patient for respiratory distress, listen, watch, and ask. Does their breathing look and sound labored? And how does the patient feel? Ask them to see if the optics are as bad as their symptoms. And as for the signs and symptoms of respiratory distress, they include: Slow or rapid breathing Unusually deep or shallow breathing Gasping for breath Wheezing, gurgling, or high-pitched noises Unusually moist or cool skin Flushed, pale, ashen, or bluish skin color Shortness of breath Dizziness or light-headedness Pain in the chest or tingling in the hands, feet, or lips Apprehensive or fearful feelings https://d3imrogdy81qei.cloudfront.net/video_images/3705/child-rescue-breathing-2015.jpg Yes 153 https://www.procpr.org/training/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/video/bleeding-control-arterial-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2094.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care A person who is the victim of arterial bleeding will instinctively grab and cover the wound to reduce the amount of blood flow, if that person is conscious and able to. To best assist in treating the wound, you should: Make sure the scene is safe. Put on latex-free gloves if available. If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer. Find the source of the bleeding; you may have to remove clothing over the wound. Make the switch from the victim's hand to a dressing pad or a clean cloth. Apply pressure. The wound will be pulsating, and it will likely take several dressing pads to control the bleeding. If the victim is conscious and can assist, this will help. Ask the victim to maintain pressure over the dressing pad or cloth. The blood will probably soak through, so apply a second pad on top of the first, rather than removing it. Continue to apply firm, direct pressure over the wound. If the victim is becoming light-headed from the blood loss, have them sit or lie down. The goal is to control the bleeding to the point where the wound is not leaking through each new dressing pad. If blood continues to leak through, continue to apply another pad or piece of cloth until it stops. Consider using a tourniquet if – you cannot control the bleeding with dressing pads and the blood loss is extreme. This is a life-threatening situation and last resort. In most cases, even arterial bleeding can be controlled using pressure plus dressing and bandages. Once you have the bleeding controlled, it's time to wrap the wound. Using an ACE roller bandage like you find in most first aid kits, start from the end of the extremity where the injury is located. If the wound is on the wrist, began wrapping from the hand. Pro Tip #1: it's important to extend the bandage several inches beyond the wound on both sides. This will help keep the wound clean and limit the chances of infection. When wrapping the wound, if extra pressure is required, twist the bandage once over the wound and continue wrapping. Repeat as often as necessary. To finish, tuck the end of the bandage into the wrap to hold it in place. Pro Tip #2: While pressure is important to control the bleeding, you don't want to cut off circulation to the extremity on which the wound occurred. Pinch a nail and the fleshy underside between two of your fingers (if the wound occurred on an arm or a leg). The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. At this point, you'll want to decide whether to call 911 for EMS services or transport the victim to the emergency room by private vehicle. Call 911 if: The victim has lost consciousness or is showing signs of losing consciousness The victim is exhibiting signs of shock – pale, cold, sweaty skin You cannot stop the bleeding A Word About Dressings and Bandages Dressings are sterile pads used to absorb blood and other fluids, help promote clotting, and prevent infection. Gauze pads are most common. Most dressing pads are porous, which allows air to circulate to the wound and promote healing. Common sizes range from 2-4-inch squares. Universal or trauma dressings are larger in size and used for larger wounds. Occlusive dressings are not porous, which means no air or fluids can pass through, and typically used for abdominal wounds. Bandages are strips of material used to hold the dressing in place, maintain pressure over the wound, control bleeding, and protect from dirt and infection. The most common type of bandage is the roller bandage that is usually made of gauze and comes in assorted widths and lengths. These are the type of bandages you find in most first aid kits. However, there are other types of bandages including: Pressure bandage – for more pressure and a snugger fit Bandage compress – thick gauze dressing attached to a gauze bandage Elastic bandage – type of roller bandage typically used for muscles, bones, and joints Triangular bandage – large bandage that can folded and used as a sling As arterial bleeding is the most severe type of bleeding, it's important to properly assess the situation quickly as a rapid response is vital for a positive outcome. If you feel like the situation is too serious to handle yourself, it's important that you or someone else at the scene call 911 immediately. https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/training/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/video/infant-landmarks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7174.mp4 Infant Landmarks Since the anatomical proportions of a baby are significantly different than that of children and adults, this section will focus on those differences as they relate to performing CPR on an infant. When Assessing an Infant An infant is considered any child under the age of one. When assessing and treating an infant who is in cardiac or respiratory distress, there are a few things to first consider. First, let's look at the signs of a healthy baby. The lips are nice and pink, as is the mucous membrane. The nail beds are also pink. The baby is moving around and appears to be physically fine and healthy. A baby in respiratory distress would likely be agitated or if it becomes even worse - lethargic and have some signs of circumoral cyanosis – blue around the lips – as well as the mucous membrane. The nailbeds might also appear blue. Pro Tip #1: Don't confuse cold hands with signs of respiratory distress. When an infant's hands are cold, they might also appear bluish. Important Infant Landmarks Compression Point and Depth As you open an infant's clothing to expose the chest, you'll want to find the nipple line. Put two thumbs on the center of the infant's chest, directly on the sternum, and slightly below the nipple line. Your fingers will reach around to the baby’s back. The depth of compression for infants is about 1½ inches (or 1/3 the anterior-posterior diameter of the chest). However, the rate of compressions is the same as adults and children – 100-120 compressions per minute. Finding a Pulse Since infants don't have much of a neck, finding the carotid artery can be difficult, which is why we have to use the brachial artery instead. To find the brachial artery, remove the infant's clothing enough to expose one arm. The brachial artery is located on the inside of the arm between the bicep and tricep against the humerus bone. Place your two fingers on the artery to check for a pulse, just as you would for other victims. Pro Tip #2: The reason we don't use our thumbs to check for a pulse is that a thumb has its own detectable pulse, which could easily give a false reading. Opening the Airway There's another thing to keep in mind. Babys have large heads that are disproportionate to the rest of their bodies. Combined with a lack of a neck, this results in a chin that rests on the chest. Before performing compressions, place something firm under the infant's shoulder blades to lift the neck and help tilt the head into a neutral or slightly sniffing position. It's important that this be a firm enough object so the infant doesn't sink down and the head is held in the correct position as you perform compressions. Warning: An infant's airway is only about the size of one of their pinky fingers, which makes the airway much tighter than children and adults. If using the standard head tilt, chin lift, this could actually occlude the airway, making it much more difficult for the baby to breathe. This can also happen when an infant's chin is resting on their chest. When performing compressions, the infant's head and neck should be in a slightly sniffing position. In other words, just a slight upturn of the nose; very close to neutral. (Imagine walking into a room and smelling a fresh apple pie and how your head rises ever so slightly as you sniff.) Compression Variation Technique There is one variation that can be used when doing compressions on a baby, which is using the heel of one hand in the center of the chest. An Infant's Heart The size of an infant's heart is approximately the size of one of their fists. It's located right under the sternum in the center of their chest. Because of its small size, finding the right compression point is critical. A Word About Infant Assessment When assessing the level of consciousness in a baby, tap them on the bottom of the feet rather than the shoulder, as part of your shout-tap-shout sequence. Also, rather than use AVPU (Alert, Verbal, Pain, Unresponsive) to measure and record a patient's level of consciousness, when treating an infant, it's more accurate to use the pediatric assessment triangle: Appearance Effort of breathing Circulation As recognizing an unresponsive infant is your first priority to providing treatment, the assessment triangle should provide you with a better reading of the infant's condition. https://d3imrogdy81qei.cloudfront.net/video_images/13008/infant-landmarks-bls-2025.jpg Yes 195 https://www.procpr.org/training/video/adult-aed-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2127.mp4 Practice: Adult AED Learn how to give CPR with an AED to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3813/adult-aed-practice-2015.jpg Yes 240 https://www.procpr.org/training/video/child-aed-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2128.mp4 Practice: Child AED Learn how to give CPR with an AED to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3815/child-aed-practice-2015.jpg Yes 256 https://www.procpr.org/training/video/infant-cpr-2-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7175.mp4 Infant CPR 2 Rescuer In this section, we're going to cover two-responder infant CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.) Also, it's important to have the right size mask.  Much of what was covered in the last section – Child CPR with Two Responders – will apply in this section – Infant CPR with Two Responders. The one difference being the method of compressions which will be explained below. Pro Tip #1: One variation that should be used when doing compressions on an infant or baby when a second responder is present, is circumferential compressions. To perform circumferential compressions, wrap your fingers around the sides of the infant's chest, placing both thumbs over the compression point just below the nipple line. One of your thumbnails should be resting on the top of the other. If for some reason you're not able to perform circumferential compressions, then an alternative method is the heel of one hand. Remember that little force will be required when performing compressions on an infant. Pro Tip #2: The rate of compressions to rescue breaths during two rescuer infant CPR is the same as with children – 15 compressions for every two rescue breaths. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve (or bag valve mask when there are two responders), begin calling out to the victim to assess whether or not the infant is responsive. Are you OK? Can you hear me?  If you don't get an initial response, place your hand on the infant's forehead and tap on the bottom of his or her feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Two-Responder CPR Technique for Infants Responder one: Draw an imaginary line across the infant's nipples and place your thumbs next to each other on the lower part of the center of the sternum to perform circumferential compressions. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, use only your thumbs to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 15 chest compressions. Responder two: Grab the bag valve rescue mask and seal it over the infant's face and nose. If available, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. When using the bag valve mask, remember not to push down on the mask, but rather, lift the mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do. Also, remember that with infants, the head-tilt, chin lift is neutral or slightly sniffing. Compress the bag on the bag valve mask and wait for the chest to rise and fall before administering the next breath. Be cautious to not over inflate the lungs as this can cause several serious issues. Responder one: Go right back into your 15 chest compressions. Responder two: Go right back to delivering two rescue breaths. Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties. Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask. Continue to perform 15 chest compressions to two rescue breaths – while switching duties every two minutes – until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About Considerations for Pediatric Patients Cardiac emergencies in children and infants are usually secondary to respiratory problems and airway restrictions. While congenital heart conditions are possible, they aren't common. When cardiac arrest occurs in children and infants, it's usually caused by one of the following: Airway and breathing problems Traumatic injuries or incidents – drowning, electrocution, poisoning, etc A hard blow to the chest Congenital heart disease Sudden infant death syndrome (SIDS) https://d3imrogdy81qei.cloudfront.net/video_images/13010/infant-cpr-2-rescuer-bls-2025.jpg Yes 191 https://www.procpr.org/training/video/two-person-aed-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7178.mp4 2-Person AED Some of this will be a review of what you learned in the cardiac arrest section – using an AED on an adult patient. >An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm. Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient. If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if the bra is a concern, you can adjust the straps or cut it away and remove it. Just make sure the AED pads are on bare skin. Necklaces should be moved to the side Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads Piercings shouldn't cause any problems It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it There are no special considerations for pregnant women Pro Tip #2: When two responders are available, the emphasis will be on a steady supply of compressions. The two responders will orchestrate their movements in a way that minimizes any stoppages or delays in chest compressions, as this will keep oxygen circulating throughout the victim's body – brain, heart, and other vital organs. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy (or bag valve mask when there are two responders) and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's pulse and breathing.  Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. Check for breathing while you are checking for a pulse. The patient may be breathing fast or slow, deep or shallow breathing, etc. Remember, gasping is not normal breathing and may be a sign the victim does not have a pulse. If you've determined at this point that the victim is unresponsive, is not breathing normally, and has no pulse, start CPR with compressions and have the second responder immediately set up and use the AED. Caution: When checking for a pulse, rescuers, including licensed healthcare providers, spend too much time checking for a pulse. Spending more than 10 seconds checking for a pulse shows worse outcomes for patients. If you are not positive you feel a pulse within those 10 seconds, begin compressions. Two-Person AED Technique for Adults Responder one: Locate proper hand placement and begin chest compressions – between the breasts and on the lower half of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Responder two:(while responder one performs compressions) Turn on the AED. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. Attach the AED pads to the patient's chest. The pads should have a diagram on placement if you need a reminder. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side mid axillary, under the left breast. Make sure they adhere well. Pro Tip #3: This will resemble a back-and-forth sort of dance until the AED is ready to use. If possible, do not stop compressions. Our goal is to apply the AED pads to the victim around the rescuer doing compressions. If you must momentarily pause compressions, begin again as soon as possible. Plug the cable into the AED and be sure no one is touching the patient, including yourself and your partner. The AED should now be analyzing the rhythm of the patient's heart. If the AED finds a shockable rhythm, it will charge and tell everyone to clear from touching the victim. If the scene is clear and no one is touching the patient, push the flashing shock button. Responder two: Immediately take over compressions from responder one. Ensure proper body mechanics and perform 30 chest compressions. It's appropriate to perform CPR over the pads, when needed. It is best practice to not remove the AED pads once they are applied. Responder two: Grab the bag valve rescue mask and seal it over the victim's face and nose. Lift the patient's mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do. Slowly, over 1 second, compress the bag valve mask about half the volume, or just until you see the chest rise. Wait for the chest to fall, about 2 seconds, before administering the second breath. Pro Tip #4:The AED takes around two minutes to reanalyze the patient, which makes this an ideal time to switch again. After about five cycles of CPR, the AED will analyze the patient again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button Go right into CPR. (This is the switch point.) strong>Responder two goes from AED and valve mask duties to compressions, while responder one takes over bag valve mask duties and control of the AED. Continue this cycle of CPR, re-analyzation, switching positions, charging, shocking, and back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About AED Maintenance For AEDs to function properly, they must be maintained like any other medical device. However, the maintenance they require is minimal. Though AEDs have various self-testing features, it's important that healthcare professionals become familiar with any visual or audible prompts the AED may use to warn of a low battery or malfunction. If the machine detects a malfunction that cannot be easily resolved by addressing the manual, you should contact the manufacturer. It may need to be returned for service. While AEDs require minimal maintenance, it's still important to remember the following: Follow the manufacturer's recommendations for periodic equipment checks Make sure that the batteries are not expired or low energy. Most AEDs have windows that you can easily see the status of the battery. (It may be a good idea to order a new battery months before it expires or is showing that it is low energy.)  Make sure the AED includes the correct defibrillation pads and that they remain sealed. Opened AED pad packaging can cause the pads to dry out and become ineffective when needed Periodically check expiration dates on the defibrillation pads and batteries, and replace as necessary After using your AED, make sure that all the accessories are back in the case and that the machine is in proper working order for its next use If at any time the AED fails to work properly, discontinue its use and contact the manufacturer immediately https://d3imrogdy81qei.cloudfront.net/video_images/13016/2-person-aed-bls-2025.jpg Yes 295 https://www.procpr.org/training/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/video/infant-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7173.mp4 Infant CPR Infant-related cardiac arrests are typically the result of: Drowning Choking/airway obstruction Electrocution Just as with child CPR, due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the infant is responsive. Are you OK? Baby baby, can you hear me?  If you don't get an initial response, place your hand on his or her forehead and tap on the bottom of the baby's feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery.  At the same time as the pulse check, look, listen and feel for breathing. Spend no more than 10 seconds looking for a pulse and breathing. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. CPR Technique for Infants Place two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should wrap around the chest. Alternatively, you can give compressions using the heel of 1 hand in the center of the chest. Conduct compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face.  Place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About CPR Compression Rate and Depth Performing proper chest compressions is essential for providing high-quality CPR, which greatly improves the patient's chances for a successful outcome. Chest compressions increase the pressure on the heart to simulate a contraction. This helps to send oxygenated blood through the arteries to the brain and other vital organs. Chest compressions also increase the likelihood of a successful AED shock for the patient, particularly if several minutes have elapsed since the patient collapsed or suffered an incident leading to respiratory distress. Chest compression effectiveness is reduced if: Compressions are too shallow The compression rate is too fast or too slow There isn't a full recoil of the chest cavity There are interruptions during CPR The patient isn't laying on a firm, flat surface Warning: Compression rates that exceed 120 per minute tend to have a negative impact on compression depth, perhaps due to responders rushing through them. Regardless, if the compression rate exceeds 120 per minute, you are less likely to compress the full 1/3 of the chest for infants and children, thereby reducing the effectiveness of CPR. If you are unsure if you're compressing at the correct depth, a feedback device might be helpful. https://d3imrogdy81qei.cloudfront.net/video_images/13006/infant-cpr-bls-2025.jpg Yes 204 https://www.procpr.org/training/video/conscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7180.mp4 Conscious Child Choking This conscious child choking lesson is for situations where you can see that a child is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. Remember to only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing the victim. How to Provide Care The first thing you want to do is face the child and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the child. "Are you choking?" The child will probably nod yes. "May I help you?" You'll likely get another nod. Don't wait too long to receive permission, as children may be a little more flustered than adults. Pro Tip #1: With children, they may not have the same level of awareness as adults. If they're only nodding or making gagging, high-pitched squeaking sounds, these are good indications that the airway is fully obstructed. Pro Tip #2: If the child can respond verbally, that means that they are able to move enough air past the larynx to speak. This is a good indication that something may be stuck but that the airway isn't obstructed. Or it could indicate a partial obstruction of the airway. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Blows Technique for Children Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. You may kneel if needed. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts.   Abdominal Thrust Technique for Children Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. Warning: It's important that when helping a choking victim who's shorter than yourself, that you lower yourself to their height. This will limit unnecessary pressure on the rib cage and prevent broken ribs or other possible harm while you perform the abdominal thrusts. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Remember to stay below the bottom tip of the rib cage (xyphoid process) and above the belly button. This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Lower yourself to the height of the child. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your hands upward as you perform each thrust. Perform five abdominal thrusts unless the object comes out or the child becomes unresponsive. Remember to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. If after the five abdominal thrusts, the object is still not out, alternate between 5 back blows and 5 abdominal thrusts. Once the object comes out, the child will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the child know that he or she is OK now and have them sit down if necessary. Children may experience more confusion and fear than adults, so letting them know that they'll be fine is important. If you called 911, let them come anyway, so the child can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there are no interal injuries. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the child into an urgent care center, hospital, or to see their physician. With children, don't leave it up to them to determine if more care is necessary. If you weren't able to remove the obstruction using the abdominal thrust technique, the child will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious child choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/training/video/infant-aed https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7177.mp4 Infant AED AED pads come in an adult size and a pediatric size, for patients less than 8 years old or 55 pounds or roughly 25 kilograms. However, remember, if you do not have pediatric pads and the patient is less than 8 years old or less than 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. Also, remember that when using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? If for some reason the scene isn't safe enough to use an AED, move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. And one last reminder: It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it. With infants, since one pad will be attached to the back, that area must also be dry. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? (With infants, shouting their name, if you know it, may help.) If you don't get an initial response, place your hand on the infant's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, immediately use the AED, if available.  If you have a second rescuer, be sure to immediately start CPR while the other rescuer applies and operates the AED. AED Technique for Infants Turn on the AED. Remove the patient's clothing to reveal a bare chest and back. Attach one AED pad to the infant's chest, carefully roll the infant on his or her side, and attach the second pad to the back. The pads should have a diagram on placement if you need a reminder. Plug the cable into the AED and be sure no one is touching the patient, including yourself. The AED should now be charging and analyzing the rhythm of the patient's heart. If the scene is clear and no one is touching the patient, push the flashing shock button. Then go right into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Place two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should wrap around the chest. Alternatively, you can give compressions using the heel of 1 hand in the center of the chest. Conduct compressions that go roughly 1.5 inches deep, or 1/3 the depth of the infant's chest, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions if there is one rescuer. If you have a second rescuer, then use a 15:2 compression to ventilation ratio. Grab the appropriately-sized rescue mask and seal it over the victim's face and nose. Place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath, about 2 seconds. After 2 minutes of CPR, the AED will analyze the patient again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button. Go right back into CPR. Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About AED Precautions When using an AED, there are several precautions to keep in mind. Some of these may be obvious (and a repeat of what you've already learned in this course), while others may not be. Since alcohol is flammable, do not use anything with alcohol on it to wipe the patient's chest or back dry. While it's OK to use adult pads on a child, the reverse isn't entirely true, as pediatric pads may not deliver enough energy to defibrillate the patient. Do not touch the patient while the AED is conducting an analysis, as this may affect the analyzation process. Before delivering an AED shock, make sure no one is touching the patient or any of the resuscitation equipment. Do not use an AED if there are flammable or combustible materials or gases present, including free-flowing oxygen. Simply redirect the flow of oxygen away from the patient around the time the AED is going to shock. Do not operate an AED inside a moving vehicle, as the movement can affect the analysis. Do not use an AED if the victim is in contact with free-standing water or in the rain. Move the patient first. Do not place AED pads on top of any patches or implantable devices. Remove patches first and adjust the pads as necessary to avoid devices like a pacemaker. https://d3imrogdy81qei.cloudfront.net/video_images/13014/infant-aed-bls-2025.jpg Yes 271 https://www.procpr.org/training/video/conscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7181.mp4 Conscious Infant Choking This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak or babble or make any noise Their lips are beginning to show signs of circumoral cyanosis – a blue ring around the lips that indicates early signs of oxygen starvation Signs that the infant is conscious include: The baby is still moving around The baby's eyes are open Remember to activate EMS as soon as possible so long as it doesn’t delay care. If possible, have another person nearby call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant. How to Provide Care Helping a conscious choking infant isn’t significantly different than helping a child or an adult. You'll still be performing a combination of back slaps and thrusts to try and dislodge the airway obstruction. The biggest difference between infants when compared to adults or children, rather than performing abdominal thrusts, for infants we need to make sure we are performing chest thrusts rather than abdominal thrusts. Warning: Due to the fragile nature of infants performing abdominal thrusts on them could cause severe internal injuries. Chest thrusts should be used for conscious choking infants. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Rest your forearm on your leg for additional support. Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Place the heel of your hand on the sternum in the center of the infant's chest. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is extremely effective if you perform the back slaps and chest thrusts properly. If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. A Word About Pediatric Considerations Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children. The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children: Hot dogs Nuts and seeds Chunks of meat or cheese Whole grapes Hard, gooey or sticky candy Popcorn Chunks of peanut butter Raw vegetables Raisins Chewing gum According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy. It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.  https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/training/video/unconscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7183.mp4 Unconscious Infant Choking This unconscious infant choking lesson is for situations where you find an infant who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the infant has a pulse but isn't breathing. You attempt rescue breathing at a rate of one breath every two to three seconds, but your first breath does not produce chest rise. You reposition the airway and try again - still no chest rise. In this scenario, you would treat this patient as an unconscious infant choking victim. The method of care will closely resemble performing CPR on an infant, however there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the infant to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Draw an imaginary line across the infant's nipples and place your two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should be wrapping around the infant’s chest. Alternatively, you may also use the heel of one hand in the center of the chest. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, and count as you perform them. Conduct 30 chest compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face. If you have an infant mask, use that.. If you can, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Here’s the difference between CPR and unconscious choking - open the airway and look for the object before giving your two breaths. If you see the object, use your pinky finger to sweep out the object. Never do a finger sweep unless you see the object. Breathe into the rescue mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. Pro Tip #2: Because infants' mouths are small, it's best to use your pinky finger combined with a hooking motion to sweep out obstructions. If the rescue breaths go in this time – causing the chest to rise and fall – check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. Pro Tip #3: For infants with a pulse rate lower than 60 beats per minute, you are instructed to override with chest compressions in CPR. But if you're only allowing 10 seconds to check a pulse, how do you know the rate per minute? Multiply the 10-second rate by six, and this will give you the number of beats per minute. If you detect a pulse but there are still no signs of normal breathing, continue to perform one rescue breath every two to three seconds for two minutes. After two minutes, reassess for a pulse and check again for normal breathing. If you still detect a pulse and the patient still isn't breathing normally, continue with one rescue breath every two to three seconds for two minutes. If you do not detect a pulse, go into full CPR – 30 chest compressions followed by two rescue breaths. Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. If you have a second rescuer, rather than 30:2, use a 15:2 compression to ventilation ratio. A Word About Vital Signs (By Age) Assessing a patient's vital signs is a crucial first step in providing care. Therefore, it's important to know what range is normal when it comes to pulse rates and respirations. For Adults (12 years and older) Pulse rate – 60 to 100 beats per minuteRespirations – 12 to 20 breaths per minute For Children (1 year to 12 years old) Pulse rate – 70 to 120 beats per minuteRespirations – 15 to 30 breaths per minute For Infants (1 month to 12 months old) Pulse rate – 100 to 140 beats per minuteRespirations – 25 to 50 breaths per minute For Neonates (full term to 30 days) Pulse rate – 120 to 160 beats per minuteRespirations – 40 to 60 breaths per minute Pro Tip #4: Infants in distress – not breathing normally – will likely be tachycardic. It's not unusual for them to range between 120-180 beats per minute on the high end, depending on their exact age. It's also not abnormal to feel a fast, slightly thready (or thin) pulse that's becoming weaker. If we cannot correct the breathing issue, infants will quickly deteriorate and have a slowing heart rate until breathing is corrected. https://d3imrogdy81qei.cloudfront.net/video_images/13026/unconscious-infant-choking-bls-2025.jpg Yes 238 https://www.procpr.org/training/video/shock https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7185.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. When organs don't receive enough blood, the body begins to compensate by conserving and limiting blood flow to the legs, arms, and the skin. As shock progresses, more systems shut down until the effects become irreversible and death occurs.  The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #1: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Shock is a serious and potentially life-threatening condition that requires immediate medical care. It is a multi-symptom and complex condition, which is also progressive. Pro Tip #2: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #3: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. If you have oxygen available, it may be appropriate to provide supplemental oxygen. Always follow local protocols when administering oxygen. https://d3imrogdy81qei.cloudfront.net/video_images/13030/shock-bls-2025.jpg Yes 235 https://www.procpr.org/training/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/video/adult-bag-valve-mask https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2085.mp4 Bag Valve Mask This lesson will focus on how to use your bag valve mask, why we might use it instead of the traditional mouth to mask rescue technique, and any concerns that may come with using a bag valve mask (BVM). There are three sizes of bag valve mask systems – infant, child and adult. There are many mask sizes and styles as well from neonate and infant all the way up to adult. Having the correct size mask helps to create a good seal for the breaths or ventilations. Having the proper size bag ensures enough air is given without an unnecessary risk of too much air into the lungs. Pro Tip #1: If you only have the adult-size bag valve system, it is not recommended to use on infants or children. Giving too much air can cause trauma to the lungs as well as a decrease in blood flow to the heart. Therefore, for best patient care, using the appropriately sized bag valve for each patient is recommended. Some aspects to be aware of concerning bag valve masks: Sometimes the oxygen reservoir will be attached right out of the bag from the manufacturer; other times you'll have to attach it yourself. The reservoir is meant to be used with 100 percent oxygen, so when you ventilate the patient, they're getting a higher concentration of oxygen to compensate for any oxygen deprivation they may be experiencing. You may have to first attach the oxygen tubing to the oxygen inlet on the bag as well as the oxygen source (tank or wall mount). Pro Tip #2: If you don't see the oxygen reservoir bag inflating, or if it's inflating too slowly, put your thumb over the outlet inside the mask. This will seal the bag system so no oxygen is escaping, and the reservoir will fill more quickly. The oxygen should be set to high flow to fill the reservoir more quickly and to keep the reservoir inflated while ventilating the patient. When sealing the mask over the patient's face, there are a couple important points to note: The shape of the mask: You have the apex part of the mask that goes over the patient's nose, and the bell part of the mask (the wider end) that goes around the victim's chin and under the bottom lip. The specific method for holding and attaching the mask: The CE method. Your index finger and thumb form the C and go around the stem of the mask and are used to balance pressure on one side of the mask when attaching it, while your palm will put pressure on the other side of the mask. Your other three fingers will form the E, as they grab the patient's mandible, or jaw line, and draw it up into the mask. Warning: Do not push the mask down onto the patient's face. This will not provide a proper seal and may even block the airway. It's your fingers and palm that creates the seal, and it's the drawing of the mandible into the mask that provides the proper head tilt, chin lift before delivering your ventilations. When a second responder comes in handy: If certain facial features are complicating the sealing of the mask, incorporate the second responder into the effort. Responder one uses two hands to create the seal, while responder two provides the ventilations using the bag. Warning: If you do not see the patient's chest rise and fall, your seal is not tight or the airway is not open, and the patient is not receiving the life-saving oxygen they need. Pro Tip #3: If there is no way to get a proper seal, there are other adjuncts available, but these may be considered advanced life support techniques in your area. Supraglottic airways – these are designed to fit the stem of the bag valve without the mask and can help deliver a secured airway with ventilations. Endotracheal tubes – these are also designed to be used with the stem of the bag valve and assist with delivering oxygen. Both options are possibilities if the mask isn't fitting or sealing properly. Pro Tip #4: If you're not able to deliver ventilations successfully using the bag valve mask, don't use it. Set it aside and use a regular rescue mask with a one-way valve and deliver breaths with the mouth to mask technique. Don't waste time that the patient doesn't have, as they are likely becoming anoxic by the second. The benefits of using a bag valve mask: They can be safer when it comes to infection control. They can deliver higher concentrations of oxygen with each breath. Another important note: Bag valve masks work best when incorporated into the team approach. Bag valve masks require practice to perfect. So, if you're supposed to be using one as part of your own particular protocol or if you simply see the benefits of using it when compared to the traditional mouth to mask rescue technique, practice as much as you can first. What do they say about practice? It makes perfect. And perfect use of the bag valve mask could mean the difference between life and death. https://d3imrogdy81qei.cloudfront.net/video_images/3729/adult-bag-valve-mask-2015.jpg Yes 415 https://www.procpr.org/training/video/child-cpr-2-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2087.mp4 Child CPR 2 Rescuer In this section, we're going to cover two-responder child CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.) Much of what was covered in the last section – Adult CPR with Two Responders – will apply in this section – Child CPR with Two Responders. There will, however, be some subtle but crucial differences that are highlighted below. Pro Tip #1: When performing chest compressions on a large child, use two hands as you would for an adult. But when performing compressions on a smaller child, use just one hand to assure you're not compressing with too much force. Pro Tip #2: The rate of compressions to rescue breaths changes during child CPR when two responders are present. Instead of performing 30 compressions to two rescue breaths, reduce the number of compressions to 15 for every two rescue breaths. It's worth mentioning again – The assessment phase is similar to one-responder situations, however, while one of you is assessing the scene and patient, the other can get the equipment ready to perform CPR, try to locate an AED if one isn't present, call 911 or a code, etc. Once chest compressions begin, that's when the efforts of each responder will begin to coordinate, including the important switch at the two-minute mark. The importance of having a fresh compressor cannot be overstated. Performing high-quality compressions will help bring the pulse pressure up as well as keeping the blood pressure as high as possible. Having two responders working together as a coordinated team will ensure the highest quality CPR gets delivered, which will give the patient the greatest chance of survival. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve (or bag valve mask when there are two responders), begin calling out to the victim to assess whether or not the child is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Two-Responder CPR Technique for Children Responder one: Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. With smaller children, it may help to draw an imaginary line across the nipples. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Remember: Use only one hand when performing chest compressions on smaller children. Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 15 chest compressions. Remember that counting out loud is even more important when two responders are working together. It allows the other responder to anticipate the delivery of rescue breaths and the all-important switching of duties. Responder two: Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. (When using the bag valve mask, remember not to push down on the mask, but rather, lift the mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do. Also, remember that with children, the head-tilt, chin lift is less pronounced than it is during adult CPR.) Compress the bag on the bag valve mask and wait for the chest to rise and fall before administering the next breath. Responder one: Go right back into your 15 chest compressions. Responder two: Go right back to delivering two rescue breaths. Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties. Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask. Continue to perform 15 chest compressions to two rescue breaths – while switching duties every two minutes – until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About Ventilations Artificial ventilation is the method of forcing air into the lungs of a patient who is not breathing on their own. The oxygen in the ventilated air will be absorbed by blood flowing through the lungs and carried to the body's tissues and vital organs. There are several ways to provide this ventilation, including: Mouth to mask using a one-way valve Using a bag valve mask with or without supplemental oxygen Mouth to mouth Mouth to nose Mouth to nose ventilation may be required if no ventilation equipment is present and if you are unable to create a proper seal over the patient's mouth. Mouth to Mouth Ventilation Steps Open the patient's airway past neutral using the head tilt, chin lift maneuver. Pinch the patient's nose shut. Create a seal over the patient's mouth using your mouth, or over the mouth and nose for an infant. Blow air into the patient's mouth. Break the seal slightly on the inhale and reseal before administering the next breath. https://d3imrogdy81qei.cloudfront.net/video_images/3733/child-cpr-2-rescuer-2015.jpg Yes 229 https://www.procpr.org/training/video/child-aed https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7278.mp4 Child AED The methods of defibrillating a child are basically the same as defibrillating an adult. One important distinction involves AED pad size. AED pads come in an adult size and a pediatric size, for patients less than 8 years old or 55 pounds - roughly 25 kilograms. Pro Tip #1: If you do not have pediatric pads and the patient is less than 8 years old or 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. Warning: Remember that when using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? If for some reason the scene isn't safe enough to use an AED, move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. Pro Tip #2: It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check for breathing and a pulse. Use the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with your AED. AED Technique for Children Turn on the AED. Remove the patient's clothing to reveal a bare chest. Attach the AED pads to the patient's chest. The pads should have a diagram on placement if you need a reminder. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side mid axillary, under the left breast. For small children, attach one AED pad to the center of the child’s chest, roll the child onto his or her side, and attach the second pad to the center of the back, between the shoulder blades.  Plug the cable into the AED and be sure no one is touching the patient, including yourself. The AED should now be analyzing the rhythm of the patient's heart. If it is a shockable rhythm, it will charge automatically and be ready to shock. If the scene is clear and no one is touching the patient, push the flashing shock button. Then go right into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Consider the size of the child when doing compressions, use one hand for a smaller child and two hands to perform compressions on older children. It also depends on the size and strength of the rescuer if one or two hands are needed to supply the proper chest compressions. Conduct compressions that go 1/3 the depth of the child's chest, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. If you have two rescuers, the compression to ventilation ratio is 15:2. Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. After two minutes of CPR, the AED will analyze the patient’s heart rhythm again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button. Go right back into CPR. If the AED says no shock advised, immediately start CPR with compressions unless there are signs of life. Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About Special AED Situations Some special considerations should be given when using an AED in certain situations. These include using an AED on a patient who has an implantable device and a patient who's suffering from hypothermia. Implantable Devices Implantable devices, like pacemakers, are sometimes located below one of the collarbones in the area where one of the AED pads should go. This can be problematic as the device could interfere with shock delivery. An ICD (Implantable Cardioverter-Defibrillator) is another common implantable device you may encounter. It's sort of like a mini version of an AED, as it detects abnormal heart rhythms and restores them to normal. If one of these devices is visible – a small lump can sometimes be seen or felt – or if you know the patient has one in a specific location, do not place the AED pad on top of it. Instead, adjust the placement of the pad to avoid the device, usually 1 inch away from the device is appropriate.  Hypothermia As already mentioned, patients who are wet pose no problems when using an AED, provided they are not submerged in water, water is not connecting the patient with the responder or anyone else, and the wet clothing is removed from the upper torso and the chest is dried off. Patients who are suffering from hypothermia do not require rewarming before using the device. However, you will want to handle them gently, as shaking them could result in V-fib. https://d3imrogdy81qei.cloudfront.net/video_images/13096/child-aed-bls-2025v2.jpg Yes 256 https://www.procpr.org/training/video/2025-guidelines-updates-bls-and-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7287.mp4 2025 Guidelines Updates - BLS and First Aid In this lesson, we're going to summarize and highlight the latest information from the 2025 American Heart Association Emergency Cardiovascular Care guidelines as they relate to Healthcare Provider CPR. Just like in previous updates, the goal of these guideline changes is simple: to improve the survival of our patients by improving early recognition, high-quality CPR, and early defibrillation. Despite decades of public education, bystander CPR and AED use uremain inconsistent, and outcomes for out-of-hospital cardiac arrest still depend heavily on what happens in the first few minutes. The 2025 ECC updates continue to emphasize that early action by healthcare providers is what truly saves lives. Many of the changes you'll see focus on improving CPR quality, reducing delays, and removing barriers that prevent people from stepping in to help. Initiation of Resuscitation for Adults The ECC continues to reinforce the importance of performing CPR with breaths. If a rescuer is not trained or does not have the ability to safely give breaths, hands-only CPR can be used, as providing compressions alone is still better than doing nothing at all. Whenever feasible, and without delaying chest compressions, CPR should be performed where the person is found, as long as high-quality CPR can be delivered safely and effectively. It's preferred that the patient be in the supine position — meaning on their back — on a firm surface, since firm surfaces improve compression depth and effectiveness. Delays caused by unnecessary movement of the patient are associated with worse outcomes. Chest compressions should be performed with the patient's torso positioned approximately at the level of the rescuer's knees. This positioning improves rescuer body mechanics and reduces fatigue. Rescuers may also consider placing their dominant hand on the sternum when performing compressions, which may further improve overall CPR quality. Pro Tip #1:The key takeaway here is don't delay chest compressions. High-quality CPR, including breaths, can significantly increase the chance of survival. When providing ventilations with a bag-mask device during adult cardiac arrest, it's reasonable for one rescuer to use two hands to open the airway and seal the mask, while a second rescuer squeezes the bag to improve ventilation effectiveness AED Use and Patient Dignity The 2025 guidelines re-emphasized an important barrier to public access defibrillation, particularly for women. Evidence suggests that the need to expose the chest may contribute to lower rates of AED use in female patients. While proper pad placement is always preferred, current evidence shows that successful defibrillation can still occur even when pad placement is not exactly perfect. Because of this, it is reasonable to apply AED pads directly to the skin by simply adjusting clothing or undergarments rather than removing them entirely, when appropriate. The priority remains rapid pad placement and early defibrillation, while maintaining patient dignity and reducing hesitation that can delay care. Mechanical CPR Devices In adult cardiac arrest, the use of a mechanical CPR device should only be considered in specific settings where delivering high-quality manual compressions may be challenging or dangerous. When mechanical CPR is used, rescuers must strictly limit interruptions in chest compressions during deployment and removal of the device. High-quality manual CPR should never be delayed while preparing or positioning a mechanical device. Foreign Body Airway Obstruction For conscious adults and children with severe foreign body airway obstruction, rescuers should perform repeated cycles of 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unresponsive. This sequence reflects evidence suggesting that back blows may be more effective and cause fewer injuries than abdominal thrusts alone. In special circumstances — such as late-stage pregnancy or when abdominal thrusts are impractical — chest thrusts should be used instead. For infants, abdominal thrusts are still not recommended. Instead, back blows and chest thrusts continue to be used. Pro Tip #2: A key update in 2025 is that chest thrusts for infants should now be performed using the heel of one hand, placed in the center of the chest, rather than the previously recommended two-finger technique. This change is based on evidence showing improved compression depth and effectiveness during severe airway obstruction. Cardiac Arrest Following Drowning For adults and children in cardiac arrest following drowning, CPR with breaths should be started before AED application. Drowning-related cardiac arrest is typically hypoxic in nature, meaning oxygen deprivation is the primary issue. Early ventilations are critical, and applying an AED first may delay the initiation of effective CPR with breaths — especially since shockable rhythms are less common in drowning cases. Eye Injuries with an Embedded Foreign Object A small but important update: when caring for a person with a foreign object embedded in the eye, rescuers should now cover only the affected eye rather than both eyes. This change is intended to reduce anxiety in the patient by allowing them to maintain vision in the unaffected eye. The previous concept was that if you covered both eyes, then that would reduce the movement of the good and the injured eye. Data shows that with the increased anxiety and potential for further injury caused by the temporary blindness, it would be safe to just bandage the injured eye.  ProTip #3: Our goal is to prevent any further injury to the eyes. Protect the injured eye(s) from any excessive pressure with a shield or cup and seek immediate medical attention. Managing Shock When caring for a person showing signs of shock who remains alert, it is reasonable to place or maintain them on their back. If the person is at risk for airway obstruction — such as decreased alertness or active vomiting — or if they cannot be continuously monitored, it is reasonable to place them in the recovery position, on their side. While elevating the feet has been shown occasionally to help the patient, the effects are often short lasting only a few minutes. Pro Tip #4: In situations where there is no evidence of trauma or injury, such as fainting or dehydration, some studies suggest that raising the feet approximately 6 to 12 inches may still be beneficial. The priority remains placing the patient safely on the ground, keeping them warm, and monitoring for airway compromise or the need for CPR A Unified Chain of Survival The 2025 guidelines introduce a single, standardized Chain of Survival that now applies to infants, children, and adults. It excludes neonates, who follow a separate neonatal chain of survival. This unified approach emphasizes early recognition, early CPR, early defibrillation, and advanced care, as well as recovery as a continuous process across all age groups. CPR in Infants and Children In infants and children, studies consistently show that CPR with both compressions and breaths provides the best chance of survival. However, if providers are unable to give breaths to an infant or child in cardiac arrest due to safety concerns, compression-only CPR is reasonable. Large observational studies show that compression-only CPR is far better than no CPR at all, and significantly improves survival outcomes compared to no bystander intervention. A Word About Left Ventricular Assist Devices (LVADs) An LVAD, or left ventricular assist device, is a mechanical pump that is surgically implanted to help the heart's main pumping chamber — the left ventricle — circulate blood throughout the body. It is used for patients with end-stage heart failure. In unresponsive adults and children with durable LVADs, chest compressions should be performed when there are signs of impaired perfusion. The presence of an LVAD does not eliminate the need for CPR during cardiac arrest. Closing Thoughts The 2025 ECC CPR guideline updates continue to reinforce a simple but powerful message: early recognition, early CPR, and early defibrillation saves lives. These updates are designed to improve CPR quality, reduce delays, and remove the barriers that prevent rescuers from acting — whether that rescuer is a parent, a bystander, or a trained professional. Guidelines will continue to evolve as science advances, but the mission remains the same: recognize the emergency, take action, and do the best you can. CPR doesn't need to be perfect to save a life. Doing something is always better than doing nothing, and confident, informed rescuers make all the difference. https://d3imrogdy81qei.cloudfront.net/video_images/13116/2025-guidelines-updates-bls-and-first-aid.jpg Yes 472 https://www.procpr.org/es/training/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/video/respiracion-agonica-no-respirar-normalmente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2022.mp4 Respiración agónica (no respirar normalmente) Un signo de parada cardiaca se describe como respiración agonal. Esto ocurre cuando una persona está haciendo un jadeo o tragarse el movimiento y no está respirando normalmente. La respiración agónica ocurre en el 40% de los paros cardiacos tempranos. Saber cuándo una persona es respiratoria agonal puede prevenir intentos agresivos de RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/es/training/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/video/abordaje-en-equipo-rcp-adulto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2090.mp4 Abordaje en equipo para RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3739/adult-cpr-team-approach-2015.jpg Yes 448 https://www.procpr.org/es/training/video/svb-bls-neonatal-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2080.mp4 Soporte vital básico (BLS) neonatal Aunque la reanimación neonatal no es necesariamente parte del programa normal de BLS (Soporte Vital Básico), creemos que es importante que aquellos que tienen un bebé de menos de un mes o aquellos que trabajan con neonatos, comprendan la diferenciación entre la RCP infantil o del bebé y la reanimación neonatal. https://d3imrogdy81qei.cloudfront.net/video_images/3719/neonatal-bls-2015.jpg Yes 376 https://www.procpr.org/es/training/video/dea-adulto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2081.mp4 DEA para adultos Ahora vamos a cubrir DEA en un adulto con un único rescatista para el profesional de la salud. https://d3imrogdy81qei.cloudfront.net/video_images/3721/adult-aed-2015.jpg Yes 353 https://www.procpr.org/es/training/video/asfixia-adulto-inconsciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2091.mp4 Asfixia en adulto inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/3741/unconscious-adult-choking-2015.jpg Yes 216 https://www.procpr.org/es/training/video/rcp-ninos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2077.mp4 RCP en niños https://d3imrogdy81qei.cloudfront.net/video_images/3713/child-cpr-2015.jpg Yes 112 https://www.procpr.org/es/training/video/rcp-adultos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2076.mp4 RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3711/adult-cpr-2015.jpg Yes 243 https://www.procpr.org/es/training/video/asfixia-nino-inconsciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2092.mp4 Asfixia en niño inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/3743/unconscious-child-choking-2015.jpg Yes 180 https://www.procpr.org/es/training/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/video/lesion-espinal-traccion-mandibular-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2084.mp4 Lesión espinal - tracción mandibular Tenemos una persona aquí que parece que se cayó por las escaleras. No había espectadores alrededor para darnos un testimonio ocular de qué pasó exactamente. No sabemos si se golpeó la cabeza, no sabemos cuántos escalones cayó, lo que sí sabemos es que está tendido en la base de una serie de escalones, un tramo de escalera y parece estar dolorido. Lo que vamos a hacer es intentar minimizar el movimiento del paciente a medida que comenzamos a averiguar más sobre lo que pudo haber ocurrido y qué está pasando. Recuerda, el objetivo de hacerlo es para averiguar si necesitamos llamar al 911 y obtener ayuda en camino o si esta persona está lo suficientemente bien para poder volver a la vida normal y simplemente salir de ello. https://d3imrogdy81qei.cloudfront.net/video_images/3727/spinal-injury---jaw-thrust-2015.jpg Yes 386 https://www.procpr.org/es/training/video/respiracion-rescate-adultos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2072.mp4 Respiración de rescate en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3703/adult-rescue-breathing-2015.jpg Yes 144 https://www.procpr.org/es/training/video/respiracion-rescate-bebe-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2074.mp4 Respiración de rescate en bebés https://d3imrogdy81qei.cloudfront.net/video_images/3707/infant-rescue-breathing-2015.jpg Yes 132 https://www.procpr.org/es/training/video/introduccion-pro-rcp https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2103.mp4 Introducción a ProRCP En este curso, cubriremos la RCP, DEA y bolsa válvula máscara en bebés, niños, adultos, dos personas, una persona. También abordaremos el enfoque en equipo, específicamente para profesionales de la salud. Cuando diseñamos ProCPR, mantuvimos en mente la agenda ocupada de la atención médica. Por eso lo desarrollamos para estar disponible las 24 horas del día, los 7 días de la semana. Así que se basa en tu horario, y no el de los instructores. Así que con eso, vamos a empezar. https://d3imrogdy81qei.cloudfront.net/video_images/3765/procpr-introduction-2015.jpg Yes 48 https://www.procpr.org/es/training/video/respiracion-rescate-adultos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2121.mp4 Práctica: Respiración de rescate en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3801/adult-rescue-breathing-practice-2015.jpg Yes 82 https://www.procpr.org/es/training/video/respiracion-rescate-ninos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2122.mp4 Práctica: Respiración de rescate en niños https://d3imrogdy81qei.cloudfront.net/video_images/3803/child-rescue-breathing-practice-2015.jpg Yes 64 https://www.procpr.org/es/training/video/respiracion-rescate-bebe-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2123.mp4 Práctica: Respiración de rescate en bebés https://d3imrogdy81qei.cloudfront.net/video_images/3805/infant-rescue-breathing-practice-2015.jpg Yes 68 https://www.procpr.org/es/training/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/video/rcp-adulto-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2124.mp4 Práctica: RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3807/adult-cpr-practice-2015.jpg Yes 92 https://www.procpr.org/es/training/video/rcp-nino-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2125.mp4 Práctica: RCP en niños https://d3imrogdy81qei.cloudfront.net/video_images/3809/child-cpr-practice-2015.jpg Yes 104 https://www.procpr.org/es/training/video/dea-dos-personas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2130.mp4 Práctica: DEA dos personas https://d3imrogdy81qei.cloudfront.net/video_images/3819/two-person-aed-practice-2015.jpg Yes 247 https://www.procpr.org/es/training/video/rcp-adultos-dos-rescatistas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2131.mp4 Práctica: RCP en adultos dos rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3821/adult-cpr-two-rescuer-practice-2015.jpg Yes 188 https://www.procpr.org/es/training/video/rcp-ninos-dos-rescatistas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2132.mp4 Práctica: RCP en niños dos rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3823/child-cpr-two-rescuer-practice-2015.jpg Yes 141 https://www.procpr.org/es/training/video/rcp-bebes-dos-rescatistas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2133.mp4 Práctica: RCP en bebés dos rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3825/infant-cpr-two-rescuer-practice-2015.jpg Yes 148 https://www.procpr.org/es/training/video/asfixia-adulto-inconsciente-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2135.mp4 Práctica: Asfixia en adulto inconsciente (asistencia médica) https://d3imrogdy81qei.cloudfront.net/video_images/3829/unconscious-adult-choking-practice-2015.jpg Yes 102 https://www.procpr.org/es/training/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/video/asfixia-nino-inconsciente-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2136.mp4 Práctica: Asfixia en niño inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/3831/unconscious-child-choking-practice-2015.jpg Yes 97 https://www.procpr.org/es/training/video/seguirdad-piscina-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2069.mp4 Seguridad en la piscina https://d3imrogdy81qei.cloudfront.net/video_images/3697/pool-safety-2015.jpg Yes 340 https://www.procpr.org/es/training/video/cuando-rcp-no-funciona-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2041.mp4 Cuando la RCP no funciona La RCP es un intento de compensar la circulación en el corazón que no está sucediendo normalmente. La RCP no detiene el proceso de morir; Simplemente disminuye la muerte celular biológica. La esperanza es que este procedimiento puede comprar tiempo para que el ccsme llegue a probar otros métodos de restaurar la circulación apropiada de la sangre oxigenada por todo el cuerpo para comprar aún más tiempo de modo que la razón subyacente por la cual la persona entró en paro cardiaco en el primer lugar puede ser Explorado Si la RCP no funciona, recuerde que le dio a esa persona la mejor oportunidad de sobrevivir. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/es/training/video/rcp-adultos-2-rescatistas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2086.mp4 RCP en adultos 2 rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3731/adult-cpr-2-rescuer-2015.jpg Yes 237 https://www.procpr.org/es/training/video/respiracion-rescate-ninos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2073.mp4 Respiración de rescate en niños https://d3imrogdy81qei.cloudfront.net/video_images/3705/child-rescue-breathing-2015.jpg Yes 153 https://www.procpr.org/es/training/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/video/es-control-hemorragia-sangrado-arterial https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2094.mp4 Sangrado arterial https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/es/training/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/video/puntos-de-referencia-bebes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7174.mp4 Puntos de referencia en lactantes (bebés) https://d3imrogdy81qei.cloudfront.net/video_images/13008/infant-landmarks-bls-2025.jpg Yes 195 https://www.procpr.org/es/training/video/dea-adulto-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2127.mp4 Práctica: DEA en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3813/adult-aed-practice-2015.jpg Yes 240 https://www.procpr.org/es/training/video/dea-nino-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2128.mp4 Práctica: DEA en niños https://d3imrogdy81qei.cloudfront.net/video_images/3815/child-aed-practice-2015.jpg Yes 256 https://www.procpr.org/es/training/video/rcp-bebes-2-rescatistas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7175.mp4 RCP en bebés 2 rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/13010/infant-cpr-2-rescuer-bls-2025.jpg Yes 191 https://www.procpr.org/es/training/video/dea-2-personas-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7178.mp4 DEA - 2 personas https://d3imrogdy81qei.cloudfront.net/video_images/13016/2-person-aed-bls-2025.jpg Yes 295 https://www.procpr.org/es/training/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/video/rcp-bebes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7173.mp4 RCP en bebés https://d3imrogdy81qei.cloudfront.net/video_images/13006/infant-cpr-bls-2025.jpg Yes 204 https://www.procpr.org/es/training/video/asfixia-nino-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7180.mp4 Asfixia en niño consciente https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/es/training/video/dea-bebe-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7177.mp4 DEA para bebés https://d3imrogdy81qei.cloudfront.net/video_images/13014/infant-aed-bls-2025.jpg Yes 271 https://www.procpr.org/es/training/video/asfixia-bebe-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7181.mp4 Asfixia en bebé consciente https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/es/training/video/asfixia-bebe-inconsciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7183.mp4 Asfixia en bebé inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/13026/unconscious-infant-choking-bls-2025.jpg Yes 238 https://www.procpr.org/es/training/video/conmocion-shock https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7185.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13030/shock-bls-2025.jpg Yes 235 https://www.procpr.org/es/training/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/video/bolsa-valvula-mascarilla-adulto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2085.mp4 Ventilación con bolsa válvula mascarilla https://d3imrogdy81qei.cloudfront.net/video_images/3729/adult-bag-valve-mask-2015.jpg Yes 415 https://www.procpr.org/es/training/video/rcp-ninos-2-rescatistas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2087.mp4 RCP en niños 2 rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3733/child-cpr-2-rescuer-2015.jpg Yes 229 https://www.procpr.org/es/training/video/dea-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7278.mp4 DEA para niños https://d3imrogdy81qei.cloudfront.net/video_images/13096/child-aed-bls-2025v2.jpg Yes 256 https://www.procpr.org/es/training/video/2025-guidelines-updates-bls-and-first-aid-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7287.mp4 Actualizaciones de las Guías 2025: Soporte Vital Básico y Primeros Auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13116/2025-guidelines-updates-bls-and-first-aid.jpg Yes 472 https://www.procpr.org/training/bls-first-aid/video/spider-bites-tick-bites-and-scorpion-stings https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6491.mp4 Spider Bites, Tick Bites and Scorpion Stings This first aid lesson is for the treatment of spider bites, tick bites, and scorpion stings. While these encounters can be alarming and sometimes painful, knowing the proper first aid steps can help ensure a swift and effective response and recovery. It's important to keep in mind that millions of people are bitten or stung by spiders, ticks, and scorpions every year in the United States alone, and most of these are harmless. However, in this lesson, we’re going to focus on generalized treatment and what to watch for in more severe cases. Remember that the priority is always safety. Once you and the victim are out of harm's way, see if there is a way to identify what bit or stung you, as this can help identify appropriate treatment if needed. But only do this if it can be done safely. Since all of these bites or stings will have punctured the skin, gently washing with soap and water is always the recommended first step. If you notice any concerning reactions or symptoms, seek medical help immediately. In that case, watch for skin discoloration or blistering, nausea, abdominal pain, difficulty breathing, change in responsiveness, or significant pain. If there are no immediate health concerns, here are the steps to handle these bites or stings. First Aid Steps for Spider Bites If you're in a geographical area where there are venomous spiders, remove yourself from the vicinity to avoid further bites.> It's important to identify the spider responsible for the bite whenever safe and possible. Wash the bite area with mild soap and water. Elevate the bitten extremity and apply a cold compress or an ice pack wrapped in a thin cloth to the bite site. Elevating the bitten extremity will help reduce pain and swelling. Leave the compress or ice pack on the bite site for about 10-15 minutes each hour. Symptoms Associated with Spider Bites Symptoms associated with spider bites can vary from minor to severe. Although extremely rare, death can occur in the most severe cases. Possible symptoms resulting from a spider bite include the following: Itching or rash Pain radiating from the site of the bite Muscle pain or cramping Reddish to purplish color or blister Increased sweating Difficulty breathing Headache Nausea and vomiting Fever Chills Anxiety or restlessness High blood pressure Pro Tip #1: For suspected or confirmed bites from venomous spiders, such as black widows or brown recluse spiders, it's crucial to seek immediate medical attention. Call emergency services or visit the nearest hospital. First Aid Steps for Tick Bites The important thing to remember with tick bites is that the longer the tick is attached, the more likely it is to transmit diseases. So acting quickly is definitely in the victim's best interest. Remove the tick promptly using a pair of fine-tipped tweezers. Grasp the tick as close to the skin's surface as possible. Pull the tick away from the skin steadily and slowly with firmness, and try to avoid twisting or crushing the tick during this process. The skin will tent, and the tick will eventually let go. Clean the area with mild soap and water. Pro Tip #2: If you're concerned about tick-borne diseases, you can preserve the tick in a sealed container or a plastic bag. This may assist healthcare professionals in identifying the tick and determining the risk of disease transmission. Please note that if the head comes off and stays embedded in the skin, call emergency services or visit the nearest hospital. A Word of Caution Avoid folklore such as painting the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible – not waiting for it to detach. If you develop a rash or fever within several days to weeks after removing a tick, see your doctor. Tick Bite Bot: An Interactive Tool for Dealing with Tick Bites The CDC has an interactive tool that can assist you in the removal of attached ticks and also advise you on when to seek medical attention. This online mobile-friendly tool asks a series of questions covering topics such as tick attachment time and symptoms. Based on the user's responses, the tool will then provide information on first-aid treatment options. First Aid Steps for Scorpion Stings Like with spider bites, remember to first remove yourself from the area to prevent further stings. Clean the sting site with mild soap and water. Apply a cold compress or an ice pack wrapped in a cloth to the sting site to help with the pain. Pro Tip #3: While most scorpion stings are harmless, seeking medical attention is essential to be safe, as venomous species can be fatal to humans. Call emergency services or visit the nearest hospital immediately. When it comes to scorpions, prevention is key. Be proactive and take precautions by checking your clothing and inside your shoes before putting them on wherever these creatures are common. And remember that if you are stung, stay calm and follow the steps above. And as always, seek professional medical help whenever necessary. Symptoms Associated with Scorpion Stings Symptoms usually subside within 48 hours, although stings from a bark scorpion can be life-threatening. Symptoms of a scorpion sting may include: A stinging or burning sensation at the injection site Extreme pain when the sting site is tapped with a finger Restlessness Convulsions Roving eyes Staggering gait Thick tongue sensation Slurred speech Drooling Muscle twitches Abdominal pain and cramps Respiratory depression https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/training/bls-first-aid/video/stroke https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2019.mp4 Stroke In this lesson, we're going to go over what a stroke is, what the signs and symptoms are that will indicate to you that there's an emergency, and what to do if you suspect a stroke. And we'll even teach you an easy-to-remember acronym to make your stroke assessment a little easier. What is a Stroke? A stroke, also called a cerebrovascular accident (CVA), is a disruption of blood flow to a part of the brain, which may cause permanent damage to brain tissue if not appropriately treated in a timely manner. There's a common analogy that works well to describe what a stroke is – a stroke is like a heart attack in the brain. This analogy works because what typically causes a stroke is usually what causes a heart attack – a blocked blood vessel – only in the brain rather than the heart. When a blood vessel blockage occurs, it starves the brain of oxygenated blood, which will quickly result in neurological effects in the patient's body. A stroke can also be caused by a bursting of a blood vessel rather than a blockage. In these cases, the condition is known as a hemorrhagic stroke, and is normally the result of an aneurism. The important takeaway is that hemorrhagic stroke is treated differently than strokes that occur from blood vessel blockage. What are the Signs and Symptoms of a Stroke? Using the acronym FAST, you'll be able to navigate quickly through the list of stroke symptoms and systematically check them off as you go. And ultimately, if the patient is having a stroke, call 911 and activate EMS. F – Facial Droop If you're having a difficult time assessing the patient for facial droop, ask them to smile at you. If the droop isn't initially very pronounced, it will be when the patient tries to smile. Does the smile look normal? Or is one corner of the mouth lower than the other? A – Arm Raise both of the patient's arms out in front of them and ask the patient to hold that position. Does one arm fall lower than the other? Or do they both remain in the position you left them? If one arm does begin to fall, as the patient cannot hold it up, it will likely be the arm on the same side of the body as the facial droop. S – Slurred Speech During medical emergencies, patients are naturally panicked, and it can affect their speech. To better assess for this stroke sign, ask them a question – like what their birth date is – or to repeat a certain phrase, like "I love blueberries". If the patient answers with slurred speech, you can check another item off your FAST checklist. T – Time Time is of the essence when it comes to treating stroke victims. But it's also important to know what time symptoms began in each victim, as this will matter when healthcare professionals begin trying to recirculate oxygenated blood back into the brain's tissue. Your quick actions and attention to detail will go a long way to helping the patient recover with as little long-lasting damage as possible. What to do if You Suspect a Patient is Having a Stroke If you haven't already called 911 and activated EMS, do so immediately. Expediting treatment is key to the patient regaining as much quality of life as they can. While waiting for EMS to arrive, reassure the patient. Tell them you're not going anywhere and that you'll take good care of them. And make them as comfortable as possible while you wait. A Word About the Signs and Symptoms of Stroke Other than the stroke alert criteria in FAST that you should be looking for, there are a few other signs and symptoms of stroke that may help you assess the patient better. Loss of vision or disturbed vision in one or both eyes; the pupils may also be of unequal size Sudden severe headache; you may hear the patient describe the pain as the worst headache ever Confusion, dizziness, agitation, loss of consciousness, or other severe altered mental states Loss of balance or coordination, trouble walking, or ringing in the ears Incontinence Pro Tip #1: it's important to understand the difference between a full-blown stroke and a TIA (Transient Ischemic Attack), sometimes called a mini-stroke. The latter is caused by reduced blood flow to a part of the brain, but unlike a stroke, the signs and symptoms disappear within a few minutes or hours of onset. With a TIA, after a short time, blood flows again and the symptoms go away. With a stroke, the blood flow stays blocked, and the brain is more likely to suffer permanent damage. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/training/bls-first-aid/video/heart-attacks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2018.mp4 Heart Attacks In this lesson, we're going to take a closer look at heart attacks, including: What they are and why they happen If there's anything we can do to help control or prevent them The signs and symptoms of a heart attack for both men and women What Causes a Heart Attack? A heart attack occurs when something occludes a blood vessel that feeds the heart. When this happens, the heart muscle begins to starve of oxygen, which causes pain plus any number of other symptoms, the totality of which is known as a heart attack. Some common ways patients may describe their symptoms include: A squeezing feeling or tightness in their chest Like something is sitting on their chest Pain that may radiate into arms, or the neck, jaw, and teeth in some cases Classic Signs and Symptoms of a Heart Attack Women often experience their own unique set of signs and symptoms that typically differs from what men may experience. So, consider this list to be men-centric, as in the classic symptoms of a heart attack. The more typically female symptoms will follow. Heavy sweating Crushing chest pain Pain that may radiate into other areas, most typically the arms Shortness of breath Weakness Nausea Dizziness Women can experience the symptoms listed above, however, the most common symptoms of a heart attack for women are: Back pain, like a muscle strain or pulled muscle Feeling achy Indigestion Warning: One problem is the way in which heart attacks are depicted in movies and on TV, as it's always a sweaty guy clutching his chest. But that's mostly only true for half the population. And if the other half (some would say, better half) are expecting those same symptoms and getting something that feels more like the flu than a heart attack, this could delay a proper response, and the patient could suffer because of that delay. Conditions with Similar Signs and Symptoms There are a number of other ailments that have been known to mimic a heart attack, including: Angina Pneumonia Pleuritis Broken ribs Pro Tip #1: Angina is a condition marked by severe chest pain, often spreading to the shoulders, arms, and neck, and is caused by a reduced blood supply to the heart. It's still a concern. Just not as concerning. Warning: It's better to rule out a heart attack after being checked out by EMS personnel or a physician than it is to dismiss symptoms as something minor. When in doubt, check it out. Once a heart attack is suspected, call 911 immediately and activate EMS. Get an ambulance on the way. If it turns out to be indigestion, you can always send them away when they arrive. Or better yet, they can examine the patient and rule a heart attack out. If a heart attack is suspected and EMS isn't activated, all that's being accomplished is slowing down a response time and treatment should things worsen. Someone's life may ultimately depend on those wasted minutes or seconds. Heart Attack Risk Factors You can really separate this into two separate categories – factors we can control and factors we cannot. Controllable Risk Factors Diet Exercise Stress Smoking Blood pressure Diabetes These are all huge factors when it comes to preventing cardiovascular disease, heart attacks, and stroke. Controlling diabetes and blood pressure, if high. Stopping smoking, if applicable. And eating better, exercising more, and relieving stress in healthy ways. These are all areas of improvement everyone can control. Uncontrollable Risk Factors Genetics Gender Age Race When it comes to uncontrollable risk factors, the hand you're dealt is the hand you're going to have to play. And unfortunately, certain people will always be predisposed to having a higher risk of heart attacks. Helping Heart Attack Patients in Other Ways Once you recognize the symptoms of a heart attack, you activate EMS, and both you and the patient wait comfortably for them to arrive, right? Well, not always. Pro Tip #2: For some reason it's human nature to deny the existence of a heart attack – just a bit of acid reflux most likely – which only delays getting help. It's also common for heart attack suspects to want to drive themselves to the hospital. Both are obviously dangerous and NOT recommended. While Waiting for the Ambulance One of the first treatments that even paramedics will use is aspirin. Aspirin may prevent a worsening of the heart attack and it could even relieve some of the symptoms. If you have aspirin, and if the patient can take it, offer it to them. Aspirin is effective because it basically acts as platelet lubricant once it's absorbed into the bloodstream. It better enables the platelets to slide by each other rather than getting stuck together and creating an even bigger clot. Does the patient have nitroglycerin tabs or spray? Can you get it for them if they cannot? Usually, the best thing you can do for someone who's having a heart attack, or showing the symptoms, is to reassure them that you'll be with them until help arrives. Tell them they're in good hands, in good care, but don't lie to them and tell them everything will be OK. Simply keep them calm and make them as comfortable as possible until EMS personnel arrive. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/training/bls-first-aid/video/five-fears-part-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2017.mp4 The Five Fears of CPR Rescue One common problem we see with training is when people have persistent fears that they can't shed, it prevents them from attempting to make a rescue. In this lesson, we're going to address those fears and hopefully eliminate them, so you'll have the confidence to push through and make a difference when faced with an emergency. The five fears are: Uncertainty of skills. You're worried that you don't know what to do, and that you'll do more harm than good. Might hurt or kill the patient. You're worried that a mistake on your part will spell trouble for the patient. Lawsuits. You're worried about getting sued, whether someone only thinks you did something wrong or you actually did do something wrong. Threat of contracting a disease. You're worried about blood and bodily fluids that contain pathogens that you would then contract. The scene is unsafe. You're worried that the scene may be unsafe and that you'll become a victim, too. At first glance, these fears may sound reasonable. However, let's tackle them one by one using some common sense that should help you eliminate your fears, so that you can become the best rescuer that you can be. Uncertain of Skills This should only be a real concern if there's no way for you to refresh your training. However, since we designed our course content to be viewed whenever it's convenient for you, rather than when an instructor is ready to teach, there's really no excuse. Whenever you feel that you're deficient in a particular area of training, go back to the training library for a refresher. It's self-paced and available 24/7. You can also ask a supervisor or someone with more experience for help. Pro Tip #1: Effort and knowledge are the cures for uncertainty. If you put in the time and master your skills, this uncertainty will vanish, and you'll be amazed that you were ever apprehensive to begin with. Might Hurt or Kill the Patient When a person is unconscious, isn't breathing normally, and has no pulse, they're already dead. And while it may sound silly to say this, it's true: Their condition cannot get worse. That patient will remain dead unless someone with life-saving skills gets involved. This alone should alleviate a lot of fear and worry about making the situation worse. During CPR compressions, a lot of new students worry about the possibility of breaking ribs or injuring a patient some other way. But this isn't really possible. Read that first paragraph again – the patient is dead and cannot get worse. However, with help, they may get better. Lawsuits The good news is that since 1985's Good Samaritan Act, people who attempt to help others are protected legally, with a couple of exceptions: If you intended to hurt the victim If you go above and beyond your level of training The Good Samaritan Act has essentially immunized people from lawsuits when they try to help others in need. Threat of Contracting a Disease As long as you have your equipment with you, this shouldn't be much of a concern. Equipment like gloves and one-way rescue masks will keep those nasty pathogens, if there are any, on the patient's side, while you the rescuer remain on your side. That's why we have this equipment – to help keep rescuers safe. So, make sure you have it with you and that you're using it, and this fear will quickly become a moot point. A Word About Hands-Only CPR Research has shown that, especially with adults and in the first few minutes, hands-only CPR is just as effective as full CPR. So, if you don't feel comfortable or confident in doing full CPR, or if you're lacking protective equipment, hands-only CPR will still benefit the patient. The Scene is Unsafe This is actually a legitimate fear and a reason to delay a rescue attempt. You can still call 911 and get EMS on the way. But if the scene is dangerous, don't do anything that will make you the next victim. Don't be a hero. If you go into a situation that can get you hurt or killed, you'll be unable to perform the rescue you're there for, so you do no good to anyone. Remain at a safe distance until the scene becomes safe, and then go in. These five fears prevent around 90 percent of people from using the skills they learned. It's natural to have them, but it's essential to shed them. Put in the time and effort when it comes to your training and crush those fears. Become more empowered than you ever thought possible and go forth and rescue confidently. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/training/bls-first-aid/video/universal-precautions-workplace https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2020.mp4 Universal Precautions in the Workplace This lesson deals with situations in which an injury or illness in the workplace leads to the presence of blood or other potentially infectious materials in the environment. It should go without saying that the scene must be cleaned up. But who does the cleanup? And more importantly, how can it be done safely? Often there are no specific employees who are designated to handle such cleanup jobs. But in other situations, there may be. If an employee was so designated, he or she would fall under the Type A category of the bloodborne pathogens rule. Such employees need to undergo specific training in bloodborne pathogens before being allowed to clean up a potentially infectious scene – training like that which is provided at ProBloodborne.com. However, for the general employee who volunteers (or not) to clean up the scene – or anyone with possible access, like first responders – this lesson is for you. A fairly common question people have is, how do I know if the scene contains bloodborne pathogens or other types of infectious materials? While that's an excellent question, the answer is likely to disappoint – Most of the time, you really don't know. The only way to know that if a scene contains pathogens is to get a sample into a laboratory and under a microscope. Assume the worst and be diligent, but most importantly … Safety First Pro Tip #1: What's the most important thing when it comes to a scene that you suspect to be infectious? Protect yourself. You must protect yourself against exposure to potentially infectious materials before engaging in any cleanup. The best way to protect yourself is by wearing gloves. And while it may sound silly, it pays to inspect your gloves before putting them on. Make sure there aren't any holes. Blow some air into a glove and hold the wrist end shut. Do you notice any air escaping through a leak? This is a great way to test for pinholes that you wouldn't be able to see. Warning: Defective gloves DO NOT protect against infectious diseases as well as gloves that aren't defective. If that's the one thing standing between you and them, better to take that one thing (your gloves) seriously. Solution Time All you need is water and household bleach, but more specifically, 1 part bleach to 9 parts water. In other words, take your pale or bucket and fill it with 1 cup of bleach and 9 cups of cold tap water. This is a simple solution but strong enough to kill most hepatitis, HIV, and other infectious pathogens. Application Time You can apply the bleach solution a couple of ways. Fill a spray bottle and spray the solution on contaminated surfaces and objects. Or dip a rag or towel into the solution and wipe those items down instead. Pro Tip #2: Consider wearing goggles, a face mask, and an apron if there's a chance of getting hit with splatter or spray of possibly infectious materials while cleaning up the scene. Better safe than sorry. An Example Situation A worker has an accident that leaves blood on an electric saw. Follow the steps below to safely clean it. Spray the saw with the bleach solution. Let it sit for 30 seconds or so. Wipe the saw down. Throw the rag or towel in the trash. (At this point, you may not be able to see visible signs of contamination, but that doesn't mean you got it all after one go.) Spray the bleach solution on the saw again. Let the saw air dry. Pro Tip #3: Letting the possibly contaminated saw air dry after the second go-around with the bleach solution is a great method of disinfecting it. When You're Done After you've cleaned all the tools and work surfaces that were affected, you'll want to properly dispose of your gloves, which involves taking them off without touching them. Remove the first glove using only glove-on-glove contact, by grabbing the wrist part of one glove (the outer part) and peeling it off. Bunch up the glove you just took off and work it into your other hand and make a fist, with the glove inside. Take one of your un-gloved fingers and using only skin-on-skin contact, push it under the wrist part of the glove and peel the second glove off. Warning: Be careful when taking off your gloves that you don't accidentally snap the material and send possibly infectious substances into the air and around the scene. Remember that initially, you'll be removing these gloves in a pretty unfamiliar way; just something to be aware of. Throw both gloves into the trash bin you've been using to dispose of your rags or towels, seal the bag up properly, and toss it into the nearest dumpster. Pro Tip #4: For larger cleanup jobs, consider getting special biohazard bags. However, it may be a good idea for jobs of any size, no matter how small, as those bags are a great way to alert others of the potential hazards inside, like waste management personnel. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/training/bls-first-aid/video/agonal-respiration-not-breathing-normally https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2022.mp4 Agonal Respiration (Not Breathing Normally) Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations. Agonal respiration is one sign of respiratory and cardiac arrest. Historically, this type of breathing has been difficult to identify and describe, especially for lay people, which can slow or hinder care and response times for cardiac arrest victims. A Word About Cardiac Arrest Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate blood to vital organs, including the brain. When heartbeats are weak, irregular, or uncoordinated, blood can't flow through the arteries to the rest of the body. If circulation is hampered or halted in any way, the body's organs cannot receive the oxygen they need to function normally. As a result, organ failure can occur. Brain damage sets in between 4-6 minutes, and after 8-10 minutes, this damage will likely be irreversible. Cardiovascular disease is the leading cause of death in the world and in the U.S., where it accounts for approximately 1 in 3 deaths. Cardiovascular disease is also the primary cause of cardiac arrest, but there are others, including: Drowning Choking Drug overdose Severe injury Brain damage Electrocution Warning: As more than 300,000 out-of-hospital cardiac arrests occur each year in the U.S., it's vital that lay rescuers and EMS professionals understand that early recognition – which is more difficult with agonal respiration – and quick action can have a tremendous impact on survival rates. Cardiac Chain of Survival To effectively respond to cardiac emergencies, it helps to understand the Cardiac Chain of Survival. Following the links in these chains – adult and pediatric – will give patients the best chance of survival. Warning: For each minute that CPR and/or defibrillation are delayed, the chance of survival is reduced by 7-10 percent. Adult Cardiac Chain of Survival Recognize the emergency and call 911 – the sooner medical personnel are called the sooner EMS can provide care for the patient. Early CPR – supplying blood and oxygen to vital organs can prevent brain damage and death. Early defibrillation – this electrical shock may restore an effective heart rhythm and increase the victim's chance of survival. Advanced life support – Medical personnel can help provide the proper equipment and medication needed to continue lifesaving care. Integrated post-cardiac arrest care – Integrated care can optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation. Pediatric Cardiac Chain of Survival Injury prevention and safety – ways to prevent cardiac arrest in children. Early CPR Early Emergency Care – Rapid activation of the EMS system or response team to get help on the way quickly. Pediatric advanced life support Integrated post-cardiac arrest care Agonal Respiration Continued Agonal respiration is characterized by abnormal breathing attempts in which the patient appears to be gasping or gulping. (Think of a fish as it tries to breathe out of the water to get an idea of what agonal respiration looks like.) These respiratory attempts originate from the lower brain stem neurons as higher, more complex neurons become increasingly hypoxic – lacking in oxygen. Agonal Respiration occurs in around 40 percent of early cardiac arrest victims. Aggressive CPR attempts are often hindered or slowed due to misinterpretation or misunderstanding of this serious condition. Pro Tip #1: It's important to remember that, when it comes to agonal respiration, these attempts from the body to breathe are routinely misinterpreted as normal breathing. However, even though it may appear the victim is breathing, he or she is not exchanging air well and will require immediate assistance to increase his or her survival rate. While lay rescuers describe agonal respiration in a number of ways, the good news is that 911 dispatchers have become better equipped to recognize all the ways in which people describe it, leading to better assistance and improved response times. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/training/bls-first-aid/video/hands-only-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2029.mp4 Hands-Only CPR Hands-only CPR is designed for the untrained lay rescuer or someone who isn't comfortable or confident giving mouth-to-mouth resuscitation. Research suggests that hands-only CPR is most effective on adults, as cardiovascular problems are often the cause of their cardiac arrest. Whereas, in children, the majority of their cardiac arrest events have to do with respiratory deficiencies. Of course, performing full CPR – a combination of 30 compressions to two rescue breaths – is always going to provide the best chances for a positive outcome. However, hands-only CPR is better than no CPR at all; even on children. How to Provide Care The first thing you want to do is make sure the scene is safe and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get a response, proceed with the following steps. Call 911 and activate EMS. Put your phone on speaker so the dispatcher can assist you. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep – for adults – or 1/3 the depth of the victim's chest and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Continue to perform chest compressions until help arrives or the victim is responsive and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About Other Cardiovascular Emergencies There are a number of conditions that can mirror cardiac arrest or make diagnosis difficult. Knowing what those are and how they're caused may help eliminate any confusion. Angina Pectoris Angina pectoris is a medical term that simply means pain in the chest. It occurs when the heart requires more oxygen than it is receiving, usually due to the arteries being too narrow. It's often triggered when the patient is exercising or becomes too excited or emotionally upset. Arrhythmias Arrhythmias are electrical disturbances in the heart that affect its regular rhythm. Some people with arrhythmias don't experience any cardiovascular problems, while in others, an arrhythmia can indicate a greater underlying problem that could lead to heart disease, stroke, or heart attack. Atrial Fibrillation Atrial fibrillation is a common type of abnormal heart rhythm, where the upper two chambers (the atria) are not coordinating their beats with the two lower chambers (the ventricles). This causes an irregular and often rapid heart rate that results in inadequate circulation to the ventricles. Atrial fibrillation is usually not life threatening, however, it could lead to a stroke or heart attack. Congestive Heart Failure Congestive heart failure is a chronic condition in which the heart can no longer pump blood effectively, thereby limiting circulation throughout the body. This can result in high blood pressure and fluid buildup – which can contribute to difficulty breathing and weight gain. People with congestive heart failure will often experience swelling of the face, hands, feet, legs, and ankles. Hypertension Hypertension, or high blood pressure, is one of the many risk factors for heart attacks and stroke. A person has hypertension if their blood pressure is higher than 140/90 mmHg. There are numerous causes of hypertension, including certain medications, stress, and high sodium intake, or underlying conditions like kidney abnormalities and/or an adrenal gland tumor. Diabetes People with diabetes often experience problems with their nerves and nervous system. In these cases, a person with this type of diabetes-related complication may experience what's known as a silent heart attack, as the brain and nervous system don't produce any symptoms, or produce warning signs that are too mild to notice. If this is the case, special diagnostic tests may be required to get confirmation of a heart attack. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/training/bls-first-aid/video/when-cpr-doesnt-work https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2041.mp4 When CPR Doesn't Work This is the last lesson in the cardiac arrest section, and a difficult topic to tackle for most. Whether you're a licensed paramedic, family member, neighbor, or stranger, the question remains the same for many people: Why didn't CPR work? That's a fair question. Even when you do everything perfectly, the desired outcome often isn't what you expected or hoped for. However, some of that hope and desire can be rooted in a misunderstanding of what CPR really is, which is the point of this lesson. CPR was designed to buy time, and nothing more. During cardiac arrest the heart is either in a fibrillatory state, meaning it's wiggling around in a disordered fashion, or it's completely asystolic, meaning it's not contracting at all. When a heart is healthy and operating as it should, it beats from top to bottom in a very organized way utilizing one-way valves. It works perfectly to circulate oxygenated blood throughout the entire body, and it does so efficiently. However, during cardiac arrest, regardless of what caused it, the heart is unable to circulate blood and oxygen and the body begins to die. The patient isn't breathing. There's no pulse. At this point, that person is clinically dead. Now, it doesn't mean that person will remain that way, as there is a difference between clinical death and biological death. What CPR aims to do, specifically the compressions, is to make up for the circulation that isn't happening naturally. The reality, though, is that even when CPR is performed perfectly, it's delivering only a small percentage of what the body needs to survive. It wasn't designed to be equal to artificial life support. Remember, it's simply a way to buy time. People have this idea that if they perform chest compressions on an unresponsive person, the body will remain alive. And he or she will remain alive so long as the chest compressions continue. But this isn't the case. CPR doesn't stop the dying process. It slows down biological death a little. But that's all it does. The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives – an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. – and the underlying cause of the cardiac arrest can be addressed. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival. CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology. The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are. If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact – by performing high quality CPR, you gave the patient the best possible chance of survival. Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way. That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. Now, you may be asking yourself, if CPR rarely works, is it even worth trying? EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying. And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember – we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them. The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough (even strangers) to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live. Isn't that the greatest gift we can give to another? This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. If you've ever performed CPR on a cardiac arrest victim, but the patient still remained dead, hopefully this greater understanding of what CPR really is has brought some peace to you, as the pain, agony, and guilt can be immense. Go forth and rescue confidently! And be at peace with yourself when you do. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/training/bls-first-aid/video/concussion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2038.mp4 Concussion This lesson is for those times when a head injury may have led to one of the more common and serious injuries – concussions. Pro Tip #1: Concussions occur as the brain moves abruptly from side to side inside the skull, essentially bouncing off the walls that protect it. In serious concussion cases, the brain can shut down immediately, causing the victim to lose consciousness. Even in situations that don't involve a loss of consciousness, a person who exhibits other concussion signs and symptoms are at least mildly concussed. Part of your job is to determine if the victim is concussed and how severe it is by reading the signs and asking open-ended questions. Warning: The most important thing to keep in mind as you deal with someone who has sustained a head injury, as soon as it appears to be a concussion, that deserves an immediate 911 call. Even if the patient begins to recover, concussions are too traumatic and can develop into something more life-threatening. How to Assess and Treat a Concussion As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "Do you know if you hit your head?" If you suspect a head injury, ask questions about headaches, blurred vision, nausea, while also looking over the victim for concussion symptoms including: Eye-tracking – can they follow your finger Blurred vision, which indicates swelling in the brain Dizziness, loss of balance Nausea, vomiting Loss of memory Dazed and confused If the victim exhibits any of these symptoms, it's best to call 911 immediately. If they don't, continue assessing them. "Do you know what day it is?" "Do you know what year it is?" If the victim answers those two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. Which as you know by now, deserves a 911 call. Pro Tip #2: When it comes to head injuries, it's better to be safe than sorry. Get the patient to the ER whenever in any doubt and get them properly examined. Always err on the side of patient welfare. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. In concussion cases, the patient will likely require a 24-hour observation period to make sure that symptoms and swelling in the brain are reduced, which is the norm. However, these issues and symptoms can also worsen. A Word About Injuries to the Head The problem is that the head lacks the padding often present in other areas of the body. Which means it can easily be injured. And that injury can easily be considered serious. There are two main types of head injuries – open and closed. An open head injury is one that breaks or penetrates the skull. Excessive bleeding can occur and controlling that bleeding will be vital for a positive outcome. The other type is a closed head injury. Closed head injuries occur when the brain strikes against the inside of the skull and when the skull remains intact. These injuries are much more difficult to detect as there is a decided lack of visible clues. The four subtypes of head injuries are: Concussion Skull fractures Penetrating wounds Scalp injuries Let's take a deeper look into the physical, emotional, and behavioral signs and symptoms of a concussion. Physical symptoms include: Headache Blurry vision Nausea or vomiting Dizziness Sensitivity to noise or light Balance problems Feeling sluggish Emotional symptoms include: Irritability Sadness Heightened emotions Nervousness or anxiety Behavioral symptoms include: Sleeping more or less than usual Difficulty falling asleep Changes in playing habits for kids Changes in eating habits Thinking and remembering skills may also be impacted and include the following symptoms: Difficulty thinking clearly Difficulty remembering events that occurred just prior to the incident and just after the incident Difficulty remembering new information Difficulty concentrating Feeling mentally foggy Difficulty processing information https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/training/bls-first-aid/video/secondary-survey https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2051.mp4 Secondary Survey The secondary survey is simply a head-to-toe examination that you'll perform on injury victims who are awake and responsive. It's important to remember to not get too focused on one obvious symptom. If you come upon a patient with an obvious arterial bleeding wound, remain focused on other potential head-to-toe problems, as you help care for the more obvious injury. How to Conduct a Head-to-Toe Exam As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Pro Tip #1: Even though the patient is awake and responsive, symptoms can always worsen. And conditions that didn't seem life-threatening a minute ago, may seem so now. If at any point things do get worse, call 911 and activate EMS. Remember to ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Notice how much they are able to move. Are they nodding when you ask a question? Are they able to move their fingers and toes? "Can you wiggle your fingers?" Look for the early signs of shock. Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. When organs don't receive enough blood, the body begins to conserve blood flow by limiting it to legs, arms, and the skin. This insufficient blood volume is one thing that can lead to shock, as can low levels of plasma and fluids in the blood and airway obstruction. Early signs of shock include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Pro Tip #2: A quick way to find out if a victim has a circulation problem, which could be a sign of shock, is to pinch a fingernail bed on the patient and count how long it takes to return to a normal pink color. Longer than 3-4 seconds could be a sign that something else is wrong. "Can you wiggle your toes?" Continue working your way down the victim, noticing any potential issues or conditions beyond the obvious. Also, make sure they're in a position of comfort, whether that's sitting, laying down, or getting to their feet and stretching out their legs. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? Warning: It's important to remember that this secondary survey is only for patients who are awake and responsive. If at any point, a once responsive patient goes unresponsive, call 911 immediately and activate EMS. A Word About Chest Injuries Chest injuries are one of the leading causes of trauma deaths in the U.S. each year. Chest injuries are most commonly the result of falls, vehicular accidents, workplace accidents, and direct blows or crushing incidents. Warning: The area around the chest, abdomen, and pelvis contain several vital organs. Therefore, any life-threatening injury in one of these areas can be particularly fatal if left untreated. There are several types of chest injuries: Blunt Trauma Any blow to the chest or abdomen that doesn't penetrate the skin would be considered a blunt trauma injury. Common symptoms include shortness of breath, chest pain, and rapid pulse. Traumatic Asphyxia Traumatic asphyxia occurs due to a severe lack of oxygen caused by a physical trauma, typically one in which the victim was crushed or pinned. Common symptoms include shock, distended neck veins, bluish discoloration, black eyes, broken blood vessels in the eyes, bleeding from the nose or ears, and coughing up blood. Fractured Ribs Fractured ribs, though painful, are rarely life-threatening. For victims, breathing will be labored for a while and deep breaths, in particular, will be very painful. Flail Chest Multiple rib fractures in multiple places results in flail chest. Flail chest is especially serious if it includes the presence of a loose section of ribs that could puncture a lung. Pneumothorax A pneumothorax is the collapse of a lung that results from too much air in the chest cavity. At the very least, breathing will be difficult. At the worst, it could lead to respiratory distress. Hemothorax A hemothorax is excessive lung pressure due to the accumulation of blood between the chest wall and lungs, which prevents the lungs from properly expanding. https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/training/bls-first-aid/video/cpr-conclusion https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2039.mp4 Conclusion Congratulations on completing your ProTrainings course. We hope it was everything you thought it would be … and more. The good news is that you’re now ready to take your exam. Remember that muscles that don’t get used begin to atrophy. Even those mental muscles. The same goes for the newly acquired skills you’ve just gained, as they can easily be forgotten if not used or refreshed regularly. Don’t let all that important knowledge get flabby. To that end, we have a free weekly video training series delivered via email that you can easily sign up for that will deliver important training right to your inbox in small doses. If you’d like to sign up for this training, you can do so here (if you're not already registered). Now that you’ve acquired these all-important life-saving skills, don’t let the fear of infectious disease stand in the way of you becoming someone’s potential hero. To combat this fear, you can get a keyring CPR shield through ProTrainings that will protect you from a disease no matter the situation. And as long as you have your keys with you, you’ll be protected. You may be in a situation where you’re not required to practice on a mannequin or perform a skills test. However, if you find out later that your employer does require this, or if you simply think this would be great practice for you (Spoiler Alert: It is!), ProTrainings has you covered with a mannequin solution for all your skills practice and training. If you’re interested in this mannequin training solution, contact ProTrainings and we’ll have one delivered to you at a convenient time. Also, for anyone who has taken one of our 100 percent online courses and still requires an evaluation, now or in the future, you can do that with a simple phone call to ProTrainings at any time Thanks again for choosing ProTrainings as your training resource. But before we sign off, we’d just like you to consider WHY you’ve chosen to learn these skills. Life is a precious thing. It’s something that should be appreciated, savored, and celebrated. As a skilled rescuer, you have enormous power to help people in need. To give back to them the one resource that is truly extinguishable – time. Time for everything that matters to them. Keep the WHY in your mind as you work hard to keep the skills you just learned fresh and valuable. Now, go forth and rescue! https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/training/bls-first-aid/video/how-to-access-ems-through-technology https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2040.mp4 How to Access EMS Through Technology The last few decades have seen a surge in the amount of technology available to the public. It affects every facet of our lives, including how we interface with and access Emergency Medical Services, along with how they're able to respond to those emergencies. This lesson will help you better understand a few aspects of using the technology available to you, including how best to leverage it to your advantage while also navigating through some of its nuances. Text Messaging Certain areas of the country have aggressively adopted text message ability to reach 911 and access EMS. However, it's important to understand that this capability doesn't exist in all locations, so it pays to be aware of the situation in your particular area before having to depend on a service that doesn't yet exist. There are obvious advantages to having this text service available, particularly for people who are hearing impaired. Or for people working in loud environments, such as factories and nightclubs. It makes sense in any situation where it's difficult to hear through either the speakerphone feature or the regular speaker. But even though it makes sense, it doesn't mean it's going to be available just yet. Using Your Cell Phone to Call 911 This is the preferred way to contact EMS, via your cell phone and talking to them directly. Speaking will always be faster than texting, especially during an emergency. A cell phone allows for hands-free communication, as you can put it on speakerphone, lay it down, and continue to help the patient while on the phone with an EMS dispatcher who can talk you through any problems you may encounter. While cell phones have truly been game-changers in this industry, there are a couple of nuances to be aware of. Does the phone in question have locking capabilities? Let's say someone other than you is trying to use your phone to call 911, but it's locked. Most cell phones these days have an emergency word that will bypass the lock and allow the user to use the phone to dial 911. This is particularly important in a situation where you hand your phone to a bystander to call 911 … a bystander who likely doesn't know your code. Time is of the essence in any emergency and seconds can sometimes matter a great deal. All cell phones are a little different when it comes to accessing EMS. It pays, not only to become familiar yourself, but also to teach others in your household how to call 911 from all the cell phones in your home. This should also include nannies, babysitters, and anyone else in a similar position. Applications and Software There have been some exciting technological developments in the areas of apps and software. One such program enables access to nearby bystanders and volunteers who are trained and available to help in case of an emergency. Pulse Point is one such application. After the trained rescuer registers with Pulse Point, they are entered into the pool of rescuers within a particular geographical area who can be notified of local emergencies. It allows those who have been trained in CPR and first aid to respond quickly in a crisis if they're nearby and available. AED Locator It's normal to be in a situation where you may need an AED but you don't have one or know where the closest one is. While this situation may be normal now, it may not be for long. Publicly available AEDs are currently being put into a database and added to a logistical map. The way it works is, if you're in need of an AED, you check your AED locator for the nearest one in your area that's been cataloged and is ready for use. As more and more are added to the database, more and more will be available when nearby emergencies occur, saving time and lives. Landline Phones and VOIP Voice-over IP applications and phones have become extremely popular. Much like cell phones, you can move them and the service from office to office or home to home, while still maintaining the same phone number and account. However, if you moved and failed to register your new location or update your account with the new information, calling 911 will be useless. The dispatcher will have no way of knowing where you're calling from. With landlines there's also a nuance to consider, as it pertains to offices. In most offices or businesses, there's usually an outbound number that must be pressed to get an outside line. In an emergency, when heads can be a bit scrambled, or for visitors who may not know that number, it's a good idea to write it down and display it prominently at every phone. Technology is great when it helps and when it speeds things up, like the time it takes to find an AED. But don't let it slow you down. Take the necessary steps to ensure that you're comfortable with all the technology available to you, as well as those coming around the next corner. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/training/bls-first-aid/video/hemostatic-agents https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2049.mp4 Hemostatic Agents A hemostatic dressing is any dressing treated with an agent or chemical that assists with the formation of blood clots. Much like tourniquets, hemostatic dressings are used with direct pressure to help control severe, life-threatening bleeding. Hemostatic dressings are usually only considered an option if: The bleeding is life-threatening The standard procedure of direct pressure failed The injury is located where a tourniquet wouldn't work, such as the torso, abdomen, groin, and neck A tourniquet was unavailable or ineffective How to Provide Care After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. Once you determine that direct pressure alone isn't working, and you've decided against using a tourniquet, apply a hemostatic agent or dressing to the wound followed by more direct pressure. Pro Tip 1: Hemostatic agents come in powders and dressing pads of numerous sizes. For large open wounds, you can pour the powder into the wound which will help speed up blood coagulation and clotting. If you're using hemostatic dressing with a large open wound, make sure you pack the dressing deep into the wound and apply continuous pressure until the bleeding is controlled. Hemostatic agents are an ideal option when EMS services are delayed or unavailable, perhaps in a wilderness setting, or when normal bleeding control options are ineffective. And like tourniquets, when it comes to hemostatic agents, you're just trying to buy some time before getting the victim to a surgical center for proper care. A Word About Internal Bleeding Internal bleeding is the blood loss from veins, arteries, and capillaries into spaces inside the body. This can be caused by injuries like blunt force trauma and fractures, but also due to certain medical conditions. Internal bleeding can also include external bleeding from the same incident. Consider how a knife wound could cause both internal and external bleeding simultaneously. Common signs of internal bleeding include: Discoloration of the skin Bruising and tenderness Nausea, vomiting, or coughing up blood Discolored, painful, tender, swollen, or firm tissue Victim protectively guarding the injury area Rapid pulse or breathing Moist, cool skin Pale or bluish skin Drop in blood pressure If you suspect that someone is bleeding internally, call 911 immediately and help keep the victim as still and calm as possible to reduce the heart's blood output. Also keep an eye on the victim for any signs of shock. Pro Tip 2: When internal bleeding is from the capillary blood vessels, the result is bruising around the wound area and is not serious. To reduce discomfort for the victim, you can apply an ice pack to the area. Like internal bleeding, injuries requiring a hemostatic dressing should be considered serious. And as with all bleeding injuries, you simply want to find the bleeding and stop the bleeding, by any means necessary. https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/training/bls-first-aid/video/mechanism-of-injury https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2050.mp4 Mechanism of Injury Physical injuries run the gamut from soft tissue injuries like bruises, cuts, and burns to those involving the musculoskeletal system and/or the head, neck, and back. While injuries can vary greatly, the tools of discovery you'll use to help you assess patients will not. When you arrive on the scene, you'll apply the mechanism of injury method to help you gain a greater understanding of what possible injuries the patient may have based, in large part, on how he or she may have sustained those injuries. How to Apply the Mechanism of Injury Method As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Ask yourself questions like: Is the victim favoring an area or limb? Is there noticeable bleeding, protruding limbs, or other injuries? Is the victim demonstrating any concussion symptoms? Is there an obvious cause of the injury – slippery walkway, etc.? Is the victim demonstrating any airway, breathing, or circulation problems? Warning: If the patient does begin showing signs of decreasing levels of consciousness or any problems involving breathing, airway, and/or circulation – numbness, tingling, inability to move limbs – call 911 immediately. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. Do you know what happened today? Are you in any pain?" Pro Tip #1: Ask the victim open-ended questions when you're assessing them, rather than yes and no questions. So, instead of asking, does your head hurt?, ask, do you have pain anywhere? Asking yes and no questions can often lead them down the wrong road. During your assessment, involve family members and friends who are nearby and may have witnessed the accident. They'll also be able tell you if the victim is behaving normally or has any medical problems or allergic reactions to medications. This is even more important when dealing with injuries to children. Pro Tip #2: Don't be too myopic. Even though the injury may seem obvious, that doesn't mean another injury isn't also lurking. Keep this in mind as you perform a full head-to-toe examination of the patient. A Word About Soft Tissue Injuries Soft tissues include all the layers of skin, fat, and muscles in the human body. The largest organ is the skin, as it contains three layers of its own – epidermis (outer area that protects against bacteria), dermis (deep layer that protects the nerves), and hypodermis (the deepest layer that protects blood vessels). Soft tissue injuries are classified as closed wounds or open wounds. A closed wound is an injury that occurs beneath the surface of the skin, meaning that the outer layer of skin is still intact. There is usually internal bleeding, even if only minimally in the form of a bruise. An open soft tissue wound involves a break in the skin's outer layer, like a cut, and usually involves external bleeding – arterial, venous, or capillary. Burns deserve a special distinction as a soft tissue injury and are classified as superficial, partial thickness, and full thickness. Closed Wounds Closed wounds occur beneath the surface of the skin and are usually the result of blunt force. The contusion can be minor, like stubbing your toe, to more serious examples of blunt force trauma, like those sustained in motor vehicle accidents. Swelling and discoloration are normal in closed wounds as these are part of the healing process. Closed wounds become more serous when they affect the deeper layers, those that protect larger blood vessels and vital organs. Heavy internal bleeding can occur from a contusion or hematoma and when it affects those deeper layers, the signs may not be immediately noticeable. Opened Wounds Open wounds are those that affect the outer layer of the skin. There are six types of open wounds: Abrasions – scrapes, rug burns, road rashes, etc. – abrasions are more painful due to the presence of nerve endings nearby but don't involve much bleeding as the capillaries are mostly affected. Amputations – the loss of a limb – amputations are serious injuries that rely on controlling blood loss and shock. Avulsions – part of skin peeled away – avulsions can be very painful, and bleeding can be heavy. Crush injuries – extreme weight or force crushes a body part – crush injuries can cause great internal damage to blood vessels and vital organs. Punctures – gun shot wounds, stabbing wounds, etc. – punctures are smaller wounds that typically close around the wound, thereby limiting the amount of external bleeding. However, the puncture can also result in internal bleeding. Lacerations – cut from a sharp object – lacerations vary in severity depending on several factors, including the type of bleeding that the laceration has caused – arterial, venous, or capillary. https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/training/bls-first-aid/video/tourniquets https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2048.mp4 Tourniquets Tourniquets are tight, wide bands placed around an arm or a leg to constrict blood vessels in order to stop blood flow to a wound. Generally, tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. Other reasons to consider using a tourniquet include: If bleeding cannot be controlled by direct pressure If the injury is in a location where direct pressure isn't possible If multiple people need help with life-threatening injuries and help is limited If the scene is unsafe or becoming unsafe Warning: Tourniquets can be extremely painful. Therefore, it's best to warn the victim beforehand. And tell them why they'll be wearing a tourniquet. How to Provide Care If you have a commercial tourniquet, great. If not, anything that you can wrap around an injured limb will work – a piece of rope, an insulated wire. Tie that into a knot and then insert a screwdriver, stick, or pen and begin twisting to tighten. Your goal in using a tourniquet is to control bleeding before hypovolemic shock sets in due to blood loss. Pro Tip 1: What may seem like a wound that won't stop bleeding, may just be due to pressure that's not being applied directly over the wound. Bandages can slip. Victims could be in shock and not applying as much pressure as it appears. Make certain that direct pressure truly fails before considering a tourniquet. We will assume that you've already made sure the scene is safe, and you're wearing latex-free gloves or have thoroughly washed your hands and have determined that the victim is currently not in shock. Apply the tourniquet over the extremity where the injury as occurred and a couple inches above the wound to limit tissue damage. Avoid wrapping around joints and follow the manufacturer's instructions. Secure the tourniquet as tightly in place as possible. Slowly tighten the tourniquet handle until bleeding stops. Fasten the handle to the tourniquet. Test the victim's toenail or fingernail to make sure you get a delayed capillary response, so you know the tourniquet is working as it should. Write down on the victim's dressing what time the tourniquet was applied and give that information to EMS. The ABCs of Bleeding Regardless of the bleeding incident, it's important to understand these simplified steps to trauma care response: A – Alert! Call 911.B – Bleeding. Find the bleeding injury.C – Compress. Apply pressure and stop the bleeding by: Applying direct pressure with a clean cloth or dressing pads. Using a tourniquet. Packing or stuffing the wound and then applying pressure. A Word About Perfusion Perfusion is how your body's circulatory system delivers oxygen and nutrients to your organs, all of which require varying amounts of perfusion. Your heart, for instance, requires constant perfusion to continue working. Your brain can last four-to-six minutes without perfusion, before damage begins to set in. Your kidneys can last 45 minutes and your skeletal system about two hours. What does this have to do with tourniquets? Pro Tip 2: It's important to keep in mind that limiting perfusion is a bad thing. But when we apply a tourniquet to a victim, that's exactly what we're doing. We're voluntarily cutting off the supply of oxygen and nutrients to a part of someone's body. So, it bears repeating: Tourniquets should only be considered if the venous or arterial bleeding incident is life-threatening and if EMS response will be delayed. https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/training/bls-first-aid/video/amputation https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2047.mp4 Amputation An amputation from trauma involves the loss of an extremity like a finger or toe but could also include an arm or a leg. It's important to not get too distracted looking for the amputated part and focus on the wellbeing of the victim. As amputation injuries often occur in machine accidents, the amputated part can get thrown quite a distance from the scene of the accident. It may also be covered in saw dust or shavings of some kind, which could make finding it more problematic. If there are other people on the scene, you may want to consider asking for help to locate the missing part. Amputation injuries are quite serious. It’s important to assess the patient beyond the amputation, including: Did the victim lose consciousness? If so, did they hit their head and are now suffering from a concussion? Is the victim showing signs of being in shock? How to Provide Care Clean-cut amputations bleed less than you might expect and often less than crushed extremities or partial amputations. The reason for this is that the arteries contract up into the stump and clamp down, which helps to control the bleeding for at least the first few minutes following the amputation. After you make sure the scene is safe, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. If the victim is conscious and not in shock or showing signs of other life-threatening injuries, ask him or her to help apply pressure to the wound. If there is already a cloth or dressing pad covering the stump, don’t remove it, as this will pull off some of the clotting blood. Apply a second piece of gauze padding and, if necessary, subsequent pieces until bleeding is controlled and apply pressure. If the victim can't help apply pressure, you'll need to manage it yourself or ask someone to assist you. Pro Tip 1: With amputation injuries, there will sometimes be a protruding bone fragment. These can be very sharp and may cut you while you attend to the victim. Therefore, it's important to be careful when dressing the wound. If you're not, you could easily: Damage the bone further Cause more pain to the victim Introduce bacteria into the wound Once you've controlled the bleeding, meaning it is no longer leaking through the dressing pads, it's time to wrap the wound with a roller gauze bandage. Pro Tip 2: Your goal in wrapping the wound is to apply enough pressure to hold the dressing pads in place and control the bleeding. Be careful not to wrap so tight that you cut off circulation. Remember to use the pinch test on finger and toe nails if appropriate and you are able to. If blood begins to leak through while you're wrapping the wound, simply insert another dressing pad and continue wrapping. If you need extra pressure at that point, twist the bandage over the wound area. This will apply a bit more torque and should help control the bleeding. When you're done wrapping, tuck or tape the end of the bandage. By this point, the bleeding should be controlled, and the patient should be stable. Continue assessing the victim for signs of shock or other health concerns. How to Handle the Amputated Extremity If you or someone at the scene were able to find the amputated part, it’s important that you handle it properly using the following steps. Make sure it's clean. Wrap it in a sterile gauze pad, preferably an abdominal dressing pad if you have one. This will offer much more insulation than regular pads and help protect the part from cold damage. Place the part into a sealable plastic bag. Put the bag with the part between two cold packs or into a bag filled with ice water and seal that bag. Warning: The amputated part has no blood flowing through it, which makes it much more susceptible to frost bite and tissue damage. You want to keep it cold, not frozen. It's also important to keep it dry. When skin becomes water logged and gets pruney, this is actually the onset of that tissue breaking down and will make reattachment more difficult. Pro Tip 3: It's important to keep the amputated part with the victim and, if possible, out of sight from the victim. You don't want to encourage psychosomatic shock, but you want the surgeons at the hospital to have access to both victim and part immediately. As amputations are serious injuries, you should be continually assessing the victim for signs of shock or other life-threatening conditions. A Word About Early Signs of Shock We will be discussing shock in great detail in the next lesson, but it's important to know that it's a progressive condition. Symptoms may seem minor at first, but the situation can quickly get worse. Your rapid response is vital. Early symptoms of shock include: The victim expresses anxious or apprehensive feelings The victim's body temperature is lower than normal The victim's breathing is quicker than normal The victim's pulse has increased The victim's blood pressure has decreased The victim's skin appears pale or clammy If you suspect that the victim is in shock, it's important to call 911 immediately. It's impossible to know when an individual will go into shock, but with amputation injuries you may want to consider the threat more elevated. And knowing the warning signs and being able to spot them early on could make a big difference. https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/training/bls-first-aid/video/first-aid-advanced-intro https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2071.mp4 ProFirstAid Advanced Introduction Welcome to ProFirstAid Advanced. In this lesson, we'll be giving you a rundown of everything you can expect to learn in this important course and even a few specifics of the course. Your instructor for the duration of your ProFirstAid Advanced course is Roy Shaw. Roy is a licensed paramedic with years of both real-world and instructor experience and also a cofounder of ProCPR and ProTrainings. In other words, you're in good hands. We created ProFirstAid Advanced with you in mind. In our busy modern world, it's hard to imagine fitting anything else into our already jam-packed schedules and especially several hours' worth of CPR and first aid training. Since your schedule is already hectic, we created ProFirstAid Advanced to be available whenever you are, 24 hours a day, seven days a week. You can squeeze in a quick lesson whenever you have a few minutes to spare, whether it's day or night, weekend or workday. It's there when you need it. ProFirstAid Advanced is a course we designed specifically for healthcare professionals like yourself who need infant, child, and adult CPR training that also includes using a bag valve mask, AED, and a team approach to CPR for two rescuers, as well as all of the first aid components. The list of occupations that can benefit from the ProFirstAid Advanced course is long and includes: CNAs LPNs LVNs Deputy Sheriffs Firefighters Lifeguards Forestry Other Health Care Professionals who also require First Aid The total course time includes about 5 hours and 30 minutes of video training as well as knowledge reviews, a final test, remedial help, and time spent reviewing downloaded material, like the student manual that comes with this course. You can download that manual from the top of your video course page. Additionally, if you want the hands on skill evaluation, we can easily add that option on. What You Will Learn in this Course Your ProFirstAid Advanced course curriculum is extremely substantial. Some of the important things you'll be learning are: Introductory First Aid Training• The Five Fears of CPR Rescue Heart Attack and Stroke• Stroke• Heart Attacks Cardiac Arrest Training• Adult, Child, Infant, Neonatal CPR• Adult CPR Team Approach• Hands-Only CPR AED Training• 2-person AED• Adult, Child, Infant AED Choking Training• Adult, Child, Infant Choking (Conscious)• Adult, Child, Infant Choking (Unconscious) Bleeding Control• Capillary, Venous, Arterial Bleeding Shock Control• Shock• Fainting Ongoing Assessment for Injury and Illness• Mechanism of Injury• Secondary Survey• Musculoskeletal Injuries• Amputation• Head, Neck, and Back Injuries• Seizure• Eye Injuries• Allergic Reactions• Snake Bites• Diabetes Heat and Cold Emergencies• Snow Safety - Prevention, Hypothermia, Frostbite• Heat and Cold Emergencies• Burns Prevention• Car Backing• Child Proofing the Home• Poison Control• Pool Safety• Child Abuse and Neglect Respiratory Arrest Training• Adult, Child, Infant Rescue Breathing• Adult Bag Valve Mask Two Rescuer Skills Training• Adult, Child, Infant 2 Rescuer CPR Bloodborne Pathogens• Reducing Your Risk• Exposure Incident ProFirstAid Advanced is an online CPR (adult, child, and infant) and First Aid certification course for the healthcare provider. We also have our ProCPR course that covers BLS without the first aid portion. If you are currently certified with Red Cross, AHA, National Safety Council, ASHI, or Medic First Aid, you are welcome to utilize the Advanced.ProFirstAid.com program and receive a new, two-year ProFirstAid Advanced certificate. Pro Tip: Please keep this in mind as you progress through your course: Although this is an online course, we are still available to answer any questions you may have. Don't be shy. If you ever need help, reach out and we'll be here for you. Also worth mentioning is that the written course material that accompanies each video lesson (like this one) will often have some additional information that isn't in the video. And you'll occasionally find areas of emphasis labeled as Pro Tips and Warnings that will be highlighted and difficult to miss. Welcome again to ProFirstAid Advanced. Now, let's get started! https://d3imrogdy81qei.cloudfront.net/video_images/3701/first-aid-advanced-intro-2015.jpg Yes 49 https://www.procpr.org/training/bls-first-aid/video/neonatal-bls https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2080.mp4 Neonatal BLS Neonates are newborns who are less than a month old. It's important to note that there are some significant differences between resuscitating neonates compared to infants. As with infants, it's most common for the respiratory drive or lack of oxygen to contribute to the neonate's unresponsiveness versus a cardiac-driven event. This is important as it reflects how we perform rescue breaths and CPR. The following CPR instructions are for respiratory distress. Pro Tip #1: The rescue mask for neonates is extremely small. It's important to have rescue masks to fit every size patient, as an adult mask could prove useless when trying to resuscitate a newborn. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin to assess whether or not the newborn is responsive. If you don't get an initial response and you can see that the infant still isn't breathing normally, place your hand on his or her forehead and tap on the bottom of the newborn's feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. Pro Tip #2: If the newborn's pulse is 100 beats per minute or less but not less than 60, perform rescue breathing – one rescue breath every two to three seconds. If the newborn's pulse is less than 60, begin to perform full neonatal CPR – three chest compressions followed by one rescue breath. CPR Technique for Neonates Just as you would for infants (the landmarks are the same), draw an imaginary line across the newborn's nipples and place two fingers on the lower part of the sternum in the center of the infant's chest. Your fingers should be perpendicular to the baby's chest, meaning your knuckles are directly above your fingers during compressions. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on neonates, use only your fingers to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go to a depth of 1/3 of the newborn's chest cavity, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform three chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Breathe once into the rescue mask and wait for the chest to rise and fall. Continue to perform three chest compressions to one rescue breath for two minutes then reassess for vital signs. If the neonate's pulse is still slow or there is no pulse, continue CPR until help arrives, an AED arrives, or the victim is responding positively and breathing normally. Pro Tip #3: Although most situations involving an unresponsive neonate will be due to a respiratory problem, remember that there is a difference in how we resuscitate an unresponsive newborn who has had a cardiac-related event that led to their current condition. If their condition was due to a congenital heart defect or cardiac arrest, perform 15 compressions to two rescue breaths and repeat. Performing Neonate CPR in a Two-Responder Setting This two-responder scenario is more likely to be found in a clinical or professional health setting. It allows the responders to incorporate things like high-flow oxygen with a bag valve mask and the use of circumferential thumb compressions. This is much more efficient when performing just three compressions to every breath, as one responder can handle the bag while the other performs the compressions. A Word About Vital Signs (By Age) Assessing a patient's vital signs is a crucial first step in providing care. Therefore, it's important to know what range is normal when it comes to pulse rates and respirations. For Adults (12 years and older) Pulse rate – 60 to 100 beats per minuteRespirations – 12 to 20 breaths per minute For Children (1 year to 12 years old) Pulse rate – 80 to 100 beats per minuteRespirations – 15 to 30 breaths per minute For Infants (1 month to 12 months old) Pulse rate – 100 to 140 beats per minuteRespirations – 25 to 50 breaths per minute For Neonates (full term to 30 days) Pulse rate – 120 to 160 beats per minuteRespirations – 40 to 60 breaths per minute https://d3imrogdy81qei.cloudfront.net/video_images/3719/neonatal-bls-2015.jpg Yes 376 https://www.procpr.org/training/bls-first-aid/video/asthma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2062.mp4 Asthma Anyone who has experienced an asthma attack will tell you what a frightening situation it can be, as your airways tighten and no matter what you do, you simply cannot get enough oxygen into your lungs. Pro Tip #1: Want to know what it feels like to have an asthma attack? Imagine only being able to breathe using a thin, plastic coffee stir straw. That would approximate how a severe asthmatic attack would feel. In this lesson we'll discuss one of the best medications for acute and chronic asthma attacks (Albuterol) and how to use it correctly. How to Treat a Patient with Asthma As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: Albuterol comes in a small aerosol container with an actuator. Whether the patient's asthma is exercise induced or persistent, the effect should be the same regardless. In this lesson, we're going to include the use of a spacer with the Albuterol dispenser. Spacers are really expensive, which probably contributes to many people not using one, and sort of resembles a small plastic sippy cup. The spacer goes between the patient's mouth and the Albuterol dispenser. Warning: When not using a spacer, much of the medication, instead of going into the patient's lungs and bronchials where it should go, winds up sitting at the back of the throat and on the tongue. This obviously decreases the dosage and the effectiveness of that dose. How to Administer Albuterol Using a Spacer Pro Tip #3: Before using your Albuterol device, make sure it has actuations remaining. To find this information, look on the back of the dispenser. Most devices have a number there inside a little window that corresponds with the number of actuations remaining. And don't forget to check the expiration date! Shake the Albuterol container just prior to using it. You don't have to shake for long. A few seconds will do the trick. Insert the Albuterol mouthpiece into the end of the spacer where it fits. (It will be obvious.) Place the other end of the spacer into the patients mouth. Make sure he or she completely exhales first. Push down on the Albuterol dispenser one time and instruct the patient to hold his or her breath for 10 seconds. Instruct the patient to exhale. Pro Tip #4: A normal dosage of Albuterol for most adults is two inhalations and children may be one or two doses. So we need to always ask the patient about their specific dosage. Repeat – patient exhales out all air, puts spacer into their mouth, dispense Albuterol, hold for 10 seconds, and exhale. If the patient doesn't get relief from two injections, ask them what their prescribed amount of time is between injections and doses. If the patient is still having trouble breathing, call 911 and activate EMS. They could be suffering from a persistent asthma attack that cannot be stopped with a simple rescue inhaler of Albuterol. Get help on the way immediately, in case the patient begins having a true respiratory emergency. It's important to avoid assumptions that the patient will get better after administering a dosage of Albuterol. Always be prepared for anything. A Word About Asthma Triggers Asthma is an illness in which the airways swell. An asthma attack happens when an asthma trigger, such as exercise, cold air, allergens, or other irritants, causes the airways to suddenly swell and narrow. This makes breathing difficult, which can be very frightening. The Centers for Disease Control and Prevention (CDC) estimates that approximately 24 million Americans are diagnosed with asthma in their lifetimes. Asthma is more common in children and young adults than in older adults, but its frequency and severity are increasing in all age groups. You can often tell when a person is having an asthma attack by the hoarse, whistling sound the person makes while inhaling and/or exhaling. This sound, known as wheezing, occurs because air becomes trapped in the lungs. But what exactly triggers an asthma attack? A trigger is simply anything that sets off an attack. And they can be very different for different people. Common asthma triggers include: Dust, smoke, and air pollution Exercise Plants Molds Perfume Medications Animal dander Temperature extremes and changes in the weather Strong emotions, such as anger, fear, or anxiety Infections, such as colds or other respiratory infections Usually, people diagnosed with asthma control their attacks by controlling environmental variables (exposure to those triggers) and through medication and other forms of treatment. https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/training/bls-first-aid/video/recovery-position https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2063.mp4 Recovery Position In this lesson, you'll learn how to safely use the recovery position, for those times when you encounter a patient who is breathing but unconscious. The recovery position is used in the following scenario: The patient is unresponsive The patient is breathing normally The patient has good skin color, good circulation It's not an immediate CPR situation How to Put a Patient into the Recovery Position As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. In this situation the patient is unresponsive to your taps and shouts, which elicits an immediate 911 call and finding and/or preparing an AED for use, as you begin to assess the scene for clues of what happened. The patient could have ended up unconscious for a number of reasons: Passed out or fainted Suffering from low blood sugar Seizure Electrocution Warning: If you suspect electrocution, take extra measures to make sure the scene is safe. Is the power source still active? Is it still touching the patient? To help keep the patient's airway open and clear, put them into the recovery position using the following steps: Warning: Only use the recovery position if you don't suspect fractures, or serious neck and back injuries. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #1: The purpose of the recovery position is to expel any foods or liquids that come up. What comes up needs to come out. If it doesn't, it could find its way into the patient's lungs. The recovery position is also a great way for the patient to lay safely while waiting for EMS. Using the patient's leg as a kickstand allows his or her body to use gravity without the threat of them rolling completely over. Pro Tip #2: You want gravity working with you as you wait for EMS to arrive. It's important to eliminate the risks of the patient choking or an obstructed airway. Having the patient facing downward will help negate those risks. Warning: If the patient loses their pulse or stops breathing, immediately roll them onto their back and start CPR. Continue to reassess the patient while you wait for EMS to respond, particularly for signs of shock, responsiveness, airway, breathing, and circulation. And treat accordingly should the situation change. A Word About the Signs of Inadequate Breathing Inadequate breathing requires careful monitoring. You may not notice all of the signs and symptoms at once, and some can be hard to spot. If you see any of them, be prepared to give assisted ventilation. When the patient has to expend too much effort to breathe and their breathing has become inadequate, you'll notice the following signs: Muscles between the ribs pull in when the patient breathes in. As the patient enhales, you may notice the muscles pulling inward between the ribs, above the collarbone, around the muscles of the neck and below the rib cage. Pursed lips breathing. The patient exhales through pursed lips, like a whistling motion. This maneuver helps control the patient's breathing pattern. Flaring out of the nostrils on inhalation can be a sign of inadequate breathing in children and infants. Apparent signs of fatigue are also an indication of labored breathing. Excessive use of abdominal muscles to breathe, as in when the patient is using the abdominal muscles to force air out of the lungs. Sweating and anxiousness are also signs of severe respiratory distress. A patient who is sitting upright and leaning forward with hands on knees could be doing so because they're struggling to breathe. Abnormal breathing sounds are also a great sign of inadequate breathing. Listen for abnormal sounds such as wheezing or crackling. Wheezing or whistling sounds indicate restricted air flow and are common with conditions such as asthma, allergic reactions, and emphysema. If the patient has a fine cracking sound on inhalation, that may indicate fluid in the lungs. https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/training/bls-first-aid/video/heat-cold-emergencies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2064.mp4 Heat-Related Emergencies As you know, the human body runs at an internal temperature of 98.6 degrees Fahrenheit, or 37 degrees Celsius. The control center responsible for regulating this internal temperature is located in the brain, and more specifically, the hypothalamus. The hypothalamus receives information and adjusts body functions to maintain this optimal temperature. The temperature range – that which allows cells to stay alive and healthy – is actually quite narrow, at between 97.8 degrees and 99 degrees. Let's quickly look at the process of how the body cools down on its own. The hypothalamus detects a rise in blood temperature. Blood vessels close to the surface of the skin begin to dilate. This brings more blood to the surface and allows heat to escape. At the end of this lesson, we'll get into the five general ways in which the body can be cooled externally, along with several types of heat-related conditions to watch out for. How to Treat for a Heat-Related Emergency Heat-related emergencies typically occur in hot environments and when the patient hasn't been rehydrating enough to compensate for water loss. Common symptoms of a heat-related emergency include: Profuse sweating Dizziness Extreme thirst Cramping, usually in arms or legs Warning: Losing fluids can be very serious. In the absence of proper medical treatment, if the condition cannot be reversed, it will likely progress to the next level which is heatstroke. Pro Tip #1: If the patient suddenly goes from wet to dry and stops sweating, it's because the patient's body doesn't have enough fluids to lose. This is a good indication that the warning above is now likely a reality, making the situation that much more serious. Your number one goal when dealing with a heat-related emergency is to cool the patient down any way you can. Ideally, the patient is able to get some fluids down. But if for some reason they aren't able to drink or swallow or can't hold fluids down, you'll need to cool them off externally. Find a water source and some containers or a hose and begin pouring water over the victim, including their clothing, to help bring their core temperature down to a safe level. Another great aid in these situations is the cold pack. If you have some available, try placing them under the patient's armpits, the back of the neck, or forehead. Pro Tip #2: The key to successfully treating someone who is having a heat-related emergency begins by recognizing that emergency. Time is crucial. Once you've diagnosed the problem, the next step is reversing the condition by cooling them down. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally, call 911 immediately and activate EMS. Then begin CPR. A Word About Heat-Related Emergencies There are several types of heat-related conditions to be aware of, but let's first look at the general ways in which the body can be cooled. Radiation Radiation involves the transfer of heat from one object to another, though without physical contact. The human body also loses heat due to radiation, mostly through the head, feet, and hands. Convection Convection occurs when cold air moves over the skin and carries heat away. The faster the flow of air, the faster the body will be cooled. Convection is why warm skin feels cooler in a breeze. Convection also assists in the evaporation process. Conduction Conduction occurs when the body is in direct contact with something that is cooler than the body's temperature. Conduction allows the body's heat to transfer to the cooler object. Think about swimming in a cold lake or leaning against a cool slab of stone. Evaporation Evaporation is the process by which a liquid or solid becomes a vapor. When body heat causes one to perspire and the perspiration evaporates, the heat that was absorbed into the sweat dissipates into the air which cools off the skin. Respiration The last way in which the body can cool itself is through respiration. Before air is exhaled, it's warmed by the lungs and airway. Respiration accounts for around 10 to 20 percent of heat loss. There are several types of heat-related illnesses (hyperthermia) to be aware of, including dehydration, exercise-associated muscle cramps, exertional heat exhaustion, and heatstroke. Dehydration Dehydration occurs when there is an inadequate supply of water in the body's tissues. Dehydration can be serious and life-threatening, particularly for the very young and very old. Symptoms, which include fatigue, headaches, irritability, nausea, and dizziness, will worsen as the body continues to lose water. Exercise-Associated Muscle Cramps Muscle cramps are thought to occur due to a combination of fluid and electrolyte loss through sweating. Muscle cramps typically come on quickly and after rigorous work or exercise and are particularly more common in warmer environments. Exertional Heat Exhaustion Exertional Heat Exhaustion occurs when the body loses more fluids than are replenished. As this happens, the body will divert blood from the surface of the body to vital organs like the heart and brain. This type of heat-related illness is usually the result of intense physical activities and often in hot and humid climates – athletes, firefighters, construction workers, etc. Heatstroke Heatstroke is the most serious type of heat-related illness and can be life-threatening if quick action isn't taken. As there is a progressive nature to these conditions, ignoring the warning signs of exertional heat exhaustion can quickly lead to a body that will become overwhelmed by heat and begin to stop functioning. https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/training/bls-first-aid/video/infant-rescue-breathing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2074.mp4 Infant Rescue Breathing This lesson focuses on how to perform rescue breathing on an unconscious infant for the healthcare provider. And there are a few differences between adult/child rescue breathing and delivering rescue breaths to an infant that we'll highlight below. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your infant-sized rescue mask with a one-way valve handy and begin calling out to the infant to assess whether or not he or she is responsive. Are you OK? Can you hear me? (With infants, shouting their name, if you know it, may help.) If you don't get an initial response and you can see that the infant still isn't breathing normally, place your hand on his or her forehead and tap on the bottom of the baby's feet, shoulder, or rub their belly. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. Look one more time for signs the infant is breathing normally. If you've determined at this point that the infant is unresponsive, not breathing normally but does have a pulse above 60 beats per minute, continue immediately with rescue breathing. Pro Tip #1: Notice that with infants, we check for a pulse using the brachial artery rather than the carotid artery. Also, keep in mind that a weak pulse can be considered the same as no pulse in infants. The dividing line is 60 beats per minute. If lower, begin CPR immediately. If above, establish that the infant isn't breathing normally, then begin rescue breathing. Rescue Breathing Technique for Infants Grab a small-sized rescue mask and seal it over the infant's face and nose. Place something firm under the infant's shoulders (if possible) to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and count out loud – one one-thousand, two one-thousand … On three one-thousand, breathe into the rescue mask again. Pro Tip #2: What does slightly sniffing look like? Imagine you've just walked into a kitchen and caught the whiff of a freshly baked apple pie. You turn your head upward ever so slightly to catch a better smell. Ever so slightly, or neutral, is our goal when delivering rescue breaths to infants. The sequence for infants is the same as the sequence for children – one rescue breath every two to three seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every two to three seconds for two more minutes. And so on. Warning: As an infant's lungs are considerably smaller than the lungs of adults and even children, be careful not to force air in beyond the full point. To do this, watch closely as you deliver rescue breaths and stop when the chest reaches its apex. Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse. Pro Tip #3: As adults don't normally breathe one breath every two to three seconds, there's a chance you may become hyperventilated while doing rescue breathing. To combat this, take in a deep breath, hold it, and use that air to deliver a few rescue breaths. This is especially important if you feel like you're about to begin hyperventilating. Remember, if at any point you discover that the patient's pulse has disappeared, go immediately into full CPR and use an AED if you have one available. A Word About Pediatric Considerations and Respiratory Emergencies It's really important to quickly recognize breathing emergencies in children and infants and to provide treatment before their hearts stop beating. In adults, when their hearts stop beating, it's typically because of a disease. However, in children and infants, their hearts are usually healthy. Which is why when a child's or an infant's heart stops beating, it's usually the result of a breathing emergency. When helping a child with respiratory problems, keep in mind that a lower airway disease may be caused by birth problems or infections such as bronchiolitis, bronchospasms, pneumonia, or croup. Several of the illnesses and diseases that affect respiratory systems in infants and children are preventable through vaccines. These include: Diphtheria Measles, mumps, and rubella Whooping cough Pneumococcal disease Mycoplasma pneumonia Chickenpox Some diseases that may not have respiratory symptoms might still be spread through respiratory transmissions, such as mumps and severe diarrhea. https://d3imrogdy81qei.cloudfront.net/video_images/3707/infant-rescue-breathing-2015.jpg Yes 132 https://www.procpr.org/training/bls-first-aid/video/opioid-overdose https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2075.mp4 Opioid Overdose As the opioid epidemic rages on and grows, learning how to treat for opioid overdose becomes even more important. And that's the focus of this lesson – learning how to assess for, and provide treatment for, opioid/opiate overdose. Opioids are central nervous system depressants. The central nervous system is responsible for controlling every organ, system, and function in the human body, including both the respiratory system and the cardiovascular system. When the central nervous system becomes depressed too much, these organs, systems, and functions will begin to slow down and eventually cease to operate. Who is at Risk of an Opioid Overdose? While you're right to think that addicts and illegal drug users are most at risk, the truth is that anyone who takes an opiate or opioid is at risk of overdosing, particularly when: An amount is taken beyond the prescribed dose It's taken in combination with other central nervous system depressants, like alcohol The patient has an unknown medical condition that creates a hypersensitivity to opioids Common opiates/opioids include: Heroin Morphine Codeine Methadone Hydrocodone (brand names: Vicodin, Lortab) Oxycodone (brand name: Percocet) There are some commonly used drugs that can cause signs and symptoms similar to an opioid overdose, including: Cocaine LSD Ecstasy Tranquilizers Marijuana Pro Tip #1: While the standard and immediate treatment for opioid overdose (spoiler alert: Naloxone) works well to reverse the condition and revive the patient, if their problem is one related to another substance, like those in the list above, naloxone will have zero effect. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If the patient is unconscious, you'll want to assess for normal breathing and determine if the patient has a pulse. As you know by now, the presence of a pulse but not normal breathing means you'll go right into rescue breathing. While the absence of both means you'll perform full CPR. While it may not always be possible to be certain of an opiate/opioid overdose, there are some signs to point in that direction, including: Drugs or empty drug packages near the victim Very slow respiration Pinpoint pupils Treatment for Opioid Overdose For patients with known or suspected opiate/opioid addiction issues, the immediate course of treatment is administering naloxone, either by intramuscular injection or intranasal mist. Of course, make sure administering naloxone is allowed per your organization's regulations and protocols. Pro Tip #2: The recommended dose of naloxone is 2mg for the rapid reversal of overdose symptoms when respiratory distress is present. The benefit of using a nasal atomizer is that it will administer the naloxone in a readily available form, like a fine mist which the patient can quickly absorb. To administer naloxone via the nasal atomizer, proceed with the following steps: Assemble the nasal atomizer per the instructions. Tilt the patient's head back slightly. Position the nasal atomizer into one nostril and briskly spray half of the amount (approximately 1cc). Position the nasal atomizer into the other nostril and spray the remaining naloxone. Wait 3-5 minutes. Continue to perform rescue breathing or CPR while waiting for the naloxone to take effect. If there isn't any change in the patient after 3-5 minutes, administer a second dose of naloxone. If a second dose doesn't revive the patient, something else is likely wrong. Either there aren't any opiates in the patient's system. Or they're unusually strong or plentiful and will require more naloxone. A Word About the Signs and Symptoms of Substance Abuse and Misuse Many of the signs and symptoms of substance abuse and misuse are similar to those of other medical emergencies. Which means you cannot necessarily assume that individuals who are stumbling, disoriented, or have a fruity, alcohol-like odor on the breath are intoxicated by alcohol or other drugs, as this may also be a sign of a diabetic emergency. As in other medical emergencies, you don't have to be certain of your diagnosis for substance abuse or misuse to provide care. It can be helpful, however, if you notice certain clues that suggest what the problem really is. Such clues will also help you provide as much complete information to advanced medical personnel so that they can continue providing prompt and appropriate care. Often these clues will come from the patient, bystanders, or the scene itself. As mentioned earlier, look for containers, pill bottles, drug paraphernalia, and signs of other medical problems. If the patient is incoherent or unconscious, try to get information from any bystanders or family members. Since many of the physical signs of substance abuse mimic other conditions, you may not be able to determine that a patient has overdosed. To provide care, you only need to recognize abnormalities in breathing, skin color and moisture, body temperature, and behavior, any of which may indicate a condition requiring professional help. https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/training/bls-first-aid/video/unconscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2091.mp4 Unconscious Adult Choking This unconscious adult choking lesson is for situations where you find a person who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the patient has a pulse but isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction. In this scenario, you would treat this patient as an unconscious adult choking victim. The method of care will closely resemble performing CPR, however there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the patient to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient. Lift the victim's chin and tilt his or her head back slightly. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Breathe into the rescue mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – check for a carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you detect a pulse but there are still no signs of normal breathing, continue to perform one rescue breath every five seconds for two minutes. After two minutes, reassess for a pulse and check again for normal breathing. If you still detect a pulse and the patient still isn't breathing normally, continue with one rescue breath every five seconds for two minutes. If you do not detect a pulse, go into full CPR – 30 chest compressions followed by two rescue breaths. Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About High Quality CPR It's important to understand what constitutes high quality CPR, as performing CPR correctly will give the victim the best chance of survival. High Quality CPR Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise Low Quality CPR Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth of less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force Warning: Once you begin CPR, it's important not to stop. If you must stop, do so for no more than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life and the patient breathing normally again, an AED being available and ready to use, or being too exhausted to continue. https://d3imrogdy81qei.cloudfront.net/video_images/3741/unconscious-adult-choking-2015.jpg Yes 216 https://www.procpr.org/training/bls-first-aid/video/child-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2077.mp4 Child CPR Much of what was covered in the last section – Adult CPR – will apply in this section – Child CPR. There will, however, be some subtle but crucial differences that will be highlighted. But first, let's recap the five links in the Child Cardiac Chain of Survival: Injury prevention and safety Early CPR Early Emergency Care Pediatric advanced life support Integrated post-cardiac arrest care Child-related cardiac arrests are typically the result of a hypoxic event, such as: Drowning Choking/airway obstruction Exacerbation of asthma Due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation. Warning: Laryngeal spasms (sudden spasm of the vocal cords) may occur in these situations, making passive ventilation during chest compressions minimal or nonexistent. Administering high-quality CPR can help overcome this oxygenation problem. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the child is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. CPR Technique for Children Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go roughly 2 inches deep, or 1/3 the depth of the child's chest, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Grab the appropriately-sized rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly – just past perpendicular. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About the Differences Between Child CPR and Adult CPR This section began by mentioning a few subtle differences between adult CPR and child CPR. There are four distinct differences to be aware of. Opening the Airway While the same head tilt maneuver is applied to children as it is for adults, make sure there is less hyperextension in a child's neck compared to adults. To do that, simply tilt the head back only slightly past neutral. Your goal is a chin angle that's less pronounced and more perpendicular to the ground. Performing Compressions The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. And in very small children, it's better to perform compressions at 1/3 of the child's chest and using just one hand. Compressions to Ventilations Ratio If there is only a single responder, continue using the 30 compressions to two ventilations ratio. However, if there are two responders, that ratio changes to 15 compressions to two ventilations. Using AEDs AEDs work the same regardless of age. However, the pads themselves, as well as pad placement, will vary based on the size of the child. If the child weighs more than 55 pounds, continue using the adult AED pads. If the child weighs less than 55 pounds, use pediatric AED pads if available. Warning: It's vitally important that the AED pads do not touch each other. If the child is too small for adult pads, and you do not have pediatric pads, place one on the center of the sternum and the other on the child's back between the scapulae. https://d3imrogdy81qei.cloudfront.net/video_images/3713/child-cpr-2015.jpg Yes 112 https://www.procpr.org/training/bls-first-aid/video/adult-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2076.mp4 Adult CPR A patient who is unconscious, not breathing normally, and has no pulse is in cardiac arrest and needs CPR. CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped. Remember the five links in the Adult Cardiac Chain of Survival: Recognize the cardiac emergency and call 911 Early CPR Early defibrillation Advanced life support Integrated, post-cardiac arrest care How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally (as you now know, agonal respiration is not breathing normally and should be considered the same as NO respirations), and has no pulse, continue immediately with CPR. CPR Technique for Adults Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression. A Word About High-Quality CPR It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. High-Quality CPR Performing chest compressions at a rate of 100-120 per minute Compressing to a depth of at least 2 inches but not exceeding 2.4 Allowing for full recoil after each compression Minimizing pauses in compressions Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise Low-Quality CPR Compressing at a rate slower than 100 per minute or faster than 120 per minute Compressing to a depth less than two inches or greater than 2.4 inches Leaning on the chest between compressions or performing compressions while not directly over the victim's heart Interrupting compressions for greater than 10 seconds Providing excessive ventilation – too many breaths or breaths with excessive force Warning: Once you begin CPR, it's important not to stop. If you must stop, do so for no more than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life with the patient breathing normally again, an AED becomes available and ready to use or you getting too exhausted to continue. https://d3imrogdy81qei.cloudfront.net/video_images/3711/adult-cpr-2015.jpg Yes 243 https://www.procpr.org/training/bls-first-aid/video/bleeding-control-arterial-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2094.mp4 Arterial Bleeding Arterial bleeding is the most severe and urgent type of bleeding. It can occur due to a penetrating injury, blunt trauma, or from damage to organs or blood vessels. As arterial bleeding is pumped directly from the heart to the rest of the body, this type of bleeding has a few distinctions: The blood is bright red in color due to its high oxygen concentration The blood tends to spurt due to the heart pumping it to the wound The pressure is higher than other types of bleeding, so it will not clot or stop as easily Warning: The pressure will only subside as blood volume decreases. This is a life-threatening situation and tissue will quickly begin to die due to lack of oxygen. How to Provide Care A person who is the victim of arterial bleeding will instinctively grab and cover the wound to reduce the amount of blood flow, if that person is conscious and able to. To best assist in treating the wound, you should: Make sure the scene is safe. Put on latex-free gloves if available. If you don't have gloves, wash your hands or use an alcohol-based hand sanitizer. Find the source of the bleeding; you may have to remove clothing over the wound. Make the switch from the victim's hand to a dressing pad or a clean cloth. Apply pressure. The wound will be pulsating, and it will likely take several dressing pads to control the bleeding. If the victim is conscious and can assist, this will help. Ask the victim to maintain pressure over the dressing pad or cloth. The blood will probably soak through, so apply a second pad on top of the first, rather than removing it. Continue to apply firm, direct pressure over the wound. If the victim is becoming light-headed from the blood loss, have them sit or lie down. The goal is to control the bleeding to the point where the wound is not leaking through each new dressing pad. If blood continues to leak through, continue to apply another pad or piece of cloth until it stops. Consider using a tourniquet if – you cannot control the bleeding with dressing pads and the blood loss is extreme. This is a life-threatening situation and last resort. In most cases, even arterial bleeding can be controlled using pressure plus dressing and bandages. Once you have the bleeding controlled, it's time to wrap the wound. Using an ACE roller bandage like you find in most first aid kits, start from the end of the extremity where the injury is located. If the wound is on the wrist, began wrapping from the hand. Pro Tip #1: it's important to extend the bandage several inches beyond the wound on both sides. This will help keep the wound clean and limit the chances of infection. When wrapping the wound, if extra pressure is required, twist the bandage once over the wound and continue wrapping. Repeat as often as necessary. To finish, tuck the end of the bandage into the wrap to hold it in place. Pro Tip #2: While pressure is important to control the bleeding, you don't want to cut off circulation to the extremity on which the wound occurred. Pinch a nail and the fleshy underside between two of your fingers (if the wound occurred on an arm or a leg). The nail should turn pale and then return to a pink color a couple seconds later. If it doesn't, the bandage is too tight. It's important to try and not cover fingers and toes with the bandage if possible, so that this test can be performed. At this point, you'll want to decide whether to call 911 for EMS services or transport the victim to the emergency room by private vehicle. Call 911 if: The victim has lost consciousness or is showing signs of losing consciousness The victim is exhibiting signs of shock – pale, cold, sweaty skin You cannot stop the bleeding A Word About Dressings and Bandages Dressings are sterile pads used to absorb blood and other fluids, help promote clotting, and prevent infection. Gauze pads are most common. Most dressing pads are porous, which allows air to circulate to the wound and promote healing. Common sizes range from 2-4-inch squares. Universal or trauma dressings are larger in size and used for larger wounds. Occlusive dressings are not porous, which means no air or fluids can pass through, and typically used for abdominal wounds. Bandages are strips of material used to hold the dressing in place, maintain pressure over the wound, control bleeding, and protect from dirt and infection. The most common type of bandage is the roller bandage that is usually made of gauze and comes in assorted widths and lengths. These are the type of bandages you find in most first aid kits. However, there are other types of bandages including: Pressure bandage – for more pressure and a snugger fit Bandage compress – thick gauze dressing attached to a gauze bandage Elastic bandage – type of roller bandage typically used for muscles, bones, and joints Triangular bandage – large bandage that can folded and used as a sling As arterial bleeding is the most severe type of bleeding, it's important to properly assess the situation quickly as a rapid response is vital for a positive outcome. If you feel like the situation is too serious to handle yourself, it's important that you or someone else at the scene call 911 immediately. https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/training/bls-first-aid/video/adult-cpr-team-approach https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2090.mp4 Adult CPR Team Approach This lesson focuses on the team approach to CPR when three or more responders or healthcare professionals are involved. There are three main takeaways from this section: It's important to establish who the team leader is in any team approach to life support. The team leader is the orchestrator for everyone else in the rescue process and directs all the action. It's important for all involved to communicate effectively, and to use what's known as closed-loop communication. Closed-loop communication refers to a command (from the team leader) that has been heard by the team member executing that command and repeated back. This establishes that each command is understood and about to be executed. It's also important to take notes and log times. This includes all facets of the rescue attempt – when chest compressions begin, when the first shock is executed, what drugs are being administered and when, etc. The Role of Team Leader The team leader is orchestrating the actions of the other team members – who is doing what and when – but also monitoring the others for quality assurance. If the team leader sees that something is being done incorrectly or could be improved upon, it's his or her job to point out the intended improvement or change in rescue care and encourage that team member through positive reinforcement. A Typical Division of Duties in a Three-Team-Member Approach Responder one: Begins performing the correct number of chest compressions based on the size of the patient and counting out loud. Responder two: Takes a position at the victim's head and readies the bag valve mask for use, performing two rescue breaths after a round of compressions have been completed and making sure that the chest rises and falls each time. Responder three: Takes notes of responder one and two's actions and times of each action. Responder three will also assist in some other aspect of care, if needed, including getting the AED ready. Responder three is also ready to jump in elsewhere when the switch occurs – when the compressor's two minutes are up and responder one switches places with responder two or three. All three responders are communicating all vital information to the rest of the team while they work. The team leader will indicate when a switch is about to occur, who is taking over for whom, if an IV should be established, what drugs will go into the IV, as well as dosages, and other important information and directives. A good team approach is vital in a rescue situation. It ensures that everyone is doing his or her job to the highest standards of care. In short, good practices and habits in a team approach leads to more saved lives. A Word About Advanced Airways If a patient has an advanced airway such as a supraglottic airway device or an endotracheal tube, CPR will be performed a little differently. A supraglottic airway device, which allows for improved ventilation, is an advanced airway that does not enter and directly protect the trachea like an endotracheal tube. When using a supraglottic airway device, like a laryngeal mask airway, a minimum of two responders must be present. Responder one provides one ventilation every six seconds, which is about 10 ventilations per minute. At the same time, responder two is performing compressions at the normal rate of between 100 and 120 compressions per minute. It's important to note that there is no pause between compressions or ventilations, and responders do not use the standard 30:2 compressions to ventilations ratio. Advanced airway devices provide a continuous delivery of compressions and ventilations without any interruptions. https://d3imrogdy81qei.cloudfront.net/video_images/3739/adult-cpr-team-approach-2015.jpg Yes 448 https://www.procpr.org/training/bls-first-aid/video/child-rescue-breathing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2073.mp4 Child Rescue Breathing This lesson focuses on how to perform rescue breathing on an unconscious child for the healthcare provider. As you'll soon see, there's one important distinction compared with rescue breathing for adults. As you learned in the last lesson, what you find during your patient assessment will determine whether you'll perform full CPR or only rescue breathing. During your assessment, use your eyes and ears – is the chest rising and falling? Is the patient making any sounds that may indicate normal breathing? Is the patient showing signs of oxygen deprivation, like blue around the lips? How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? Pro Tip #1: There are two different sizes of rescue masks with one-way valves. There's an adult/child size and an infant size. You should always carry both, but if you don't and the mask you do have is too big, try turning it upside down. What you're aiming for is a good seal over both the nose and mouth. If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. Look one more time for signs the patient is breathing normally. If you've determined at this point that the child is unresponsive, not breathing normally but does have a pulse, continue immediately with rescue breathing. Pro Tip #2: So, you know that agonal respiration isn't normal breathing. But do you know what it looks like? Have you ever seen a fish out of water gasping for air? It's similar to that. However, the important thing to remember is that while it really does look like breathing, it really isn't. Rescue Breathing Technique for Children Grab an appropriately-sized rescue mask and seal it over the child's face and nose. Lift the victim's chin and tilt his or her head back slightly – just past perpendicular. Breathe into the rescue mask and count out loud – one one-thousand, two one-thousand … On two or three one-thousand, breathe into the rescue mask again. Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse. Pro Tip #3: The sequence has changed. With children, you're going to perform one rescue breath every two to three seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every two to three seconds for two more minutes. And so on. Remember to make sure the patient's chest rises as you perform your rescue breaths. If it doesn't, this could indicate an airway obstruction. Remember, if at any point you discover that the patient's pulse is gone, go immediately into full CPR and use an AED if you have one available. A Word About Respiratory Emergencies Identifying a respiratory emergency quickly and providing high-quality care is essential, as we humans cannot survive long without oxygen. The human brain is quick to be impacted by oxygen deprivation. After 4-6 minutes, brain damage is possible. Between 6-10 minutes, brain damage is likely. And after 10 minutes, it's all but certain. Reasons for breathing difficulties are numerous and include: An obstruction Low oxygen environment The presence of poisonous gases Infection Trauma Poor circulation Other health issues There are two types of respiratory emergencies – respiratory distress and respiratory arrest. During respiratory distress, breathing is difficult, labored, and/or restricted in some way. During respiratory arrest, breathing stops entirely. Respiratory distress is often a sign of more serious health conditions and should be taken seriously. As for the causes of respiratory distress, they include: A partially obstructed airway Illness Chronic conditions such as asthma Electrocution, including lightning strikes Heart attack Injury to the head, chest, lungs, or abdomen Allergic reactions Drugs Poisoning Emotional distress When assessing a patient for respiratory distress, listen, watch, and ask. Does their breathing look and sound labored? And how does the patient feel? Ask them to see if the optics are as bad as their symptoms. And as for the signs and symptoms of respiratory distress, they include: Slow or rapid breathing Unusually deep or shallow breathing Gasping for breath Wheezing, gurgling, or high-pitched noises Unusually moist or cool skin Flushed, pale, ashen, or bluish skin color Shortness of breath Dizziness or light-headedness Pain in the chest or tingling in the hands, feet, or lips Apprehensive or fearful feelings https://d3imrogdy81qei.cloudfront.net/video_images/3705/child-rescue-breathing-2015.jpg Yes 153 https://www.procpr.org/training/bls-first-aid/video/bleeding-control-venous-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2095.mp4 Venous Bleeding Uncontrolled bleeding is the number one cause of preventable deaths due to a trauma. While venous bleeding is usually less serious than arterial bleeding, it still can pose a serious health risk to the victim. Venous bleeding can be the result of external trauma, as in something cutting or puncturing a vein, or internal trauma, due to a broken bone or organ damage. Venous bleeding involves blood that is returning to the heart, so there won't be as much pressure as arterial bleeding. However, the blood loss can still be severe. Venous bleeding distinctions are: The blood is dark red, not bright like arterial bleeding The blood flow is steady but not spurting; it can still be quick, though The pressure is lower than arterial bleeding so it's usually easier to control How to Provide Care A person who is the victim of venous bleeding will likely be applying pressure to the wound or cut by the time you arrive to help. Some things to keep in mind with venous bleeding are: It will often stop on its own in 4-6 minutes It's usually easy to control with direct pressure What may seem like a lot of blood is likely to just be smeared, dripping blood which often looks like more than it really is As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. Find the source of the bleeding and ask the victim if he or she is cut anywhere else to make sure you're not missing another wound. Place a dressing pad or cloth over the wound. Apply pressure. At this point, the one dressing pad will usually be enough to control venous bleeding. However, you may also want to consider assessing the severity of the cut. Pro Tip 1: When you remove pressure, do the folds of skin around the cut begin to come apart, or does the skin appear to be staying together. If the skin is coming apart, stitches are likely necessary. If not, the wound will probably heal on its own and stitches can be avoided. As can a trip to the emergency room. If a trip to the emergency room is warranted but EMS services are not, it's still a good idea to have someone else drive the victim. There may be a chance that the victim has difficulty seeing his or her own blood, which could cause psychogenic shock. It's always better if the victim is a passenger rather than the driver. Before you wrap the wound, make sure it's properly cleaned using a bacterial ointment if you have one. This will combat any bacteria that may have gotten into the cut and reduce the chances of infection. Pro Tip 2: Consider the chances of tetanus. If the victim was cut by something dirty and hasn't had a tetanus shot in the last 10 years, a trip to the emergency room is a necessity regardless of the severity of the wound. After cleaning the wound, reapply a dressing pad that completely covers the area. Wait and see if the bleeding stops or if it leaks through. Most venous cuts will stop after applying the first pad. Warning: There are reasons why venous bleeding cannot be easily controlled and these include: the victim has a bleeding disorder or is on blood thinners. Make sure to ask the victim if it appears that the bleeding is difficult to stop. It's now time to wrap the wound, and taping the pad is usually sufficient. Just be aware to maintain constant pressure while you tape. And as before with arterial bleeding, pinch the finger or toe nails if the extremities are involved and see if blood returns to the nails. You don't want to cut off blood supply. Your goals in tapping or bandaging the wound are: Maintain pressure and control bleeding Cover completely so dirt and debris cannot get inside the cut At this point it's always a good idea to make sure the patient is stable and not in shock. If their skin has good color and isn't cold or clammy, and if they haven't lost consciousness, EMS probably will not be needed. A Word About Disease Transmission To reduce your risk of disease transmission, there are a few guidelines to keep in mind: Avoid contact with the victim's blood by wearing latex-free gloves and protective eyewear if you have them. Avoid touching your mouth, nose, and eyes while providing care, and don't drink or eat anything before washing your hands. Wash your hands thoroughly after providing care, even if you wore gloves. Always dispose of the gloves or change gloves before helping someone else. As venous bleeding is often not a severe injury, it's still important to remember that it still has the potential to become a serious situation, especially if bleeding cannot be controlled or the victim goes into shock. When in doubt, it's best to call 911 and let the EMS professionals handle the situation. https://d3imrogdy81qei.cloudfront.net/video_images/3749/bleeding-control-venous-bleeding-2015.jpg Yes 214 https://www.procpr.org/training/bls-first-aid/video/child-proofing-the-home https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2068.mp4 Child Proofing the Home Child-proofing a home is essential to protect children against normal household items that could present a risk to them, such as sharp objects, and choking and electrical hazards. Pro Tip: To see what a child sees, you have to get to their level. So, drop down to your hands and knees and begin crawling around the house looking for hazards that children can get into. You may be surprised what you notice seeing things from that perspective. How to Child Proof a Home There are a number of hazards in any home to be aware of, including: Choking hazards. Any loose item that can fit into a child's mouth will likely end up … in a child's mouth. It takes just a few minutes to pick these items up and prevent a possible emergency. Electrocution hazards. Items that may not be a choking hazard can still be put into an electrical outlet. If those items are metal, that could be a problem. Children are naturally curious and tend to exist according to the mantra, I wonder what happens if. Burn threats. Young kids aren't big enough to reach the stove yet, but that doesn't mean that burn hazards don't exist. Watch where you put hot beverages like coffee, tea, and soup. On the edge of a low-lying tabletop that can be reached by an infant is a burn waiting to happen. Staircase threats. Staircases are dangerous environments for small children. Keep doors to stairs closed or use an adjustable safety gate that fits into stairways. Also, keep stairs clear of items that everyone, adults included, can trip over. Child-proofing a home will greatly help eliminate these unnecessary hazards. Prevention takes only a bit of time and effort, but it can make a huge difference in the health and lives of the children in that home. A Word About Helping a Conscious Choking Infant Since the biggest threat, and reason for child-proofing a home, is likely choking, let's take a look at the exact technique for helping a conscious choking infant. You'll be performing a combination of back slaps and chest thrusts to try and dislodge the airway obstruction. But first, if there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Draw an imaginary line across the infant's nipples and place two fingers on the sternum in the center of the infant's chest. Your fingers should be perpendicular to the chest, meaning your knuckles are directly above your fingers. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. And they can do a quick assessment for internal bleeding or other damage. If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is around 80 percent effective if you perform the back slaps and chest thrusts properly. If you couldn't remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/3695/child-proofing-the-home-2015.jpg Yes 140 https://www.procpr.org/training/bls-first-aid/video/adult-cpr-2-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2086.mp4 Adult CPR 2 Rescuer In this section, we're going to cover two-responder adult CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.) The advantage of having a second, fully-trained and experienced rescuer is that the two of you can share in tasks and responsibilities. Rather than one of you having to do it all on your own. The type of rescue mask you're using doesn't change the two-responder technique when it comes to the sharing of duties; neither does the presence or absence of supplemental oxygen. Pro Tip #1: The advantage of two -responder CPR is the alleviation of rescuer fatigue. Performing the compressions and rescue breaths yourself will begin to tire you over time and perhaps diminish the quality of CPR being administered. The assessment phase is similar to one-responder situations, however, while one of you is assessing the scene and patient, the other can get the equipment ready to perform CPR, try to locate an AED if one isn't present, call 911 or a code, etc. Once chest compressions begin, that's when the efforts of each responder will begin to coordinate, including the important switch at the two-minute mark. Warning: The point of two-responder CPR is to limit fatigue and maintain the delivery of high-quality CPR. So, don't negate this benefit. Be sure to coordinate a switch at the two-minute mark so neither of you are performing chest compressions for longer than two minutes without a rest. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your bag valve mask, or rescue mask with a one-way valve (or bag valve mask when there are two responders), handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Two-Responder CPR Technique for Adults Responder one: Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Pro Tip #2: Counting with the correct cadence and out loud will help you maintain a consistent rhythm. However, when there are two responders, counting out loud is even more important. It allows the other responder to anticipate the delivery of rescue breaths and the all-important switching of duties. Responder two: Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. (When using the bag valve mask, remember not to push down on the mask, but rather, lift the mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do.) Compress the bag on the bag valve mask and wait for the chest to rise and fall before administering the next breath. Responder one: Go right back into your 30 chest compressions. Responder two: Go right back to delivering two rescue breaths. Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties. Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask. Continue to perform 30 chest compressions to two rescue breaths – while switching duties every two minutes – until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About Considerations for Older Adults In older adult patients, a general decrease in pain perception may cause a different reaction to a heart attack. Older adults often suffer what is known as a silent heart attack, meaning there is a lack of common symptoms we most often associate with heart attacks – chest pain or pressure, for instance. For these older adult patients, the symptoms of a heart attack mostly tend to include general weakness or fatigue, aches or pains in the shoulders, and indigestion and/or abdominal pain. https://d3imrogdy81qei.cloudfront.net/video_images/3731/adult-cpr-2-rescuer-2015.jpg Yes 237 https://www.procpr.org/training/bls-first-aid/video/child-cpr-2-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2087.mp4 Child CPR 2 Rescuer In this section, we're going to cover two-responder child CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.) Much of what was covered in the last section – Adult CPR with Two Responders – will apply in this section – Child CPR with Two Responders. There will, however, be some subtle but crucial differences that are highlighted below. Pro Tip #1: When performing chest compressions on a large child, use two hands as you would for an adult. But when performing compressions on a smaller child, use just one hand to assure you're not compressing with too much force. Pro Tip #2: The rate of compressions to rescue breaths changes during child CPR when two responders are present. Instead of performing 30 compressions to two rescue breaths, reduce the number of compressions to 15 for every two rescue breaths. It's worth mentioning again – The assessment phase is similar to one-responder situations, however, while one of you is assessing the scene and patient, the other can get the equipment ready to perform CPR, try to locate an AED if one isn't present, call 911 or a code, etc. Once chest compressions begin, that's when the efforts of each responder will begin to coordinate, including the important switch at the two-minute mark. The importance of having a fresh compressor cannot be overstated. Performing high-quality compressions will help bring the pulse pressure up as well as keeping the blood pressure as high as possible. Having two responders working together as a coordinated team will ensure the highest quality CPR gets delivered, which will give the patient the greatest chance of survival. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve (or bag valve mask when there are two responders), begin calling out to the victim to assess whether or not the child is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the child's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Two-Responder CPR Technique for Children Responder one: Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. With smaller children, it may help to draw an imaginary line across the nipples. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Remember: Use only one hand when performing chest compressions on smaller children. Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart. Conduct compressions that go 2 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 15 chest compressions. Remember that counting out loud is even more important when two responders are working together. It allows the other responder to anticipate the delivery of rescue breaths and the all-important switching of duties. Responder two: Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. (When using the bag valve mask, remember not to push down on the mask, but rather, lift the mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do. Also, remember that with children, the head-tilt, chin lift is less pronounced than it is during adult CPR.) Compress the bag on the bag valve mask and wait for the chest to rise and fall before administering the next breath. Responder one: Go right back into your 15 chest compressions. Responder two: Go right back to delivering two rescue breaths. Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties. Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask. Continue to perform 15 chest compressions to two rescue breaths – while switching duties every two minutes – until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About Ventilations Artificial ventilation is the method of forcing air into the lungs of a patient who is not breathing on their own. The oxygen in the ventilated air will be absorbed by blood flowing through the lungs and carried to the body's tissues and vital organs. There are several ways to provide this ventilation, including: Mouth to mask using a one-way valve Using a bag valve mask with or without supplemental oxygen Mouth to mouth Mouth to nose Mouth to nose ventilation may be required if no ventilation equipment is present and if you are unable to create a proper seal over the patient's mouth. Mouth to Mouth Ventilation Steps Open the patient's airway past neutral using the head tilt, chin lift maneuver. Pinch the patient's nose shut. Create a seal over the patient's mouth using your mouth, or over the mouth and nose for an infant. Blow air into the patient's mouth. Break the seal slightly on the inhale and reseal before administering the next breath. https://d3imrogdy81qei.cloudfront.net/video_images/3733/child-cpr-2-rescuer-2015.jpg Yes 229 https://www.procpr.org/training/bls-first-aid/video/unconscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2092.mp4 Unconscious Child Choking This unconscious child choking lesson is for situations where you find a child who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the child has a pulse but isn't breathing normally. Any attempts to deliver a rescue breath have failed, most likely due to an obstruction. In this scenario, you would treat this patient as an unconscious child choking victim. The method of care will closely resemble performing CPR on a child, however there are subtle differences to pay attention to. Pro Tip #1: There is also one important distinction when performing rescue breaths on a child who has a pulse but isn't breathing normally versus an adult – one rescue breath every three seconds for two minutes, which has been highlighted in the steps below to help you remember. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the patient to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Remember that to maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm. Conduct compressions that go about 2 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Remember to allow for full recoil of the chest cavity after performing each chest compression. You want to allow the chest to come all the way back to the neutral position before performing another compression. Lift the victim's chin and tilt his or her head back slightly – just past perpendicular. Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps. Breathe into the rescue mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. If the rescue breaths go in this time – causing the chest to rise and fall – check for a carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you detect a pulse but there are still no signs of normal breathing, continue to perform one rescue breath every three seconds for two minutes. After two minutes, reassess for a pulse and check again for normal breathing. If you still detect a pulse and the patient still isn't breathing normally, continue with one rescue breath every three seconds for two minutes. If you do not detect a pulse, go into full CPR – 30 chest compressions followed by two rescue breaths. Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About the Differences Between Child CPR and Adult CPR There are four distinct differences to be aware of. Opening the Airway While the same head tilt maneuver is applied to children as it is for adults, make sure there is less hypertension in a child's neck compared to adults. To do that, simply tilt the head back only slightly past neutral. Your goal is a chin angle that's less pronounced and more perpendicular to the ground. Performing Compressions The compressions you perform on a child are very similar to those you would perform on an adult. The only difference is in the compression depth. While adult CPR has a depth of 2-2.4 inches, when administering CPR on a child, two inches will usually be the maximum depth. And in very small children, it's better to perform compressions using just one hand. Compressions to Ventilations Ratio If there is only a single responder, continue using the 30 compressions to two ventilations ratio. However, if there are two responders, that ratio changes to 15 compressions to two ventilations. Using AEDs AEDs work the same regardless of age. However, the pads themselves, as well as pad placement, will vary based on the size of the child. If the child weighs more than 55 pounds, continue using the adult AED pads. If the child weighs less than 55 pounds, use pediatric AED pads if available. Warning: It's vitally important that the AED pads do not touch each other. If the child is too small for adult pads, and you do not have pediatric pads, place one on the center of the sternum and the other on the child's back between the scapulae. https://d3imrogdy81qei.cloudfront.net/video_images/3743/unconscious-child-choking-2015.jpg Yes 180 https://www.procpr.org/training/bls-first-aid/video/pool-safety https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2069.mp4 Pool Safety Every year numerous lives are needlessly lost to drowning incidents, and many of those lost are young children. In this lesson, you'll learn how to recognize a drowning victim and how to help them to safety. Many times, a person who is a true drowning victim behaves differently than we might expect. They're likely not yelling for help, as they could be taking in water and unable to speak. It's important to understand what a drowning victim looks like. Signs of a potential drowning victim include: Exaggerated movements Head bobbing up and down at water line Arms flailing Making little noise beyond sounds of splashing How to Safely Rescue a Potentially Drowning Victim Once you've identified a potential drowning victim, use the following methods to rescue them and help them safely out of the pool. Pro Tip #1: The protocol for rescuing a drowning victim can be summed as such: Reach. Throw. Don't go. DO NOT swim out to get them unless you're a trained and certified lifeguard. Otherwise, you could end up a second drowning victim. Try to reach the victim from the side of the pool. If the victim is close enough, make sure you stay low to the ground and maintain a low center of gravity, while reaching out to them with your hand. Pull them out of the pool or assist them in getting to the nearest ladder and then out. Turn a towel into a rope. If you can't reach the victim with a hand, grab a towel and coil it up into a makeshift rope. Swing one end out to the drowning victim while you hang onto the other end. Drag the towel in with the victim in tow and help them out of the water. Use a pole or leaf skimmer. A swimming pool usually has these sorts of poles laying around, either for rescue purposes or cleaning and maintenance. And they often can telescope in and out, making them ideal to aid a drowning victim who is further away from the side of the pool. Pro Tip #2: If using a pole to assist a drowning victim, make sure you're standing with your forward-leading foot out in front of you. Lean back and use your weight as a counterbalance. Extend the pole and lower it down beside the victim. Once they grab it, lean back and pull them to safety. Use a life jacket or floatation device. If the victim is too far out to reach any other way, see if there are some floatation devices, like pool noodles or life jackets that you can toss out to them. Once the victim has the floatation device, instruct them to kick their feet and encourage them to keep coming, as they're likely exhausted and scared. Pull them to safety once they reach the side of the pool. If you called 911 and activated EMS, it's a good idea to keep them coming, especially if the victim took in some water. There could be some potential breathing issues or an aspirational pneumonia developing. Warning: If the victim is unresponsive when pulled from the water, begin CPR immediately. And always call 911 as soon as you think there's an emergency. If it turns out there isn't an emergency, you can always cancel the 911 call. But if turns out to be a real emergency, you'll be glad you activated EMS. A Word About Drowning When it comes to drowning, there are several critical facts and statistics to be aware of. Some important statistics. Drowning is the fifth most common cause of death from accidental injury in the United States for all ages, and it rises to the second leading cause of death for children ages 1 to 14. And males are more than three times more likely to drown than females. On the threat of drowning. Younger children can drown at any moment, even in as little as an inch of water. Young children commonly drown in home pools. Children with seizure disorders are 13 times more likely to drown than those without such disorders. Early recognition is key. Most people who are drowning spend their energy trying to keep their mouth and nose above water. As you learned earlier, recognizing someone who seems to be having trouble in the water, but is not calling out for help, may help save their life. There are three types of water-related victims: A distressed swimmer who is too tired to continue but afloat. A drowning victim who is active and vertical but not moving forward. A drowning victim who is passive, floating, or submerged and not moving. Don't become a victim yourself. Only those trained in swimming rescues should enter the water to assist with drowning emergencies. For your safety, look for a lifeguard before attempting a rescue, have the appropriate safety equipment, call for additional resources immediately if you do not have that equipment, and only swim out if you have the proper training, skills, and equipment. https://d3imrogdy81qei.cloudfront.net/video_images/3697/pool-safety-2015.jpg Yes 340 https://www.procpr.org/training/bls-first-aid/video/child-abuse https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2070.mp4 Child Abuse and Neglect Child abuse and neglect is a very serious topic and not one that anyone enjoys reading about. But it's vitally important, especially for those of you working in an industry mandated to report any suspicions of abuse and neglect. Pro Tip #1: A mandated reporter is a person required by law to report reasonable suspicions of abuse and neglect, such as teachers, day care providers, EMS personnel, coaches, camp staff, and other professionals. According to statistics from the U.S. Department of Health and Human Services, 679,000 children were the victims of abuse and neglect in 2013, and in that same year 1500 children died as a result. Of those 679,000 child abuse victims, 80 percent suffered from neglect, 18 percent from physical abuse, and nine percent from sexual abuse. These numbers indicate a serious problem that has become far too common. In this lesson, you'll learn the key indicators for recognizing abuse and neglect in children. How to Recognize Abuse and Neglect Child abuse is a prevalent problem that can occur anywhere, including: Child day care centers Schools Religious institutions Recreational and athletic facilities Camps Residential facilities The child's home What is Neglect? Neglect by a parent or primary caregiver is the most prominent type of child abuse. It's defined as a failure to provide adequate food, clothing, shelter, supervision, or medical attention. Indications of neglect include a child who … Looks undernourished Appears lethargic and tired Has poor hygiene Is inappropriately dressed for the weather Sustains injuries due to lack of supervision Has poor self esteem Has trouble relating to others What is Physical Abuse? Physical abuse is defined as non-accidental physical injury to a child – by striking, shaking, throwing, burning, biting, cutting, etc. Pro Tip #2: All kids get bumps and bruises from time to time, particularly those that are more adventurous or into sports. It's important for you to understand when those injuries occur due to abuse versus regular childhood mishaps. Physical indications of physical abuse include: Questionable bruises, cuts, and welts Cuts and bruises to the torso, back, buttocks, and thighs Injuries in various stages of healing, indicating abuse over time Bruises shaped like the objects that were used – belt buckle, electrical cord, etc. Burns like those from cigarettes, particularly on the soles of the feet, palms of the hands, back, and buttocks Immersion burns like you would get from scalding hot water Burns in the shape of irons, stove top burners, etc. Rope burns, especially on the arms, legs, neck, and torso Fractures Black eyes Behavioral indications of physical abuse include when the child is … Uncomfortable with physical contact Wary of adults Apprehensive when other children cry Emotionally unstable, aggressive one moment, withdrawn the next Frightened of own parents Afraid to go home – perpetually arrives to school early and stays late Trying to hide the injuries – reluctant to change in front of others, wears clothes to conceal injuries Pro Tip #3: Does the child have a history of running away from home? A child with a long history of repeated attempts to run away can also be cause for concern, particularly when combined with any other indicators of abuse. What is the Difference Between Discipline and Abuse? This comes up occasionally as corporal punishment (spankings and such) are still allowed in certain areas of the U.S. What defines discipline? It is a learning process to teach appropriate behavior. What defines abuse? Inflicting pain; that's it. There's no learning objective. It's usually the result of anger, frustration, and loss of control. How Can You Tell the Difference Between Abuse and Accidental Injury? As mentioned earlier, kids get hurt sometimes; it's part of being a kid. But sometimes it's much more than that. And while injuries from abuse and accident can look similar, there are some important differences you should know about. When it comes to accidental cuts and bruises, the areas most affected are on the outside of the body, like knees and elbows. However, with abuse, the common areas are the stomach and buttocks. As frequency goes up, the chances of accidental injury go down. Look for injuries, especially bruises, in different stages of healing, as in different colors. This may become a moot point if the child is a tackle football player. Do the injuries resemble an object – like a wooden spoon or electrical cord – or appear in a pattern. These are pretty suspicious circumstances and most likely from an adult. Has the parent or primary caregiver provided the same story as the child? Does their relationship appear normal, or does the child appear afraid of the parent or caregiver? What is Sexual Abuse? Sexual abuse is a complex type of child abuse and is defined as any illegal sexual act upon a child including incest, rape, indecent exposure, fondling, child prostitution, and child pornography. There are often no visible signs to accompany sexual abuse, or else they're too subtle to notice or attributed to something else. Add to that how the adult abuser is usually able to manipulate the child into silence and uncovering sexual abuse becomes even more difficult. For the child, this sort of manipulation is beyond their scope of understanding. It's emotionally confusing. And it results in a wide range of emotional responses. Indications of child sexual abuse include when the child has … Inappropriate knowledge of sex Sexually explicit drawings An unexplained fear of a person or place or is attempting to avoid a familiar adult Nightmares or sleep disruptions Become withdrawn Guilt and shame issues Symptoms of depression and anxiety Wild mood swings Pro Tip #4: The best indicator is when a child says so. Take statements seriously. Resolve doubt in favor of the child. And err on the side of protection. Three Ways Sexually Abused Children Share Their Experience Because of the secrecy involved or the fact they're told something bad will happen, children who are sexually abused rarely tell anyone. They may, however, provide a mix of clues if you're paying attention. Here are three examples of things a child suffering from sexual abuse may say. Indirectly – My babysitter keeps bothering me. Disguised – What would happen if a girl was being touched in a bad way and she told someone? With strings attached – I'm having a problem, but if I tell you about it, you have to promise not to tell anyone. When dealing with a child who has been sexually abused, listen, remain calm, and encourage the child to talk, but never press them. Be honest. Tell them the truth, which is that you may need to tell someone in order to get them the help they need. If you ever suspect abuse or neglect, report your suspicion to local law enforcement or child protective services in your area. And if you're a mandated reporter, you have a legal responsibility to report. https://d3imrogdy81qei.cloudfront.net/video_images/3699/child-abuse-2015.jpg Yes 896 https://www.procpr.org/training/bls-first-aid/video/adult-rescue-breathing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2072.mp4 Adult Rescue Breathing In this lesson, we're going to look at how and when to use rescue breathing on an unconscious adult patient. The main factor when it comes to rescue breathing is whether or not you can find a pulse. As you know, if the patient isn't breathing normally and doesn't have a pulse, you go immediately into CPR. However, if when assessing the patient, you do find a pulse and are confident that it is a pulse, that's when you'll use rescue breathing. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. Look one more time for signs the patient is breathing normally. If you've determined at this point that the victim is unresponsive, not breathing normally (as you now know from previous lessons, agonal respiration is not breathing normally and should be considered the same as NO respirations), but does have a pulse, continue immediately with rescue breathing. Rescue Breathing Technique for Adults Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. Breathe into the rescue mask and count out loud – one one-thousand, two one-thousand, three one-thousand, four one-thousand, five one-thousand … On six one-thousand, breathe into the rescue mask again. Continue using the rescue breathing technique until help arrives or the patient revives. If you have an AED, consider preparing it for use just in case the patient loses his or her pulse. Pro Tip #1: You're going to continue to perform one rescue breath every six seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every six seconds for two more minutes. And so on. Pro Tip #2: Make sure the patient's chest rises as you perform your rescue breaths. If it doesn't, this could indicate an airway obstruction. Warning: If at any point you discover that the patient's pulse is gone, go immediately into full CPR and use an AED if you have one available. A Word About the Respiratory System The respiratory system is divided into two parts – the upper airway tracts and the lower airway tracts. The lower airway tracts access the respiratory system through the nose and mouth. As air is inhaled through the nose, it's warmed and humidified. Air inhaled through the mouth goes over the tongue and into the pharynx. The pharynx is divided into three parts – the nasopharynx, the oropharynx, and the laryngopharynx. The nasopharynx lies behind the nasal cavity. The oropharynx is located behind the oral cavity and is the shared passageway for both food and air. The laryngopharynx is the lowest part of the throat and divides into two passageways. The back portion is the entrance to the esophagus, which is the passageway for food. The front portion is the larynx, which is the continuation of the respiratory system. Above the larynx is the epiglottis – a flap of cartilage that folds down over the larynx to close it off to the trachea during swallowing, so that food doesn't enter. Incidentally, this only works if the person is conscious. After air travels through the pharynx, it then passes through the larynx. At the top of this structure is the hyoid bone (a horseshoe-shaped bone that helps support the structure of the larynx), made mostly of cartilage, muscle, and membranes. Below the hyoid bone are the thyroid and cricoid cartilages, which form the larynx. The lower airway tract begins below the vocal cords and consists of the trachea, bronchi, and lungs. The trachea is a hollow tube that's supported by rings of cartilage. It extends downward until it divides into two branches called bronchi, that connect with each lung. The two bronchi are also hollow tubes and supported by cartilage. And they, too, divide – into lower airways called bronchioles. Bronchioles are thin hollow tubes that remain open and lead to the alveoli. The alveoli – small sacs that form the end of the airway – number in the millions. Each alveolus shares a wall with capillary blood vessels. This point, where the walls of the alveoli and the walls of the capillaries come into contact, is where external respiration takes place – that all-important exchange of oxygen and carbon dioxide between the respiratory and circulatory systems. https://d3imrogdy81qei.cloudfront.net/video_images/3703/adult-rescue-breathing-2015.jpg Yes 144 https://www.procpr.org/training/bls-first-aid/video/adult-bag-valve-mask https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2085.mp4 Bag Valve Mask This lesson will focus on how to use your bag valve mask, why we might use it instead of the traditional mouth to mask rescue technique, and any concerns that may come with using a bag valve mask (BVM). There are three sizes of bag valve mask systems – infant, child and adult. There are many mask sizes and styles as well from neonate and infant all the way up to adult. Having the correct size mask helps to create a good seal for the breaths or ventilations. Having the proper size bag ensures enough air is given without an unnecessary risk of too much air into the lungs. Pro Tip #1: If you only have the adult-size bag valve system, it is not recommended to use on infants or children. Giving too much air can cause trauma to the lungs as well as a decrease in blood flow to the heart. Therefore, for best patient care, using the appropriately sized bag valve for each patient is recommended. Some aspects to be aware of concerning bag valve masks: Sometimes the oxygen reservoir will be attached right out of the bag from the manufacturer; other times you'll have to attach it yourself. The reservoir is meant to be used with 100 percent oxygen, so when you ventilate the patient, they're getting a higher concentration of oxygen to compensate for any oxygen deprivation they may be experiencing. You may have to first attach the oxygen tubing to the oxygen inlet on the bag as well as the oxygen source (tank or wall mount). Pro Tip #2: If you don't see the oxygen reservoir bag inflating, or if it's inflating too slowly, put your thumb over the outlet inside the mask. This will seal the bag system so no oxygen is escaping, and the reservoir will fill more quickly. The oxygen should be set to high flow to fill the reservoir more quickly and to keep the reservoir inflated while ventilating the patient. When sealing the mask over the patient's face, there are a couple important points to note: The shape of the mask: You have the apex part of the mask that goes over the patient's nose, and the bell part of the mask (the wider end) that goes around the victim's chin and under the bottom lip. The specific method for holding and attaching the mask: The CE method. Your index finger and thumb form the C and go around the stem of the mask and are used to balance pressure on one side of the mask when attaching it, while your palm will put pressure on the other side of the mask. Your other three fingers will form the E, as they grab the patient's mandible, or jaw line, and draw it up into the mask. Warning: Do not push the mask down onto the patient's face. This will not provide a proper seal and may even block the airway. It's your fingers and palm that creates the seal, and it's the drawing of the mandible into the mask that provides the proper head tilt, chin lift before delivering your ventilations. When a second responder comes in handy: If certain facial features are complicating the sealing of the mask, incorporate the second responder into the effort. Responder one uses two hands to create the seal, while responder two provides the ventilations using the bag. Warning: If you do not see the patient's chest rise and fall, your seal is not tight or the airway is not open, and the patient is not receiving the life-saving oxygen they need. Pro Tip #3: If there is no way to get a proper seal, there are other adjuncts available, but these may be considered advanced life support techniques in your area. Supraglottic airways – these are designed to fit the stem of the bag valve without the mask and can help deliver a secured airway with ventilations. Endotracheal tubes – these are also designed to be used with the stem of the bag valve and assist with delivering oxygen. Both options are possibilities if the mask isn't fitting or sealing properly. Pro Tip #4: If you're not able to deliver ventilations successfully using the bag valve mask, don't use it. Set it aside and use a regular rescue mask with a one-way valve and deliver breaths with the mouth to mask technique. Don't waste time that the patient doesn't have, as they are likely becoming anoxic by the second. The benefits of using a bag valve mask: They can be safer when it comes to infection control. They can deliver higher concentrations of oxygen with each breath. Another important note: Bag valve masks work best when incorporated into the team approach. Bag valve masks require practice to perfect. So, if you're supposed to be using one as part of your own particular protocol or if you simply see the benefits of using it when compared to the traditional mouth to mask rescue technique, practice as much as you can first. What do they say about practice? It makes perfect. And perfect use of the bag valve mask could mean the difference between life and death. https://d3imrogdy81qei.cloudfront.net/video_images/3729/adult-bag-valve-mask-2015.jpg Yes 415 https://www.procpr.org/training/bls-first-aid/video/adult-rescue-breathing-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2121.mp4 Practice: Adult Rescue Breathing Learn how to perform rescue breathing on an unconscious adult who is not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3801/adult-rescue-breathing-practice-2015.jpg Yes 82 https://www.procpr.org/training/bls-first-aid/video/child-rescue-breathing-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2122.mp4 Practice: Child Rescue Breathing Learn how to perform rescue breathing on an unconscious child who is not breathing by watching the procedure performed on a manikin. https://d3imrogdy81qei.cloudfront.net/video_images/3803/child-rescue-breathing-practice-2015.jpg Yes 64 https://www.procpr.org/training/bls-first-aid/video/infant-rescue-breathing-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2123.mp4 Practice: Infant Rescue Breathing Learn how to perform rescue breathing on an unconscious infant who is not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3805/infant-rescue-breathing-practice-2015.jpg Yes 68 https://www.procpr.org/training/bls-first-aid/video/hands-only-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2114.mp4 Practice: Hands Only CPR When doing hands-only or compression-only CPR, you do not do cycle breathing. You simply continue chest compressions until EMS arrives. Learn this skill by watching the procedure be performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/training/bls-first-aid/video/adult-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2124.mp4 Practice: Adult CPR Learn how to give CPR to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3807/adult-cpr-practice-2015.jpg Yes 92 https://www.procpr.org/training/bls-first-aid/video/two-person-aed-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2130.mp4 Practice: Two Person AED Watch how to two people can work together to give CPR with an AED to an unconscious adult who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3819/two-person-aed-practice-2015.jpg Yes 247 https://www.procpr.org/training/bls-first-aid/video/adult-cpr-two-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2131.mp4 Practice: Adult CPR Two Rescuer Watch how to two people can work together to give CPR to an unconscious adult who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3821/adult-cpr-two-rescuer-practice-2015.jpg Yes 188 https://www.procpr.org/training/bls-first-aid/video/child-cpr-two-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2132.mp4 Practice: Child CPR Two Rescuer Watch how two people can work together to give CPR to an unconscious child who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3823/child-cpr-two-rescuer-practice-2015.jpg Yes 141 https://www.procpr.org/training/bls-first-aid/video/infant-cpr-two-rescuer-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2133.mp4 Practice: Infant CPR Two Rescuer Watch how two people can work together to give CPR to an unconscious infant who is not breathing. This procedure acted out on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3825/infant-cpr-two-rescuer-practice-2015.jpg Yes 148 https://www.procpr.org/training/bls-first-aid/video/seizure https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2101.mp4 Seizure In this lesson, you'll learn how to treat an adult patient who goes into a seizure or has just come out of one. A person can go into a seizure for too many reasons to mention. As you are concerned, why it happened isn't important. Being able to recognize that it did happen is the key. For you to know if a seizure took place, ideally you or someone else saw the patient go into a tonic state that exhibited the following signs: Hands are gripped and pointed inward The patient is actively seizing The patient ends the seizure in the postictal state (relaxed recovery) How to Treat a Patient who is Actively Seizing There are a few important things that you can do when a person is suffering from a seizure to help protect them from further harm. First, is there anything around the patient that could injure them, such as sharp objects? If there is, remove the threat from the scene or move the patient to a safer area. If the patient is having a zootomic clonic seizure – in which they are fluctuating between contracting and relaxing – they could bang their head on the ground. To protect their head, simply cup your hands together and place them underneath the patient's head. Warning: Never hold down a seizing patient or try to stop the seizure in any way. Just support and protect the patient during the seizure. Then, once the seizure is over, assess for more serious situations like cardiac arrest. How to Treat a Patient after a Seizure Pro Tip #1: There are several things to do post-seizure, but the most important is calling 911 and activating EMS if it hasn't already been done. As soon as you determined that the patient had a seizure, and you don't know if the patient is an ongoing epileptic, call 911 immediately. After EMS has been activated, begin to assess the patient for a couple of things. Is the patient moving and breathing normally again? Are they beginning to return to consciousness? If the patient isn't moving or breathing normally, and isn't responsive to your taps and shouts, go right into CPR and retrieve or find an AED. If the patient is beginning to breathe normally again, does the breathing appear to be agonal respirations or more corrective breathing? To help keep the patient's airway open and clear, put them into the following recovery position. Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground. Bring the patient's furthest leg over their other leg so that their legs are crossed. Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side. Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway. Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over. Pro Tip #2: A person who has just experienced a seizure – essentially an electrical storm in the brain – will be low on oxygen. As a result, they may be confused or combative and this will likely last a few minutes. While waiting for EMS to arrive, continue to assess the patient for breathing and recovery signs, like talking. Any signs that the patient is becoming more responsive are good signs. If the patient begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive. A Word About Pediatric Seizures A seizure is a disorder in the brain's electrical system, which is sometimes marked by loss of consciousness and often by uncontrollable muscle movement, also referred to as convulsions. In children, febrile seizures are the most common type of seizure. These seizures occur with a rapidly-rising or excessively-high fever, typically higher than 102° F. Children with febrile seizures may exhibit some or all of the following signs and symptoms: Sudden rise in body temperature Jerking of the head and limbs Loss of bladder or bowel control Confusion Drowsiness Crying out Becoming rigid Holding the breath Rolling the eyes upward To assess what type of seizure the child has had and why, it's important to ask good questions: Has the child ever had seizures before? If so, is the child on medications for them? If not, is there a family history of seizures? Does the child have diabetes? If so, what type of insulin/medication is being used and when was the last time it was given? Has the child started taking any new medications lately? If the child takes medications, is it possible there may have been an overdose? Could the child have taken someone else's medication by accident? Could the child have ingested anything poisonous? Has the child had a recent injury, particularly a head trauma? Has the child seemed sick or had a high fever, stiff neck, or headaches? What did the seizure look like? Did it involve the child's whole body, or only one half of the body? Did it start in one area and progress to the rest? Did the child fall when the seizure began and if so, was it possible the child's head struck an object or the floor? These are just some of the questions you can use to help decipher what type of seizure the child had and why. https://d3imrogdy81qei.cloudfront.net/video_images/3761/seizure-2015.jpg Yes 246 https://www.procpr.org/training/bls-first-aid/video/how-to-use-an-epipen https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2102.mp4 How to Use an EpiPen Epinephrine is the first line of defense when it comes to treating anaphylaxis. And the sooner it's administered, the less severe the allergic reaction. Remember, anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Anaphylaxis can cause the body's blood vessels to suddenly dilate, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen starved. Anaphylactic shock will cause death if not treated. People with a history of allergic reactions should always carry an epinephrine pen. Pens are single dose, pre-filled, automatic injection devices, also known as epi pens. The following instructions are specifically for Epi Pen brand. If you're using a different brand of epi pen, be sure to follow the manufacturer's instructions. How to Use an Epi Pen Pro Tip #1: Any time an epi pen is used, be sure to call 911 and activate EMS. The person, even if feeling better, must seek further medical attention after a severe allergic reaction. Remove the pen's safety cap. Grip the pen in your hand with the tip pointing down. Warning: Never put your thumb, fingers, or hand over the tip of the pen; you may accidentally inject yourself while treating the patient. Firmly push the tip of the pen into the patient's outer thigh at a 90-degree angle and until you hear the pen click. Needles can penetrate clothing. Keep the auto injector firmly pressed against the patient's thigh; hold for 3 seconds. Pull the epi pen straight out. Warning: Make sure you don't pull the pen out at an angle. This can cause a lot of pain and bleeding. And if blood comes out of the leg, there's a good chance the effectiveness of the shot will be reduced. Rub the area for 10 seconds, as this will increase absorption of the epinephrine within the leg muscle. Pro Tip #2: A second epi pen may be used if symptoms persist or recur and if EMS has been delayed for more than 5 to 10 minutes. Usually the patient will notice some airway relief pretty quickly, as the tightness in the throat begins to dissipate. There are, however, some unfortunate side effects that some patient's may experience, including: Rapid heartbeat Shakiness Feelings of anxiety Dizziness Headache Pro Tip #3: Once you administer an epinephrine injection, make note of the time it was delivered and tell EMS when they arrive. A Word About Epinephrine Epinephrine is a drug that slows or stops the effects of anaphylaxis. If a patient is known to have an allergy that could lead to anaphylaxis, they may carry an epinephrine auto-injector (an epi pen) that can deliver a single dose of the drug. Epinephrine devices are available in different doses, as the dose of epinephrine is based on weight – 0.15 mg for children weighing between 33 and 66 pounds, and 0.3 mg for children and adults weighing more than 66 pounds. People with a known history of anaphylaxis would be wise to carry an anaphylaxis kit containing at least two doses of epinephrine with them at all times. Why a second dose? Because more than one dose may be needed to stop a strong anaphylactic reaction. It's important to remember that a second dose is administered only if emergency medical responders are delayed and the patient is still having signs and symptoms of anaphylaxis 5 to 10 minutes after administering the first dose. It's important to act fast when a patient is having an anaphylactic reaction, as difficulty breathing and shock are both life-threatening conditions that could suddenly erupt. If the patient is unable to self-administer the medication, you may need to help them with the epi pen. Only assist if/when: The patient has a previous diagnosis of anaphylaxis and has been prescribed an epinephrine auto-injector The patient is having signs and symptoms of anaphylaxis The patient requests your help using an auto-injector Your state laws permit giving assistance https://d3imrogdy81qei.cloudfront.net/video_images/3763/how-to-use-an-epipen-2015.jpg Yes 140 https://www.procpr.org/training/bls-first-aid/video/child-cpr-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2125.mp4 Practice: Child CPR Learn how to give CPR to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3809/child-cpr-practice-2015.jpg Yes 104 https://www.procpr.org/training/bls-first-aid/video/adult-aed-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2127.mp4 Practice: Adult AED Learn how to give CPR with an AED to an adult who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3813/adult-aed-practice-2015.jpg Yes 240 https://www.procpr.org/training/bls-first-aid/video/unconscious-adult-choking-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2135.mp4 Practice: Unconscious Adult Choking (Healthcare Provider) Learn how to rescue an unconscious adult that is choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3829/unconscious-adult-choking-practice-2015.jpg Yes 102 https://www.procpr.org/training/bls-first-aid/video/unconscious-child-choking-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2136.mp4 Practice: Unconscious Child Choking Learn how to rescue an unconscious child that is choking by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3831/unconscious-child-choking-practice-2015.jpg Yes 97 https://www.procpr.org/training/bls-first-aid/video/fainting https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2056.mp4 Fainting This lesson focuses on what to do when you come upon a patient who has just fainted. Fainting is defined as a temporary loss of consciousness that's usually related to temporary insufficient blood flow to the brain. Fainting is also referred to as syncope, blacking out, or passing out. There are a number of reasons why a person would pass out and many of those are not at all life-threatening. In fact, when someone faints, the biggest concern is usually the victim's inability to protect themselves as they're falling, which can lead to a number of things going wrong – broken bones, head or face injuries, etc. In many fainting situations, there is no one around who witnessed the accident. Which means you may need to put on your detective hat to properly discover potential injuries. How to Assess and Treat a Patient who Faints As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #1: The first thing you'll want to do is to assess for life-threatening conditions, including head and neck injuries. After ruling out more serious conditions, begin to see if the patient has a simple problem, like low blood sugar or dehydration that contributed to his or her passing out. When you come upon a fainting victim, as long as there is nothing more serious going on, they will likely be awake and responsive. They may be sitting up already or are ready to sit up with your help. At this point you'll want to interview the patient to see what's going on. "Can you tell me what happened here today?" "Do you hurt anywhere?" It's common for fainting victims to be weak and dizzy afterward. The important thing is that the patient is awake and responsive enough to answer your questions. However, continue to monitor for: Airway issues Breathing problems Weak or rapid pulse Pale, clammy skin Pale and clammy skin are signs of shock. If you determine the patient to be in shock, that warrants an immediate 911 call and activation of EMS. As always, err on the side of patient welfare. Pro Tip #2: Just because the situation doesn't appear serious doesn't mean it can't suddenly become serious. If you don't have an AED already, it's a good idea to send someone at the scene to go find one. If, for instance, the fainting was caused by a serious heart dysrhythmia, an AED could be lifesaving. It's typical for fainting victims to begin to recover under their own powers. As they are coming around, gauge their mental alertness, ask again about the presence of pain, and of course, continue to assess for signs of something more serious: Decreased level of consciousness Airway, breathing, or circulation problems Signs of shock Long-bone fractures Varying degrees of responsiveness If you, at any point, notice any of the above, call 911 and activate EMS or call in a code if you're in a healthcare setting. Then treat the patient accordingly. A Word About Syncope and Presyncope Syncope, or fainting, is caused due to a temporary reduction in blood flow to the brain. Depriving the brain of its normal blood flow can cause it to momentarily shut down. When this happens, it triggers a fainting episode or syncope. But what specifically triggers fainting? There are a number of things that trigger it, including: Emotional shock Pain Certain medical conditions Overexertion In pregnant women and older people – getting up from a seated or lying position Syncope can occur without warning. Or there could be some early signs, such as dizziness, the feeling of being lightheaded, or feeling like your about to faint. Together, these symptoms have a name – presyncope. How to Prevent Someone in Presyncope from Fainting Help the patient lay down. Continue to monitor the patient's breathing and level of consciousness. Instruct and help the patient perform physical counter-pressure maneuvers (PCM). Three Examples of Physical Counter-Pressure Maneuvers Have the patient grip one hand at the fingers with the other and try to pull them apart without letting go. They should hold the grip for as long as they can or until their symptoms disappear. Have the patient hold a rubber ball or similar object in their dominant hand and then squeeze the object for as long as they can or until their symptoms disappear. Have the patient cross one leg over the other and squeeze them together tightly. Have them hold this position for as long as they can or until their symptoms disappear. Physical counter-pressure maneuvers help raise the patient's blood pressure through skeletal muscle contraction and, in many cases, will resolve symptoms of faintness. Let the patient know to avoid holding their breath while performing the maneuvers. An easy way to avoid this is to engage the patient and keep him or her talking. https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/training/bls-first-aid/video/animal-and-human-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2370.mp4 Animal and Human Bites In this lesson, you'll learn what to do when you come across patients who've been bitten by animals and/or humans. There are a few considerations that differentiate animal and human bites. However, for the most part, general first aid care will be the same for both. How to Treat for Animal and Human Bites As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Let's quickly differentiate between minor wounds and serious wounds. A minor wound is defined as bites that caused teeth marks, bruising, or scratching. When you encounter minor wounds, simply wash the area thoroughly with soap and water. For scratches, apply an antibiotic ointment to prevent infection, then cover the area with a clean bandage. A serious bite wound is one in which the skin has been punctured or torn and is bleeding. A victim with an open bite wound must seek advanced treatment from a physician due to the high risk of infection. A serious bite wound can include severe bleeding. Unless the wound is still oozing or spurting blood, wash the area with soap and water, apply sterile dressing, and seek advanced medical treatment. If the wound is still bleeding, apply direct pressure with a clean dry cloth or sterile gauze pad and first stop the bleeding. Apply a bandage once the bleeding has been controlled. If your serious bite wound does include arterial or severe bleeding, apply direct pressure, call 911, and watch for signs of shock. A severe bleeding incident is one in which the wound is spurting or pulsating blood and the bleeding is difficult to control. Special Considerations for Human Bites The most common type of human bite occurs among young children who are curious, angry, or frustrated. Children at day care centers are most at risk for human bite wounds. Most human bite wounds among children are harmless, as more serious child bite wounds are very unusual. The biggest threat when it comes to human bites is infection, as human saliva contains hundreds of species of bacteria. In fact, a bite wound is more likely to become infected if it came from a human versus an animal. Pro Tip #1: For any human bite wounds that break the skin, the patient will need to seek advanced medical care due to the risk of infection. And while highly unlikely, bloodborne pathogens like HIV and hepatitis B or C can be transmitted by human bites. Special Considerations for Animal Bites Most animal bites come from domestic pets like cats and dogs and typically involve young children. The biggest threat with animal bites, even domesticated animals, is the risk of rabies. If the animal bite included the skin being punctured by a non-immunized animal, or from an animal whose immunization status is unknown, the patient will need to be treated by a physician immediately. Pro Tip #2: Most rabies cases involve wild animals, like foxes, raccoons, skunks, and the most common rabies carrier of them all – bats. If you suspect that a patient was bitten by one of the above, keep in mind the need to seek swift medical treatment for rabies. Warning: Tetanus can be a concern in both animal and human bites. If a patient suffered a deep bite wound and he or she hasn't had a tetanus shot in more than five years, a booster shot should be encouraged. When it comes to animal and human bites, just following the general first aid guidelines, particularly for bleeding control and infection control, will encompass the majority of the treatment you provide. A Word About Animal Bites Dog bites are the most common among all types of wild and domestic animals. It's important that when a person is bitten, that they are quickly removed from the situation if possible. It's equally important to do so in a way in which you're not endangering yourself or others. Clean minor wounds with soap and clean water and do your best to control bleeding with major wounds. If the patient is bleeding severely, apply pressure and control it as best you can until advanced medical personnel arrive. Tetanus and rabies immunizations may be necessary, so it's vital that bites from any wild or unknown domestic animals be reported to the local health department or another agency according to local protocols. If the animal is still loose, follow local protocols regarding contacting animal control to capture the animal. Try to obtain and provide a description of the animal and the area in which the animal was last seen. https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/training/bls-first-aid/video/treating-ear-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6488.mp4 Ear Injuries In this lesson, we'll take a look at both external and internal ear injuries and how to apply first-aid treatment for both. Ear injuries can occur due to various causes, such as trauma, loud noises, or foreign objects that have been accidentally or purposely inserted into the ear. Knowing how to assess and provide initial first aid treatment for any ear injury is essential to minimize discomfort and prevent further complications. This lesson will guide you through the assessment and first aid treatment options for some of the more common ear injuries. Pro Tip #1: Before we begin, it's important to note that ear injuries can range from minor to severe. In cases of severe ear injury or if the injury involves hearing loss, it's crucial to seek medical assistance. Therefore, assessment of the ear injury is vital. Having said that, even in the event of a severe ear injury, you should still provide first aid to alleviate discomfort. Now let's take a look at how to assess and provide first-aid treatment for an ear injury. First Aid Treatment for External Ear Injuries Inspect the external ear for any visible injuries, cuts, or bleeding. If there is bleeding, apply gentle pressure with a clean cloth or sterile gauze to control it. Maintain pressure until the bleeding stops. Do not insert any objects into the ear canal, and do not attempt to clean the ear extensively. If there are signs of infection, such as redness, swelling, or discharge, seek medical attention. First Aid Treatment for Foreign Objects in the Ear If a foreign object - such as a small toy or insect – is visible and can be easily removed without pushing it in further, use clean tweezers or your fingers to fish it out. However, remember to use EXTREME caution and try to remove it gently. Avoid using sharp objects or excessive force, as this may cause injury or push the object deeper into the ear potentially causing permanent hearing loss. If the object cannot be easily removed, or if moving the object causes pain, discomfort, or bleeding, be sure to stop and seek medical attention. First Aid Treatment for Bleeding from in the Ear Foreign bodies or significant head trauma can lead to bleeding from the ear canal. For this type of bleeding injury, it is best to quickly seek medical attention. As for the bleeding, loosely apply a dressing or other clean materials to the outside of the ear and track how much blood came out, such as how many gauze pads or towels were used. Pro Tip #2: If you try to apply direct pressure, this could cause a build-up of pressure in the ear and cause an increase in pain or lead to other complications. Monitoring the victim and asking how they are doing will help determine if the pain is suddenly getting worse. If it is, it might be caused by this direct pressure. Remember, while these first aid measures can provide initial relief, seeking professional medical care for significant ear injuries, severe pain, changes in hearing, or especially head trauma that causes bleeding from the ear is essential. A Word About Basilar Skull Fractures Basilar skull fractures are fractures that occur in the base of the skull, which is the area at the bottom of the skull that supports the brain. Symptoms related to the ear that can occur with basilar skull fractures include: Battle's Sign: This refers to bruising behind the ear and is a common sign of basilar skull fracture. It typically appears a few days after the injury and is due to bleeding beneath the skin. Hearing Loss: Basilar skull fractures can affect the structures of the middle and inner ear, leading to conductive or sensorineural hearing loss. Conductive hearing loss occurs when sound waves cannot reach the inner ear due to damage to the ear canal, eardrum, or middle ear bones. Sensorineural hearing loss occurs due to damage to the inner ear or auditory nerve. Tinnitus: Ringing or buzzing in the ear (tinnitus) can occur as a result of the injury to the inner ear structures. Ear Bleeding: Bleeding from the ear canal (otorrhagia) can occur if the fracture involves damage to the temporal bone or surrounding structures. Dizziness and Vertigo: Damage to the inner ear or vestibular system can cause dizziness, vertigo (the sensation of spinning), and imbalance. Facial Nerve Dysfunction: Fractures involving the temporal bone can affect the facial nerve (cranial nerve VII), leading to facial weakness or paralysis on the affected side. CSF Leak: In severe cases of basilar skull fracture, cerebrospinal fluid (CSF) can leak from the nose or ear (otorrhea). This can be a serious complication requiring medical attention. https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/training/bls-first-aid/video/car-backing https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2067.mp4 Car Backing / Reversing This lesson deals with car backing emergencies and how you can prevent them. You're probably well aware of the extreme number of lives lost each year on U.S. roads and highways. But how many of you give consideration to lives lost by another type of traffic accident – those involving vehicles backing up? A number of lives are lost each year from slow-backing accidents, and many of these occur at home in the driveway. The problem is that, even when you're alert and paying attention while backing up, children can still dart behind your vehicle and get quickly into a blind spot in the time it takes to glance at the rearview mirror. Warning: When a small child is behind a vehicle, the driver often cannot see the child in any of the mirrors, creating a dangerous blind spot for the child. Which is why adopting a safe routine for backing up is so important. Create a Safe Backing Routine It's important to have a policy or protocol in place that you can execute each time before you even put the car in reverse to ensure your children are safe before backing out. You can put together a safe backing routine a number of ways, but one that works well is to establish a visible gathering place for all the kids. The gathering place should be in a location you can see them and in front of the vehicle. Do a head count. When all kids are accounted for, put the vehicle in reverse and back out slowly. Be sure to continue to monitor the children for any movement, but also in a way that allows you to scan mirrors for traffic and other people. Backing up at a minimal speed is important, as it may be necessary to suddenly stop in case there's an emergency. Pro Tip: A car moving slowly is a car with the ability to stop quickly. (Not really Pro Tip material, but better than leaving you Pro Tipless this lesson.) Remember that an ounce of prevention is worth a pound of cure. And that any moments of inconvenience are well worth the bit of extra effort. A Word About Lightning Yes, lightning! While it has absolutely nothing to do with car backing emergencies, it does deserve special recognition, as an ounce of prevention is truly worth a pound of cure when it comes to lightning strikes. In the U.S., there are more deaths each year due to lightning strikes (100) than due to any other weather-related hazard or event, including blizzards, hurricanes, floods, tornadoes, earthquakes, and volcanic eruptions. During a lightning strike, the lightning travels back and forth between the ground and the cloud many times during that one visible flash. How's that, you ask? Well, lightning travels at a swift 300 miles per second. The list of possible effects on someone who has been struck by lightning include: Thrown through the air Clothes burned off Heart stops beating Neurological damage Fractures Loss of hearing Loss of sight A single lightning strike can wreak havoc on the human body, as it can deliver up to 50 million volts of electricity, or enough to light 13,000 homes. Precautions You Can Take to Avoid Being Struck by Lightning During storms, it pays to use common sense and to respect the power of nature. Use the following precautions to stay safe in inclement weather. Postpone activities promptly and remember that thunder and lightning can strike without rain. Go inside a completely enclosed building. If you cannot find one, a cave is a good option, but move as far back as possible from the cave entrance. Watch cloud patterns and conditions for signs of an approaching storm. Designate safe locations and use them at the first sound of thunder. And remember, every five seconds between the flash of lightning and the sound of thunder equals one mile of distance. Use the 30-30 rule. When you see lightning, count the seconds until you hear thunder. If that time is 30 seconds or less, the thunderstorm is within six miles. Seek shelter immediately. The threat of lightning continues for a much longer period than most people realize. So, wait at least 30 minutes after the last clap of thunder before leaving the shelter. If inside during a storm, keep away from windows. Injuries may occur from flying debris or glass if a window breaks. Stay away from plumbing, electrical equipment, and wiring during a thunderstorm. Water and metal are both excellent conductors of electricity. Do not use a corded telephone or radio transmitter except for emergencies. Bonus Precaution: If the movie Caddyshack taught us anything, it's the dangers of golfing during a thunderstorm. Hit the clubhouse for an hour or three, or postpone entirely. https://d3imrogdy81qei.cloudfront.net/video_images/3693/car-backing-2015.jpg Yes 110 https://www.procpr.org/training/bls-first-aid/video/dental-and-oral-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6489.mp4 Dental and Oral Injuries In this lesson, we'll take a look at dental and oral injuries and how you can apply first aid to treat them. Dental and oral injuries, such as tooth, tongue, or lip injuries, can occur unexpectedly and may require immediate first aid. Knowing how to assess and provide initial treatment can help alleviate pain and prevent further complications. This lesson will guide you through the assessment phase and first aid treatment options for some of the more common dental and oral injuries. Pro Tip: Before we begin, it is really important to remember that dental and oral injuries can vary in severity. For more severe injuries, seeking prompt dental or medical assistance is crucial. However, in minor cases, you can provide initial first aid to alleviate discomfort and help the healing process. First Aid Treatment for Tooth, Tongue, and Lip Injuries If a permanent tooth is lost, follow the first aid steps below. Try to locate the tooth and handle it only by the crown. Avoid contact with the root – the part that is hidden in the gums - as touching this could damage the tooth. If the tooth is dirty, gently and quickly rinse the tooth with water. Do not scrub or remove any tissue fragments. Gently reposition the tooth back into its socket and have the patient bite on a clean cloth, such as a piece of gauze, to hold it in place. If the first option is not possible, place it in a suitable storage medium, such as milk, saliva, or a tooth preservation kit, and seek dental care immediately, as the chance of saving a knocked-out tooth decreases with time. Additionally, according to the latest guidelines of the International Association of Dental Traumatology, it is not recommended to replant a primary tooth. It is still advisable to place the tooth in a storage medium and seek further evaluation by a dentist. There are many other dental injuries that could occur, but there is very little we can do about these. The best recommendation is not to move or irritate the area and seek immediate dental care. If there's bleeding from the tongue or lip, have the person rinse their mouth with water to clear any blood. You can gently clean the injured area with a damp cloth or gauze pad to remove debris. This will allow you to assess the extent of the injury. Apply direct pressure to the wound with a clean cloth or sterile gauze to control bleeding. If there is significant bleeding or the wound is deep, seek immediate medical attention since this may lead to breathing problems as blood can make breathing increasingly difficult. It may also cause the patient to swallow blood which can quickly lead to nausea and vomiting, further compromising the airway. Encourage the person to avoid hot or spicy foods and to maintain good oral hygiene. Remember, while these first aid measures can provide relief, seeking professional dental or medical care is always essential. A Word About Dental Avulsion Injuries A dental avulsion injury - also known as a knocked-out tooth - can damage both the tooth and the supporting soft tissue and bone, resulting in the permanent loss of the tooth. Dental avulsion is relatively uncommon compared to other dental injuries but can occur in various age groups, particularly among children and young adults involved in sports or accidents. It most commonly affects children and adolescents, often due to falls or sports-related injuries. The peak incidence is seen in the 7-14 age group. Studies suggest that dental avulsion accounts for approximately 0.5 to 3 percent of all dental injuries. It tends to affect males more frequently than females, possibly due to higher participation rates in contact sports. Participation in contact sports (e.g., football, hockey, and basketball), inadequate use of mouthguards during sports activities, and accidents (falls and collisions) are significant risk factors. Immediate reimplantation of an avulsed tooth is believed to result in the greatest chance of tooth survival. The longer a tooth is out, the more likely it will be permanently lost. In situations that do not allow for immediate reimplantation of an avulsed tooth, it is beneficial to temporarily store it in a variety of solutions that are shown to prolong the viability of dental cells. If available, place the avulsed tooth in Hanks' Balanced Salt Solution or in another oral rehydration salt solution, or wrap the tooth in cling film to prevent dehydration and improve the likelihood of successful replantation by a dental professional. This should always be done as quickly as possible. If an avulsed permanent tooth cannot be immediately replanted in either Hanks’ Balanced Salt Solution, oral rehydration salt solutions, or cling film, store the tooth in cow’s milk or saliva, as these are your best secondary options. Keeping the tooth "safe" in the saliva inside the person's mouth is also not suggested as the patient will often keep moving the tooth around which can further damage to the roots of the tooth. An avulsed tooth should never be stored in tap water.  The viability of an avulsed tooth stored in any of the above solutions is limited. And reimplantation of the tooth within an hour after avulsion provides the best chance for tooth survival. Following the loss of a permanent tooth, it is essential to seek rapid medical assistance for reimplantation. The long-term success of replantation depends on various factors, including the extra-alveolar time (time the tooth is out of its socket), the storage medium used for transporting the tooth, and the condition of the tooth and surrounding tissues. Complications may include pulp necrosis (death of the tooth's inner tissue), infection, root resorption (breakdown of the tooth root), and periodontal issues. Prevention is often a key to avoiding oral injuries while playing contact sports. The proper use of mouthguards is highly recommended. https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/training/bls-first-aid/video/penetrating-trauma https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6490.mp4 Penetrating Trauma In this lesson, we'll go over the treatment options for penetrating injuries like gunshot wounds, knife stabbings, or any other type of similar penetrating trauma. Penetrating injuries can often be life-threatening and will usually require immediate treatment. Knowing how to assess and provide first aid for these injuries can make a critical difference in the outcome of the victim.  In this lesson, we will guide you through the assessment phase and initial treatment of penetrating injuries. Pro Tip #1: Before we begin, it's essential to remember that first aid is not a substitute for professional medical care. In the case of penetrating injuries, it is vital to call emergency services immediately. Your main goal is to provide initial care and support until professional medical help arrives. First Aid Steps for Penetrating Trauma Injuries As always, the first thing you want to do is ensure that the scene is safe. Carefully assess the scene for any ongoing danger and ensure your safety and the safety of others before approaching the injured person. If there is an active threat, prioritize your safety and seek a safe location before providing aid. Your safety and the safety of others is always the most important step. Once you have determined that the scene is safe, follow the steps below. Step 1: Call 911 for help. If you cannot call emergency services yourself, ask someone else at the scene to do this, providing others are in the vicinity, as you may have your hands full with the victim. Step 2: Provide accurate details to emergency services about the situation, including your location and the nature of the injury. Calling for professional medical help is crucial for the injured person's survival. Also, remaining calm, if possible, will help to ensure the proper communication of vital information Step 3: Control the bleeding by applying direct pressure to the wound using a clean cloth, a sterile dressing, or even your gloved hand. Pro Tip #2: It is always recommended that you utilize universal precautions. Use personal protective equipment (PPE) at all times. Protecting yourself should not be overlooked. Step 4: Maintain pressure until medical professionals take over. If the object causing the penetration is still in the wound, don't remove it, as it may be acting as a plug to control the bleeding. If you believe there is a possibility that the penetrating item such as a bullet, knife, or other item may have gone through the body, check to see if there is a wound where the object came out. With bullets especially, the exit wound is usually larger than the entry wound. Pro Tip #3: Controlling the bleeding is of the utmost importance. Apply firm and continuous pressure to the wound. Treating the wound with a dressing and bandage will help the clot to form and stop the bleeding. Step 5: Once the bleeding has been controlled, help the victim get into a comfortable position, preferably lying flat on the ground if possible. Then, cover the injured person with a blanket or any available material to help maintain their body heat. This can reduce the risk of hypothermia, help with the clotting process, and provide comfort to the victim. Step 6: Lastly, provide reassurance. Keep the injured person calm and reassure them that help is on the way. It's important not to lie to them or give them false hope. Minimizing their movement to avoid exacerbating the injury, keeping them calm, and reassuring them that you are taking good care of them can all aid in their recovery. Pro Tip #4: Do not probe or irrigate the wound. Inserting objects into the wound or attempting to clean the wound extensively may cause further damage or introduce infection. It's important to resist the urge to probe or irrigate the wound. Your focus should be on controlling bleeding, keeping them warm, providing comfort and reassurance, and waiting for professional medical help to arrive. Remember, in most cases, maintaining the victim’s airway, breathing, and circulation will be the most important steps in a critical penetrating trauma emergency, as cardiac arrest may become an additional threat. These are the basic steps for providing the initial care for a penetrating injury. Once emergency medical services arrive, they'll take over and provide the appropriate medical treatment. A Word About Cardiac Arrests Associated with Penetrating Traumas According to the American Heart Association, basic and advanced life support for the trauma patient are fundamentally the same as that for the patient with a primary cardiac arrest, with a focus on support of the airway, breathing, and circulation. Cardiopulmonary deterioration associated with trauma has several possible causes including: Hypoxia secondary to respiratory arrest, airway obstruction, large open pneumothorax, tracheobronchial injury, or thoracoabdominal injury Injury to vital structures, such as the heart, aorta, or pulmonary arteries Severe head injury with secondary cardiovascular collapse Underlying medical problems or other conditions that led to the injury, such as sudden cardiac arrest Diminished cardiac output or pulseless arrest from tension pneumothorax or pericardial tamponade Extreme blood loss leading to hypovolemia and diminished delivery of oxygen Even with a rapid and effective out-of-hospital response, victims with out-of-hospital cardiac arrest due to trauma rarely survive. Those patients with the best outcome from trauma arrest generally are young, have treatable penetrating injuries, have received early endotracheal intubation, and undergo prompt transport to a trauma care facility. Remembering your CPR training during a penetrating trauma injury could be vital for whomever you're administering first aid to should they fall victim to a cardiac arrest. It pays to be prepared. https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/training/bls-first-aid/video/wash-your-hands https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/1234.mp4 Handwashing Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination. When Should You Wash Your Hands? Wash your hands whenever they're visibly dirty, but also: Before having any contact with clients/patients Before putting on your gloves Before performing any procedures After contact with a client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items After using the bathroom After touching garbage After removing your gloves Proper Hand-Washing Technique Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations. Use a disposable paper towel to turn on the sink faucet. Thoroughly wet your hands. Apply a generous amount of soap. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds. Rinse your hands under the running water. Dry your hands with a disposable paper towel. Use that towel to turn off the sink faucet. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it doesn't eliminate all types of germs. Proper Use of Hand Sanitizer Hand sanitizers that are alcohol-based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas. Continue to massage the hand sanitizer into your hands for 20 seconds. Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed when using a hand sanitizer. On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol. This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics of your situation and workplace. However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately. A Word About Personal Protective Equipment Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear. Disposable Latex-Free Gloves Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens. Eye Protection Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes. CPR Breathing Barriers CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient. Masks A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective. Gowns In situations where there are large amounts of blood or other possibly infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/training/bls-first-aid/video/allergic-reactions https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2060.mp4 Allergic Reactions While there are only around 1500 deaths each year in the U.S. from severe allergic reactions, it is nonetheless frightening how quickly these allergic reactions can occur. Around 50 million Americans suffer from an allergy, and this is a number that's apparently on the rise. One theory as to why has to do with our too-sterile modern life. One that includes: Antibacterial soap Hand sanitizer Air-tight homes An increase in environmental pollutants It seems our body's immune systems aren't developing as effectively to fight germs and other foreign invaders like they were in the past. The most common causes of all allergic reactions are from foods (number one) and insects (number two). Children are most affected when it comes to food allergies. And while most kids outgrow their food allergies, according to the CDC, the number of children with food allergies rose by 18 percent in a 10-year span from 1997 to 2007. Pro Tip #1: While most kids outgrow most food allergies, there is one that cannot be outgrown – the peanut. Sadly, peanut allergies are for life. What Causes an Allergy? The job of your immune system is to protect your body from foreign invaders – various bacteria, germs, and viruses. A healthy immune system protects the body even in the presence of these invaders. However, when there is an allergy present, the immune system will mistakenly target and overreact to a threat that doesn't really exist. This results in your immune system attacking a harmless substance that has recently been eaten, inhaled, injected, or come into contact with the skin. And that substance is called an allergen. An allergen can be introduced to the body a number of times with no trouble. Then, for seemingly no reason, the body one day decides to flag that allergen as a foreign invader, which triggers the body to attack the allergen. And to further complicate matters, the body will remember the allergen and produce specific antibodies that will attack the allergen even more fiercely next time it's introduced into the body. Pro Tip #2: This is why allergic reactions are often more severe the second or third time – the build-up of antibodies and larger battles. When the immune system attacks the allergen, high quantities of histamine and other chemicals are released into the surrounding tissues. Depending on the part of the body affected, symptoms can include: Itching Hives and rash Sneezing Wheezing Swelling of the face Runny nose Nausea There is one particular kind of allergic reaction that can be especially life-threatening – anaphylaxis. Anaphylaxis is a severe and sudden allergic reaction that affects many parts of the body at the same time within mere minutes of the allergen coming into contact with the body. Warning: Anaphylaxis can cause the body's blood vessels to suddenly dilate – as in opening all the way up, which can lead to anaphylactic shock. Anaphylactic shock can cause a sudden drop in blood pressure resulting in organs like the brain quickly becoming oxygen-starved. Anaphylactic shock will cause death if not treated. One common and basic treatment for anaphylactic shock is epinephrine (or an epi-pen), as it constricts blood vessels and opens the airway, thereby reducing the effects of the allergen. The most common causes of anaphylaxis are bees and other stinging insects, latex, medications and the following foods: Nuts Fish Shellfish Eggs Milk The most common cause of severe, life-threatening allergic reactions is by far the peanut. How to Treat for Allergic Reactions As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first things you'll want to look for are the signs and symptoms of allergic reactions and anaphylactic shock: Trouble breathing Wheezing Tightness in the throat Itchiness on the tongue Swelling of the face Hives Pale skin Rapid heart rate Low blood pressure Nausea Vomiting Diarrhea Dizziness How children typically describe an allergic reaction may better help understand some of the signs: It feels like there's hair on your tongue You experience tingling Your mouth itches It feels like something is stuck in your throat Your lips feel tight Your body feels weird all over Warning: The key element with allergic reactions is time. Don't wait. Call 911 immediately. If available, use an epi-pen. But don't wait for symptoms to get better. The three steps to providing care for allergic reactions are: Recognize the signs early Call EMS or a code if in a healthcare setting Assist the patient with an epi-pen if needed Pro Tip #3: Keep the patient calm. Sit them down. Make sure they're comfortable. To make breathing easier, have the patient sit straight up and lean forward. If the patient is feeling faint or is losing consciousness, lie them down, elevate their legs, and keep them warm. Talk to them, reassure them, but be prepared to begin CPR if they suddenly stop breathing or become completely unresponsive. Warning: There is the possibility of a secondary reaction after the first. Which is why the patient should be monitored for four to six hours after the initial allergic reaction. A Word About how to Know if it's Anaphylaxis? Depending on the situation, there may be different things to watch out for as you put the puzzle pieces together. Here's a cheat sheet that may help. Situation #1: You know that the patient has been exposed to an allergen. What to Look For: Trouble breathing OR Signs and symptoms of shock Situation #2: You think the patient may have been exposed to an allergen. What to Look For: Any TWO of the following: A skin reaction Swelling of the face, neck, tongue, or lips Trouble breathing Signs and symptoms of shock Nausea, vomiting, cramping, or diarrhea Situation #3: You do not know if the patient has been exposed to an allergen. What to Look For: A skin reaction (such as hives, itchiness, or flushing) OR Swelling of the face, neck, tongue, or lips PLUS Trouble breathing OR Signs and symptoms of shock https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/training/bls-first-aid/video/musculoskeletal-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2053.mp4 Musculoskeletal Injuries The musculoskeletal system is actually the combination of two specific systems – the muscular system and the skeletal system, including each of your 206 bones. And let's not forget the ligaments, tendons, and joints that hold it all together. Breaks, strains, sprains, and soft tissue injuries are some of the most common types of injuries that you'll likely encounter, in everyone from the elderly to youth sports participants. How to Assess and Handle a Musculoskeletal Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions." "Do you remember what just happened?" "How much pain or discomfort are you in?" So long as the patient is conscious, alert, and breathing normally, activating EMS can likely wait while you investigate further, as calling 911 is often not required with these types of injuries. Pro Tip #1: The real question that needs answering is this: Does this injury require activating EMS, a visit to the ER, or is it something the patient can shake off? So, how do we answer that question? With musculoskeletal injuries, the patient will often times be self-splintering – instinctively holding the area in pain – when you find them. That injury will be obvious, so make sure you also look for those that aren't. "Do you hurt anywhere else?" Also begin to further assess the injured area. If clothing is in the way, cut around that area to expose the injury. Look for bruising, swelling, some kind of deformity or abnormal angulation, bone fragments, bleeding, etc. Do you see any signs of a serious injury? Or a developing condition? How is the victim's skin color? Are the nail beds bluish or pink and normal? Poor circulation can be serious and warrants an immediate 911 call. Ask the patient how he or she feels. People, especially adults, have a sense of whether or not an injury is serious. With children, you may have to read between the lines a bit and pay more attention to body language and whether they're becoming more concerned about the injury or less concerned. If the two of you are coming to the same conclusion – that maybe the injury isn't that bad, help them walk it off, so to speak. Assist them in whatever way they need – getting to their feet or by helping to support their body weight. If it's not bad, as you suspected, they'll be fine. However, if the inverse is obvious, that the patient is in pain and the injury is now causing more discomfort, help them back into a comfortable position, call 911, and help protect and stabilize the injured area as best as you can until help arrives. Pro Tip #2: If you can safely stabilize an injury, do so. But make sure stabilization won't cause secondary problems, increase the patient's discomfort, or aggravate the injury. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. A Word About the Musculoskeletal System Injuries to muscles, bones, and joints can be difficult to detect. Knowing the specific mechanisms of the injury will provide important clues about which body parts are likely injured. There are three basic mechanisms of injury: Direct force – when the injury is located at the point of impact Indirect force – when the injury is located some distance from the point of impact Twisting force – when the injury is caused by a rotating force There are four basic types of musculoskeletal injuries to keep in mind when assessing patients, each of which is caused by one of the mechanisms above. Fractures Fractures are bones that are broken or damaged – chipped, cracked, etc. Fractures can either be closed, meaning the skin over the injury is intact. Or they can be open, in that the injury is exposed, making it much more serious. Open fractures are more prone to infection. And they can include excessive bleeding that may be difficult to control. Dislocations Dislocations are the displacement of a bone. When a severe force causes a bone to move one joint away from its normal position, this is known as a dislocation. Dislocations also typically result in ligaments and tendons that have been stretched, torn, or displaced. Shoulders and fingers dislocate more easily than other areas of the body. Sprains Sprains occur when ligaments are torn or stretched. The greater the number of ligaments involved, the more severe the sprain. Strains Strains are similar to sprains but involve muscles and tendons instead of ligaments. And as tendons are stronger than muscles, making them more resistant to injury, when dealing with strains, they're more likely to involve a muscle than a tendon. https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/training/bls-first-aid/video/snake-bites https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2059.mp4 Snake Bites In this lesson, you'll learn how to treat a patient who has been bitten by a venomous snake. When dealing with snake bite victims, there is one special point to take note of: If you have the snake, DO NOT bring it to the hospital, just take a picture from a safe distance or remember key features of the snake so the venom can be identified. Just don't get bit yourself trying to look at or take a picture of the snake. How to Treat a Patient who has been Bitten by a Snake As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Call 911 and activate EMS. Give them as much information as possible so that the patient gets routed to a hospital that has the correct antivenom. Get the patient into a comfortable position – seated or laying down – where they can be as calm as possible. They could become dizzy, and you don't want them falling and injuring themselves. Reassure the patient – tell him or her that they're in good hands, that EMS is on the way, and that they'll be taken good care of. You don't want them to get excited, nervous, or agitated, as the patient's heart rate will increase and circulate the venom faster. Warning: What you don't want to do – You don't want to use a cold pack; these have been widely ruled out now. And you certainly don't want to suck out the venom, unless you have a special fondness for urban myths. Keep the patient's snake-bitten limb or area level with the heart, if possible.  Raising or lowering of the extremity may both be correct, but that would depend on the species of snake and the condition of the patient.  Get the patient into the ambulance with as little movement as possible. Is there a golf cart around? How about a stretcher? How close can the ambulance get? You don't want them walking, or moving, any more than is absolutely necessary. Get the patient to the correct hospital with the correct antivenom and the life-saving treatment they may need. A Word About Venomous Snakes Snakebites kill few people in the United States. Of the estimated 7000 to 8000 people reportedly bitten each year, fewer than five die. And most of those deaths occur because the person has an allergic reaction, is in poor health, or because too much time passes before the person receives medical care. When it comes to the biggest threat, rattlesnakes account for most snakebites and nearly all of the deaths from snakebites. Venomous snakebite signs and symptoms include: One or two distinct puncture wounds, which may or may not bleed. The exception is the coral snake, whose teeth leave a semicircular mark Severe pain and burning at the wound site immediately after or within four hours of the bite Swelling and discoloration at the site of the bite immediately after or within four hours of the incident If the bite is from a venomous snake such as a rattlesnake, copperhead, cottonmouth, or coral snake, call 911 and activate EMS for more advanced medical personnel. To give care until help arrives, simply follow the steps outlined above. And if you're interested in more of what not to do, we have a list for that, too: Do not apply ice Do not cut the wound Do not apply suction Do not apply a tourniquet Do not use electric shock, like from a car battery https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/training/bls-first-aid/video/adult-aed https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2081.mp4 Adult AED An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm. Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from any water first, then use the AED. These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient. If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if it is a concern, you can disconnect it and remove it from the pathway to the heart. Necklaces should be moved to the side Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads Piercings shouldn't cause any problems It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it There are no special considerations for pregnant women Pro Tip #2: It's OK to be just as aggressive with a pregnant woman as you would any other patient. The primary focus should be on the mother, as saving her will also help save the baby. The care you provide to the mother won't put the baby in any more jeopardy. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with your AED. AED Technique for Adults Turn on the AED. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. Attach the AED pads to the patient's chest. The pads should have a diagram on placement if you need a reminder. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side mid axillary, under the left breast. Make sure they adhere well. Plug the cable into the AED and be sure no one is touching the patient, including yourself. The AED should now be charging and analyzing the rhythm of the patient's heart. If the scene is clear and no one is touching the patient, push the flashing shock button. Then go right into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. After one round of CPR, let the AED analyze the patient again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button. Go right back into CPR. Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About Abnormal Heart Rhythms The most common abnormal heart rhythm that causes cardiac arrest is known as ventricular fibrillation, or V-fib, for short. When in V-fib, the patient's heart ventricles fibrillate, or quiver, without any organized rhythm. Electrical impulses fire randomly, which prevents the heart from pumping and circulating blood. Another less common and less life-threatening abnormal heart rhythm is called ventricular tachycardia, or V-tach, for short. In V-tach, the heart is controlled by an abnormal electrical impulse that fires too fast for the heart's chambers to completely fill, which disrupts the heart's ability to pump and circulate blood. Both V-fib and V-tach typically result in no pulse and no normal breathing. https://d3imrogdy81qei.cloudfront.net/video_images/3721/adult-aed-2015.jpg Yes 353 https://www.procpr.org/training/bls-first-aid/video/nosebleeds https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/6487.mp4 Nosebleeds In this lesson, we're going to cover nosebleeds and how to apply first aid in the event you or someone you know gets one. Nosebleeds, also known medically as epistaxis, can catch us off guard and happen when we least expect them. However, they’re often quite harmless and can usually be managed easily. Each year, around 60 million people get nosebleeds in the United States alone. They are most likely to occur in the winter when cold weather and indoor heating dry the nasal passages. Most nosebleeds are minor and the bleeding will often stop on its own, but some people may require medical attention. This lesson will teach you the proper way to handle them. But before we proceed, bear in mind that while most nosebleeds are benign, there are exceptions. Pro Tip #1: If a nosebleed is intense, continues for over 20 minutes, or pairs with other symptoms, one should seek immediate medical help. It's important to note that if someone is on prescription blood thinners, their risk of a continued hemorrhage increases significantly, as these medications can intensify bleeding and challenge the standard control techniques. It's important and recommended that these patients seek further medical attention. First Aid Steps for Nosebleeds While nosebleeds are usually nothing to worry about, the presence of blood can make people feel anxious or queasy, particularly if it is their own blood. Reassure the affected person and urge them to stay calm. Ask the nosebleed victim to sit down and lean forward slightly, as this helps keep the blood from trickling down the back of the throat. Once you have your safety gloves on, or if the individual can do it themselves, pinch the soft section of the affected person's nostrils just past the nasal bone. Hold this pinch for about 10-15 minutes without releasing any of the pressure. This simple act applies pressure on the blood vessels of the nose and helps facilitate clotting. If the victim has any blood pooling in their mouth or throat, instruct them to carefully spit it out rather than swallow it. It is important to contain the blood spray or splatter through this process, which can be associated with sneezing, coughing, spitting, or speaking. Pro Tip #2: A backward tilt could lead to potential complications like aspiration or ingestion and vomiting. So step two is more vital than it may sound. Eye protection along with a face shield may be necessary - in addition to gloves – to fully protect the care provider appropriately. If no PPE (Personal Protective Equipment) is available, be sure to stand next to the patient, rather than in front of their face, as this may help protect you. Pro Tip #3: It's important to note that while a cold compress can help constrict blood vessels, cold blood does not clot swiftly. If you choose to use an ice pack, it is suggested to be placed on the bridge of the nose or the rear of the neck. Once the victim's nose stops bleeding, encourage the patient to resist the urge to blow their nose, as this can dislodge the clot and cause the nose to begin bleeding again. One common misconception is to pack the nose with gauze or tissue. This should be avoided in a first-aid scenario. And remember, only a physician should decide on medical nose packing. Also, for those patients who may be on blood thinners, the pressure might need to be maintained longer, and a physician's intervention may be required. Utilizing these first-aid methods, most nosebleeds can be managed easily. But remember, persistent bleeding, recurring episodes, or additional symptoms or complications may warrant prompt medical attention via a 911 emergency services phone call. A Word About Applying Pressure to a Stubborn Nosebleed The two most important factors when successfully controlling a nosebleed are: The amount of pressure applied. The amount of time the pressure is maintained. Remember that the pressure must be firm, and it must be maintained for a long time. Methods of applying pressure include pinching the nose with your fingers or using gauze or cloth placed over the nose and then pinching. If bleeding continues, try adjusting where you are pinching the nose or adjusting the pressure with which you are pinching the nose. About Hereditary Hemorrhagic Telangiectasia HHT is a genetic disorder in which blood vessels do not develop normally leading to bleeding that can be serious or life-threatening. A person with HHT may form abnormal capillaries or abnormal capillary connections between the arteries and veins. Capillaries are tiny blood vessels that pass blood from arteries to veins. The abnormal blood vessels formed in HHT are often fragile and can burst, which then causes bleeding. Men, women, and children from all racial and ethnic groups can be affected by HHT and experience the problems associated with this disorder, some of which are serious and potentially life-threatening. Nosebleeds are the most common sign of HHT, resulting from small abnormal blood vessels within the inside layer of the nose. While rare, it's important to understand that sometimes a nosebleed is a sign of a greater underlying problem. https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/training/bls-first-aid/video/cardiac-chain-of-survival https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7171.mp4 Cardiac Chain of Survival The phrase Cardiac Chain of Survival> is a framework that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest. In this lesson, we will be covering the Cardiac Chain of Survival. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation. The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective. Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival. Cardiac Arrest Chain of Survival The Cardiac Chain of Survival includes the following links: The Recognition and Activation of Emergency Responses  Early High-Quality CPR Early Defibrillation Advanced Resuscitation Post Cardiac Arrest Care Recovery and Survivorship The Recognition and Activation of Emergency Responses - the recognition of cardiac arrest and the activation of the emergency response system is a must do if there is any chance of survival for this victim. This actually goes further into recognizing serious medical problems that will quickly lead to cardiac arrest. Early recognition and treatment of life-threatening conditions can prevent progression to cardiac arrest and improve outcomes. Learn to recognize those early symptoms before cardiac arrest. Early High-Quality CPR - when CPR is performed to the best of your abilities, it significantly improves the chance of survival of the cardiac arrest. Our focus needs to be on good body mechanics to ensure adequate depth and rate for the longest possible time. Stay within the recommended compression rate, provide breaths and minimize any pauses to as short as necessary, but never more than 10 seconds. >Defibrillation - AED accessibility has never been better. AEDs can be usually found in schools, churches, stores, with law enforcement, fire departments, and occasionally even within the home. AEDs have been designed to be easy to use and they work! Use it as soon as it is available. Advanced Resuscitation - advanced resuscitation is usually by emergency medical services (EMS) personnel or within hospitals. This involves advanced treatments like medications and additional treatments that most people do not have access or training with. Post Cardiac Arrest Care - once a victim regains a pulse, there is a long series of assessments and treatments that are involved. We try to stabilize the victim, figure out what caused the problem in the first place, and some therapies to have the best outcomes for the victim. Recovery and Survivorship - recovery includes additional treatment, observation, rehabilitation, and psychological support. This extends beyond the patient to the immediate family members as they are a critical support for the patient. The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly. Warning:The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim. Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life. Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue. If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival. https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/training/bls-first-aid/video/conscious-adult-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7179.mp4 Conscious Adult Choking This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the back blows and abdominal thrusts correctly. Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing and rescuing the victim. How to Provide Care The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person. "Are you choking?" The person will probably nod yes. "May I help you?" You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second. Back Blows Technique for Adults Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts. Abdominal Thrust Technique for Adults Stand behind the victim, placing one foot between the victim’s feet and the other shoulder width apart further behind for a strong stance. Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button (navel) using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Pro Tip #2: Make sure you stay below the bottom tip of the rib cage (xyphoid process) and above the belly button (navel). This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your palms upward as you perform each thrust. Perform five abdominal thrusts or until the object comes out. Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. Alternate between Back Blows and Abdominal Thrusts until the object comes out or the victim becomes unconscious. If the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary. If the victim goes unconscious, ensure 911 has been called and begin CPR with chest compressions. However, before giving breaths, we check the airway before giving breaths. This is the skill for unconscious choking. If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there is no interal injuries. If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK. If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure. Special Consideration for Pregnant Women It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment. However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum. Therefore, if the 5 back blows do not work perform 5 chest thrusts. Switch between back blows and chest thrusts until the object is dislodged, the victim loses consciousness or trained rescuers take over. Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in. A Word About Types of Airway Obstruction There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO). Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat. The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs. Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction. https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/training/bls-first-aid/video/infant-cpr https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7173.mp4 Infant CPR Infant-related cardiac arrests are typically the result of: Drowning Choking/airway obstruction Electrocution Just as with child CPR, due to the nature of these occurrences, providing proper ventilation and oxygenation will be vital for a successful resuscitation. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve, begin calling out to the victim to assess whether or not the infant is responsive. Are you OK? Baby baby, can you hear me?  If you don't get an initial response, place your hand on his or her forehead and tap on the bottom of the baby's feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery.  At the same time as the pulse check, look, listen and feel for breathing. Spend no more than 10 seconds looking for a pulse and breathing. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. CPR Technique for Infants Place two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should wrap around the chest. Alternatively, you can give compressions using the heel of 1 hand in the center of the chest. Conduct compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face.  Place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About CPR Compression Rate and Depth Performing proper chest compressions is essential for providing high-quality CPR, which greatly improves the patient's chances for a successful outcome. Chest compressions increase the pressure on the heart to simulate a contraction. This helps to send oxygenated blood through the arteries to the brain and other vital organs. Chest compressions also increase the likelihood of a successful AED shock for the patient, particularly if several minutes have elapsed since the patient collapsed or suffered an incident leading to respiratory distress. Chest compression effectiveness is reduced if: Compressions are too shallow The compression rate is too fast or too slow There isn't a full recoil of the chest cavity There are interruptions during CPR The patient isn't laying on a firm, flat surface Warning: Compression rates that exceed 120 per minute tend to have a negative impact on compression depth, perhaps due to responders rushing through them. Regardless, if the compression rate exceeds 120 per minute, you are less likely to compress the full 1/3 of the chest for infants and children, thereby reducing the effectiveness of CPR. If you are unsure if you're compressing at the correct depth, a feedback device might be helpful. https://d3imrogdy81qei.cloudfront.net/video_images/13006/infant-cpr-bls-2025.jpg Yes 204 https://www.procpr.org/training/bls-first-aid/video/infant-cpr-2-rescuer https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7175.mp4 Infant CPR 2 Rescuer In this section, we're going to cover two-responder infant CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.) Also, it's important to have the right size mask.  Much of what was covered in the last section – Child CPR with Two Responders – will apply in this section – Infant CPR with Two Responders. The one difference being the method of compressions which will be explained below. Pro Tip #1: One variation that should be used when doing compressions on an infant or baby when a second responder is present, is circumferential compressions. To perform circumferential compressions, wrap your fingers around the sides of the infant's chest, placing both thumbs over the compression point just below the nipple line. One of your thumbnails should be resting on the top of the other. If for some reason you're not able to perform circumferential compressions, then an alternative method is the heel of one hand. Remember that little force will be required when performing compressions on an infant. Pro Tip #2: The rate of compressions to rescue breaths during two rescuer infant CPR is the same as with children – 15 compressions for every two rescue breaths. How to Provide Care After making sure the scene is safe, that your gloves are on, and that you have your rescue mask with a one-way valve (or bag valve mask when there are two responders), begin calling out to the victim to assess whether or not the infant is responsive. Are you OK? Can you hear me?  If you don't get an initial response, place your hand on the infant's forehead and tap on the bottom of his or her feet. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Two-Responder CPR Technique for Infants Responder one: Draw an imaginary line across the infant's nipples and place your thumbs next to each other on the lower part of the center of the sternum to perform circumferential compressions. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, use only your thumbs to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 15 chest compressions. Responder two: Grab the bag valve rescue mask and seal it over the infant's face and nose. If available, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. When using the bag valve mask, remember not to push down on the mask, but rather, lift the mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do. Also, remember that with infants, the head-tilt, chin lift is neutral or slightly sniffing. Compress the bag on the bag valve mask and wait for the chest to rise and fall before administering the next breath. Be cautious to not over inflate the lungs as this can cause several serious issues. Responder one: Go right back into your 15 chest compressions. Responder two: Go right back to delivering two rescue breaths. Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties. Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask. Continue to perform 15 chest compressions to two rescue breaths – while switching duties every two minutes – until help arrives, an AED arrives, or the victim is responding positively and breathing normally. A Word About Considerations for Pediatric Patients Cardiac emergencies in children and infants are usually secondary to respiratory problems and airway restrictions. While congenital heart conditions are possible, they aren't common. When cardiac arrest occurs in children and infants, it's usually caused by one of the following: Airway and breathing problems Traumatic injuries or incidents – drowning, electrocution, poisoning, etc A hard blow to the chest Congenital heart disease Sudden infant death syndrome (SIDS) https://d3imrogdy81qei.cloudfront.net/video_images/13010/infant-cpr-2-rescuer-bls-2025.jpg Yes 191 https://www.procpr.org/training/bls-first-aid/video/spinal-injury---jaw-thrust https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2084.mp4 Spinal Injury - Jaw Thrust This section is about providing care for someone who has taken a fall or sustained a physical injury that may appear to include the spine, and how you should proceed in these situations. Before we get into the jaw thrust CPR technique, there are some other things to keep in mind first. When you encounter a victim who appears to be immobile and in pain, you want to minimize their movement as much as possible, as you inquire more about what happened, how the patient is feeling, and whether or not you need to activate EMS. If the victim is conscious, let them know who you are and that you're there to help. Instruct the patient to not move and avoid nodding, and to answer your questions verbally, as you continue to assess his or her condition. Look specifically for head wounds and bleeding – from the head, nose, and ears. Check to see if the person has any broken teeth and if their pupils are responsive to light. Pro Tip #1: To check for responsiveness to light, simply place one hand over the patient's eyes and then remove it. Do the pupils react? If not, the victim could have a possible concussion and swelling of the brain. If you suspect this to be the case, call 911 immediately. Otherwise, if the victim is conscious, has a heartbeat, and is breathing normally, you may not have to call 911, at least while you continue to assess the situation. Some questions you should ask include: Do you remember what happened? Did you hit your head? Can you tell me what hurts? Can you move your arms, legs, fingers, toes? Do you know what day it is? Do you know what year it is? Should the victim answer one of those last two questions incorrectly, you may be dealing with someone who may have an altered mental state, likely due to a head injury. Remember, if you suspect a head injury at any point during your evaluation, call 911 immediately. Warning: If the patient is showing signs of paralysis, this could potentially lead to spinal shock. You may recall learning about the signs of shock in the bleeding control course material – pale, cold, sweaty, etc. If the patient does go into shock, this could lead to the patient becoming unresponsive and requiring CPR. Pro Tip #2: If you see signs of shock, cover the patient with a blanket or coat. It's important to keep them warm while you continue to reassess for airway or circulation problems. Should the patient become unresponsive or begin having trouble breathing normally, or go into full cardiac arrest, proceed with CPR using the jaw thrust technique to avoid any potential and/or further spinal injuries. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the patient's forehead and tap on his or her collarbone, while also reminding yourself not to move the neck or head. If you still do not get a response, proceed with CPR as you normally would. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc. Check for the carotid pulse (or brachial pulse in infants), located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with CPR. Jaw thrust Technique when Performing CPR The purpose of the jaw thrust technique is to minimize cervical spine movement. It requires two responders. One should be positioned at the head of the patient, while the other begins chest compressions as you normally would. When you get to the point of delivering two breaths into the rescue mask, proceed with the following steps: Place the apex of your rescue mask over the bridge of the victim's nose. Seal the bell part of the mask just below the patient's bottom lip and above the chin. Place both of your thumbs on top of the mask, as your fingers fan out and over the sides of the patient's face. As you push down on the mask with your thumbs, use your fingers to grab the mandible, or jaw, and pull it up into the mask. Pro Tip #3: The jaw line goes down then hooks at the back of the jaw, providing the leverage points you'll be using to pull the jaw upward, into the mask. Warning: Remember that you do not want to perform a normal head tilt, chin lift on a patient who you suspect may have a spinal injury. The only scenario when you would use the normal maneuver is if you are the lone responder and you have no choice. As you pull the jaw up into the mask, give one rescue breath, wait for the chest to rise and fall, and give one more rescue breath in the same manner. Continue with CPR – chest compressions followed by jaw thrust rescue breaths – until help arrives, an AED arrives, or the patient is responsive and breathing normally. A Word About Two-Responder CPR When two responders are available, responder one should size up the scene and make sure it's safe, begin the primary patient assessment, and then begin chest compressions. Responder two should call for help, get/find an AED, or prepare its readiness if you have one, while responder one continues with 30 chest compressions followed by two rescue breaths. Continue this way until responder two is ready to jump in and take over or until the AED is ready to use. When the AED is ready, responder one should move to the patient's head while responder two gets into a hovering position to perform chest compressions. Switch positions when the responder performing chest compressions becomes fatigued. Pro Tip #4: The best time to switch positions is while the AED is analyzing the patient. Use an agreed upon term like switch, and make sure the responder doing the chest compressions is counting out loud so the other responder can anticipate the switch. https://d3imrogdy81qei.cloudfront.net/video_images/3727/spinal-injury---jaw-thrust-2015.jpg Yes 386 https://www.procpr.org/training/bls-first-aid/video/infant-landmarks https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7174.mp4 Infant Landmarks Since the anatomical proportions of a baby are significantly different than that of children and adults, this section will focus on those differences as they relate to performing CPR on an infant. When Assessing an Infant An infant is considered any child under the age of one. When assessing and treating an infant who is in cardiac or respiratory distress, there are a few things to first consider. First, let's look at the signs of a healthy baby. The lips are nice and pink, as is the mucous membrane. The nail beds are also pink. The baby is moving around and appears to be physically fine and healthy. A baby in respiratory distress would likely be agitated or if it becomes even worse - lethargic and have some signs of circumoral cyanosis – blue around the lips – as well as the mucous membrane. The nailbeds might also appear blue. Pro Tip #1: Don't confuse cold hands with signs of respiratory distress. When an infant's hands are cold, they might also appear bluish. Important Infant Landmarks Compression Point and Depth As you open an infant's clothing to expose the chest, you'll want to find the nipple line. Put two thumbs on the center of the infant's chest, directly on the sternum, and slightly below the nipple line. Your fingers will reach around to the baby’s back. The depth of compression for infants is about 1½ inches (or 1/3 the anterior-posterior diameter of the chest). However, the rate of compressions is the same as adults and children – 100-120 compressions per minute. Finding a Pulse Since infants don't have much of a neck, finding the carotid artery can be difficult, which is why we have to use the brachial artery instead. To find the brachial artery, remove the infant's clothing enough to expose one arm. The brachial artery is located on the inside of the arm between the bicep and tricep against the humerus bone. Place your two fingers on the artery to check for a pulse, just as you would for other victims. Pro Tip #2: The reason we don't use our thumbs to check for a pulse is that a thumb has its own detectable pulse, which could easily give a false reading. Opening the Airway There's another thing to keep in mind. Babys have large heads that are disproportionate to the rest of their bodies. Combined with a lack of a neck, this results in a chin that rests on the chest. Before performing compressions, place something firm under the infant's shoulder blades to lift the neck and help tilt the head into a neutral or slightly sniffing position. It's important that this be a firm enough object so the infant doesn't sink down and the head is held in the correct position as you perform compressions. Warning: An infant's airway is only about the size of one of their pinky fingers, which makes the airway much tighter than children and adults. If using the standard head tilt, chin lift, this could actually occlude the airway, making it much more difficult for the baby to breathe. This can also happen when an infant's chin is resting on their chest. When performing compressions, the infant's head and neck should be in a slightly sniffing position. In other words, just a slight upturn of the nose; very close to neutral. (Imagine walking into a room and smelling a fresh apple pie and how your head rises ever so slightly as you sniff.) Compression Variation Technique There is one variation that can be used when doing compressions on a baby, which is using the heel of one hand in the center of the chest. An Infant's Heart The size of an infant's heart is approximately the size of one of their fists. It's located right under the sternum in the center of their chest. Because of its small size, finding the right compression point is critical. A Word About Infant Assessment When assessing the level of consciousness in a baby, tap them on the bottom of the feet rather than the shoulder, as part of your shout-tap-shout sequence. Also, rather than use AVPU (Alert, Verbal, Pain, Unresponsive) to measure and record a patient's level of consciousness, when treating an infant, it's more accurate to use the pediatric assessment triangle: Appearance Effort of breathing Circulation As recognizing an unresponsive infant is your first priority to providing treatment, the assessment triangle should provide you with a better reading of the infant's condition. https://d3imrogdy81qei.cloudfront.net/video_images/13008/infant-landmarks-bls-2025.jpg Yes 195 https://www.procpr.org/training/bls-first-aid/video/infant-aed https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7177.mp4 Infant AED AED pads come in an adult size and a pediatric size, for patients less than 8 years old or 55 pounds or roughly 25 kilograms. However, remember, if you do not have pediatric pads and the patient is less than 8 years old or less than 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. Also, remember that when using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? If for some reason the scene isn't safe enough to use an AED, move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. And one last reminder: It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it. With infants, since one pad will be attached to the back, that area must also be dry. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? (With infants, shouting their name, if you know it, may help.) If you don't get an initial response, place your hand on the infant's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, immediately use the AED, if available.  If you have a second rescuer, be sure to immediately start CPR while the other rescuer applies and operates the AED. AED Technique for Infants Turn on the AED. Remove the patient's clothing to reveal a bare chest and back. Attach one AED pad to the infant's chest, carefully roll the infant on his or her side, and attach the second pad to the back. The pads should have a diagram on placement if you need a reminder. Plug the cable into the AED and be sure no one is touching the patient, including yourself. The AED should now be charging and analyzing the rhythm of the patient's heart. If the scene is clear and no one is touching the patient, push the flashing shock button. Then go right into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Place two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should wrap around the chest. Alternatively, you can give compressions using the heel of 1 hand in the center of the chest. Conduct compressions that go roughly 1.5 inches deep, or 1/3 the depth of the infant's chest, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions if there is one rescuer. If you have a second rescuer, then use a 15:2 compression to ventilation ratio. Grab the appropriately-sized rescue mask and seal it over the victim's face and nose. Place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath, about 2 seconds. After 2 minutes of CPR, the AED will analyze the patient again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button. Go right back into CPR. Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About AED Precautions When using an AED, there are several precautions to keep in mind. Some of these may be obvious (and a repeat of what you've already learned in this course), while others may not be. Since alcohol is flammable, do not use anything with alcohol on it to wipe the patient's chest or back dry. While it's OK to use adult pads on a child, the reverse isn't entirely true, as pediatric pads may not deliver enough energy to defibrillate the patient. Do not touch the patient while the AED is conducting an analysis, as this may affect the analyzation process. Before delivering an AED shock, make sure no one is touching the patient or any of the resuscitation equipment. Do not use an AED if there are flammable or combustible materials or gases present, including free-flowing oxygen. Simply redirect the flow of oxygen away from the patient around the time the AED is going to shock. Do not operate an AED inside a moving vehicle, as the movement can affect the analysis. Do not use an AED if the victim is in contact with free-standing water or in the rain. Move the patient first. Do not place AED pads on top of any patches or implantable devices. Remove patches first and adjust the pads as necessary to avoid devices like a pacemaker. https://d3imrogdy81qei.cloudfront.net/video_images/13014/infant-aed-bls-2025.jpg Yes 271 https://www.procpr.org/training/bls-first-aid/video/two-person-aed-1 https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7178.mp4 2-Person AED Some of this will be a review of what you learned in the cardiac arrest section – using an AED on an adult patient. >An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm. Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient. If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if the bra is a concern, you can adjust the straps or cut it away and remove it. Just make sure the AED pads are on bare skin. Necklaces should be moved to the side Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads Piercings shouldn't cause any problems It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it There are no special considerations for pregnant women Pro Tip #2: When two responders are available, the emphasis will be on a steady supply of compressions. The two responders will orchestrate their movements in a way that minimizes any stoppages or delays in chest compressions, as this will keep oxygen circulating throughout the victim's body – brain, heart, and other vital organs. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy (or bag valve mask when there are two responders) and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Continue to assess the victim's pulse and breathing.  Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. Check for breathing while you are checking for a pulse. The patient may be breathing fast or slow, deep or shallow breathing, etc. Remember, gasping is not normal breathing and may be a sign the victim does not have a pulse. If you've determined at this point that the victim is unresponsive, is not breathing normally, and has no pulse, start CPR with compressions and have the second responder immediately set up and use the AED. Caution: When checking for a pulse, rescuers, including licensed healthcare providers, spend too much time checking for a pulse. Spending more than 10 seconds checking for a pulse shows worse outcomes for patients. If you are not positive you feel a pulse within those 10 seconds, begin compressions. Two-Person AED Technique for Adults Responder one: Locate proper hand placement and begin chest compressions – between the breasts and on the lower half of the sternum. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper bodyweight to supply the force for the chest compressions, and count as you perform them. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. Responder two:(while responder one performs compressions) Turn on the AED. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. Attach the AED pads to the patient's chest. The pads should have a diagram on placement if you need a reminder. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side mid axillary, under the left breast. Make sure they adhere well. Pro Tip #3: This will resemble a back-and-forth sort of dance until the AED is ready to use. If possible, do not stop compressions. Our goal is to apply the AED pads to the victim around the rescuer doing compressions. If you must momentarily pause compressions, begin again as soon as possible. Plug the cable into the AED and be sure no one is touching the patient, including yourself and your partner. The AED should now be analyzing the rhythm of the patient's heart. If the AED finds a shockable rhythm, it will charge and tell everyone to clear from touching the victim. If the scene is clear and no one is touching the patient, push the flashing shock button. Responder two: Immediately take over compressions from responder one. Ensure proper body mechanics and perform 30 chest compressions. It's appropriate to perform CPR over the pads, when needed. It is best practice to not remove the AED pads once they are applied. Responder two: Grab the bag valve rescue mask and seal it over the victim's face and nose. Lift the patient's mandible up into the mask – using the CE form to seal the mask – and incorporate the proper head-tilt, chin lift as you do. Slowly, over 1 second, compress the bag valve mask about half the volume, or just until you see the chest rise. Wait for the chest to fall, about 2 seconds, before administering the second breath. Pro Tip #4:The AED takes around two minutes to reanalyze the patient, which makes this an ideal time to switch again. After about five cycles of CPR, the AED will analyze the patient again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button Go right into CPR. (This is the switch point.) strong>Responder two goes from AED and valve mask duties to compressions, while responder one takes over bag valve mask duties and control of the AED. Continue this cycle of CPR, re-analyzation, switching positions, charging, shocking, and back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About AED Maintenance For AEDs to function properly, they must be maintained like any other medical device. However, the maintenance they require is minimal. Though AEDs have various self-testing features, it's important that healthcare professionals become familiar with any visual or audible prompts the AED may use to warn of a low battery or malfunction. If the machine detects a malfunction that cannot be easily resolved by addressing the manual, you should contact the manufacturer. It may need to be returned for service. While AEDs require minimal maintenance, it's still important to remember the following: Follow the manufacturer's recommendations for periodic equipment checks Make sure that the batteries are not expired or low energy. Most AEDs have windows that you can easily see the status of the battery. (It may be a good idea to order a new battery months before it expires or is showing that it is low energy.)  Make sure the AED includes the correct defibrillation pads and that they remain sealed. Opened AED pad packaging can cause the pads to dry out and become ineffective when needed Periodically check expiration dates on the defibrillation pads and batteries, and replace as necessary After using your AED, make sure that all the accessories are back in the case and that the machine is in proper working order for its next use If at any time the AED fails to work properly, discontinue its use and contact the manufacturer immediately https://d3imrogdy81qei.cloudfront.net/video_images/13016/2-person-aed-bls-2025.jpg Yes 295 https://www.procpr.org/training/bls-first-aid/video/conscious-child-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7180.mp4 Conscious Child Choking This conscious child choking lesson is for situations where you can see that a child is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat. Remember to only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing the victim. How to Provide Care The first thing you want to do is face the child and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the child. "Are you choking?" The child will probably nod yes. "May I help you?" You'll likely get another nod. Don't wait too long to receive permission, as children may be a little more flustered than adults. Pro Tip #1: With children, they may not have the same level of awareness as adults. If they're only nodding or making gagging, high-pitched squeaking sounds, these are good indications that the airway is fully obstructed. Pro Tip #2: If the child can respond verbally, that means that they are able to move enough air past the larynx to speak. This is a good indication that something may be stuck but that the airway isn't obstructed. Or it could indicate a partial obstruction of the airway. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Blows Technique for Children Stand to the side and slightly behind the victim, but facing them with feet shoulder width apart. You may kneel if needed. Support the victim with the seatbelt hold. For this, take one arm and use it to support the chest. Then, lean them forward. Take the heel of your other hand and locate the center of their back between their shoulder blades (scapula)  and deliver 5 forceful back blows. If the airway is still obstructed, move to abdominal thrusts.   Abdominal Thrust Technique for Children Elevate the victim's arms and elbows so you have clear access to the abdominal area. Locate the belly button using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point. Warning: It's important that when helping a choking victim who's shorter than yourself, that you lower yourself to their height. This will limit unnecessary pressure on the rib cage and prevent broken ribs or other possible harm while you perform the abdominal thrusts. On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically. Remember to stay below the bottom tip of the rib cage (xyphoid process) and above the belly button. This is the diaphragmatic region where you'll be performing the abdominal thrusts. Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm. Lower yourself to the height of the child. Keep your elbows out so they're resting on the victim's ribs as little as possible. Thrust up and in and turn your hands upward as you perform each thrust. Perform five abdominal thrusts unless the object comes out or the child becomes unresponsive. Remember to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations. If after the five abdominal thrusts, the object is still not out, alternate between 5 back blows and 5 abdominal thrusts. Once the object comes out, the child will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds. Encourage the victim and let the child know that he or she is OK now and have them sit down if necessary. Children may experience more confusion and fear than adults, so letting them know that they'll be fine is important. If you called 911, let them come anyway, so the child can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Advanced medical evaluation is still usually encouraged to ensure there are no interal injuries. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the child into an urgent care center, hospital, or to see their physician. With children, don't leave it up to them to determine if more care is necessary. If you weren't able to remove the obstruction using the abdominal thrust technique, the child will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious child choking procedure. https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/training/bls-first-aid/video/conscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7181.mp4 Conscious Infant Choking This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including: They cannot cough They cannot breathe They cannot speak or babble or make any noise Their lips are beginning to show signs of circumoral cyanosis – a blue ring around the lips that indicates early signs of oxygen starvation Signs that the infant is conscious include: The baby is still moving around The baby's eyes are open Remember to activate EMS as soon as possible so long as it doesn’t delay care. If possible, have another person nearby call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant. How to Provide Care Helping a conscious choking infant isn’t significantly different than helping a child or an adult. You'll still be performing a combination of back slaps and thrusts to try and dislodge the airway obstruction. The biggest difference between infants when compared to adults or children, rather than performing abdominal thrusts, for infants we need to make sure we are performing chest thrusts rather than abdominal thrusts. Warning: Due to the fragile nature of infants performing abdominal thrusts on them could cause severe internal injuries. Chest thrusts should be used for conscious choking infants. If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure. Back Slap and Chest Thrust Technique for Infants Place your thumb and index finger over the baby's cheekbones and around the face. Make sure you're supporting the infant's head and neck. Turn the infant over so they are facing down. Rest the infant's body on your forearm, so their legs are straddling your bicep. Rest your forearm on your leg for additional support. Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts. Using your other palm, perform five back slaps between the infant's shoulder blades. Using the same hand that you just used to perform the back slaps, hold the back of their head and neck and turn the baby over so they are facing up. Place the heel of your hand on the sternum in the center of the infant's chest. Make sure the head is lower, just like before, at around a 30-45-degree angle. Perform five chest thrusts, much like you would when performing CPR on an infant. Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction. Continue to perform a combination of back slaps and chest thrusts until the object comes out and the infant is breathing normally again. If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary. This conscious infant choking procedure is extremely effective if you perform the back slaps and chest thrusts properly. If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure. A Word About Pediatric Considerations Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children. The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children: Hot dogs Nuts and seeds Chunks of meat or cheese Whole grapes Hard, gooey or sticky candy Popcorn Chunks of peanut butter Raw vegetables Raisins Chewing gum According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy. It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.  https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/training/bls-first-aid/video/unconscious-infant-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7183.mp4 Unconscious Infant Choking This unconscious infant choking lesson is for situations where you find an infant who is unconscious, and you suspect they became unresponsive due to an airway obstruction. Ideally, either you or a bystander witnessed the victim choking before they went unconscious. Through further assessment, you find that the infant has a pulse but isn't breathing. You attempt rescue breathing at a rate of one breath every two to three seconds, but your first breath does not produce chest rise. You reposition the airway and try again - still no chest rise. In this scenario, you would treat this patient as an unconscious infant choking victim. The method of care will closely resemble performing CPR on an infant, however there are subtle differences to pay attention to. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy. Assess the infant to make sure he or she is not breathing normally and is unconscious. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. Then go right into chest compressions. Draw an imaginary line across the infant's nipples and place your two thumbs on the lower part of the sternum in the center of the infant's chest. Your fingers should be wrapping around the infant’s chest. Alternatively, you may also use the heel of one hand in the center of the chest. Stand or kneel directly over the patient's chest. As less pressure is needed when performing CPR on infants, and count as you perform them. Conduct 30 chest compressions that go to a depth of 1/3 of the infant's chest cavity, which should be around 1.5 inches deep, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Grab the rescue mask and seal it over the victim's face and nose. Pro Tip #1: It's important to have a properly sized rescue mask. In other words, one that fits the size of the victim's face. If you have an infant mask, use that.. If you can, place something firm under the infant's shoulders to lengthen the neck a little and create a neutral or slightly sniffing head position. Here’s the difference between CPR and unconscious choking - open the airway and look for the object before giving your two breaths. If you see the object, use your pinky finger to sweep out the object. Never do a finger sweep unless you see the object. Breathe into the rescue mask and wait for the chest to rise and fall. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions. Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths. Pro Tip #2: Because infants' mouths are small, it's best to use your pinky finger combined with a hooking motion to sweep out obstructions. If the rescue breaths go in this time – causing the chest to rise and fall – check for a pulse using the brachial artery, located on the inside of the arm between the bicep and tricep against the humerus bone. Use the flat parts of your index and middle fingers and press on that artery. Spend no more than 10 seconds looking for a pulse. Pro Tip #3: For infants with a pulse rate lower than 60 beats per minute, you are instructed to override with chest compressions in CPR. But if you're only allowing 10 seconds to check a pulse, how do you know the rate per minute? Multiply the 10-second rate by six, and this will give you the number of beats per minute. If you detect a pulse but there are still no signs of normal breathing, continue to perform one rescue breath every two to three seconds for two minutes. After two minutes, reassess for a pulse and check again for normal breathing. If you still detect a pulse and the patient still isn't breathing normally, continue with one rescue breath every two to three seconds for two minutes. If you do not detect a pulse, go into full CPR – 30 chest compressions followed by two rescue breaths. Continue until help arrives, an AED arrives, or the victim is responding positively and breathing normally. If you have a second rescuer, rather than 30:2, use a 15:2 compression to ventilation ratio. A Word About Vital Signs (By Age) Assessing a patient's vital signs is a crucial first step in providing care. Therefore, it's important to know what range is normal when it comes to pulse rates and respirations. For Adults (12 years and older) Pulse rate – 60 to 100 beats per minuteRespirations – 12 to 20 breaths per minute For Children (1 year to 12 years old) Pulse rate – 70 to 120 beats per minuteRespirations – 15 to 30 breaths per minute For Infants (1 month to 12 months old) Pulse rate – 100 to 140 beats per minuteRespirations – 25 to 50 breaths per minute For Neonates (full term to 30 days) Pulse rate – 120 to 160 beats per minuteRespirations – 40 to 60 breaths per minute Pro Tip #4: Infants in distress – not breathing normally – will likely be tachycardic. It's not unusual for them to range between 120-180 beats per minute on the high end, depending on their exact age. It's also not abnormal to feel a fast, slightly thready (or thin) pulse that's becoming weaker. If we cannot correct the breathing issue, infants will quickly deteriorate and have a slowing heart rate until breathing is corrected. https://d3imrogdy81qei.cloudfront.net/video_images/13026/unconscious-infant-choking-bls-2025.jpg Yes 238 https://www.procpr.org/training/bls-first-aid/video/burns https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7187.mp4 Burns Burns are a complex injury, as there are varying degrees of burns, different sizes, and different locations that can present unique challenges. And there are also different types of burns – thermal, chemical, and electrical. In this lesson, when we talk overall about burns, then how to treat them, starting with thermal burns. Then, we'll discuss some information on chemical and electrical burns. How to Assess and Treat a Burn Injury As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." The first thing you want to do is assess how bad the burn is. To determine the degree of burn, look for the following signs: 1st degree (superficial) – usually presents itself as a pink outer ring; characterized by redness and pain 2nd degree (partial-thickness) – will present itself with blistering skin and is usually very painful 3rd degree (full-thickness) – dark, charred areas; can include life-threatening complications Warning:  The following burns should be seen immediately at a hospital for treatment: Large 2nd burns that involve the face, hands, feet, or genitalia All 3rd degree burns Any burn that has concern for inhalation injury (soot around the nose or mouth, difficulty breathing)  The concerning part about burns is that you may not see the full extent or concern of the injury until hours later. After the burning process has ended, the injured skin starts the healing process. This involves the moving of fluid to the injured area causing swelling, pain, dehydration/shock and other potentially life threatening conditions. Minor seeming injuries may be far more serious if not evaluated or treated by professionals. Sequence of Treatment for Burn Victims Remove the body from the burn. This can mean a few different things – like the presence of smoldering clothing or a victim who's laying in burning embers. Cool the burn. Pour cool clean water over the burn for five to 20 minutes. Your goal is to remove residual heat from the burned tissue. This will stop the burning process. Even room temperature water is appropriate as that is still over 20 degrees cooler than normal body temperature and can remove heat from the skin. Apply loose, dry, sterile dressing over the wound. Begin wrapping above the burn and wrap particularly lightly over the burn. During 3rd degree burns, the nerve endings become damaged, so there is less pain. However, 1st and 2nd degree burns can be quite painful. Pro Tip #1:Observe the patient for signs of shock or dizziness. If they are losing their balance, help them into a seated or lying position, whichever is more comfortable. At the first sign of shock, call 911 and activate EMS immediately. Look for inhalation burns. Is the victim wheezing? Is there some swelling or burns around the face? Have the eyebrows been burned? Is there soot on the inside of the victim's mouth or nose? All of these could signal possible future complications in the form of respiratory issues. Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock Pro Tip #2: Skin is the major organ that controls your body temperature. If we damage it from a burn, then pour cold or cool water over the body (burned area), the victim could become cold and start to shiver, hypothermia has now set in. Once the burn is cooled, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. Chemical Burns You're likely going to encounter two types of chemical burns – those from dry chemicals and those from wet. When you're dealing with dry chemicals, you first want to brush off as much of the loose, dry chemical as you safely can. Safety is key. You don't want to become the next victim. After brushing off the loose chemical, rinse the burn for a minimum of 15 minutes, again using cool clean water. When dealing with wet chemicals, go right into rinsing them off using cool, clean water. Pro Tip #3: Dilution is the solution to pollution. When dealing with chemical burns, rinsing them off with cool, clean water will have a weakening effect, as the chemicals are diluted again and again with every dousing of clean water. Electrical Burns Electrical burn situations require an extra level of safety. Before anything, make sure the energy source has been removed before coming into contact with the patient. This could mean removing the patient from the energy source, cutting the power, or something else. You cannot risk becoming another patient at the scene. Pro Tip #4: There is a significant difference between electrical entry burn wounds and electrical exit burn wounds. Entry wounds look like typical thermal burns. But exit wounds may look more like shotgun exit wounds – huge, explosive, and damaging. Manage the entry wound the same as you would a thermal burn. Manage the exit wound as the situation requires, which will likely include treatment options for tissue damage and excessive bleeding. Warning: As electricity travels through the body it can affect the conductivity of the heart, which could potentially damage the conduction points in the heart and contribute to secondary cardiac issues. With electrical burns, monitoring for heart dysrhythmias for 24 to 72 hours in hospital might be necessary. A Word About Burn Victim Pediatric Considerations It's important to note that children have greater surface areas relative to their weights than adults. This can become a major factor when it comes to staying warm and hydrated. Victims with severe burns tend to lose a lot of water through evaporation and leaking from the burned area. This increases our concerns as it can lead to hypothermia and shock. Monitor the victim for signs of dehyration, shock or hypothermia. Immediately seek advanced medical intervention if any of these are seen. After Burn Care If the burn is minor, and the burning has been completely stopped, at-home treatment might be appropriate. The 2024 ECC Guidelines suggest petrolatum (with or without topical antibiotics such as polymyxin), honey, and aloe have been shown to improve healing time in certain burns. Over the counter pain medications may help with pain when used correctly. All treatment should be under the direction of your physician. https://d3imrogdy81qei.cloudfront.net/video_images/13034/burns-bls-2025.jpg Yes 345 https://www.procpr.org/training/bls-first-aid/video/shock https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7185.mp4 Shock Shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. When organs don't receive enough blood, the body begins to compensate by conserving and limiting blood flow to the legs, arms, and the skin. As shock progresses, more systems shut down until the effects become irreversible and death occurs.  The Four Main Types of Shock Hypovolemic Shock Hypovolemic shock is caused by a severe lack of blood and bodily fluids. The most common types of hypovolemic shock is dehydration and hemorrhagic shock, which occurs as a result of significant water or blood loss. Obstructive Shock Obstructive shock is caused by an obstruction to blood flow usually within the blood vessels, like a pulmonary embolism – a blood clot in a lung artery. Distributive Shock When there is an inadequate distribution of blood that results in low levels of blood returning to the heart, this can cause distributive shock. Examples include septic shock (due to toxins), anaphylactic shock (due to food allergies), and neurogenic shock (due to spinal cord or brain trauma). Pro Tip #1: One item to keep in mind is when you think of shock, it is the pale, cool, clammy skin. Which is true, unless we have distributive shock. Since distributive shock causes blood vessels to dilate (expand), this causes increased blood flow to the skin often making it warm and flushed (red). Cardiogenic Shock Cardiogenic shock is the result of the heart being unable to pump correctly to supply enough blood to vital organs. This can be caused by an injury to the heart, disease, or trauma. How to Provide Care Shock is a serious and potentially life-threatening condition that requires immediate medical care. It is a multi-symptom and complex condition, which is also progressive. Pro Tip #2: The goal of care when the victim is in shock is to find and fix the problem that's sending them into shock. In the case of bleeding injuries, controlling blood loss is the first priority to help allow enough oxygenated blood to circulate, thereby keeping cells and vital organs working properly. The first step is to recognize the signs and symptoms of shock and realize that these can all progress and therefore should be monitored periodically. Look for these early signs of shock: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin As shock progresses, the victim's skin could become more pale, clammier, and the other symptoms could get worse. Clammy skin, incidentally, is due to a restriction in blood flow to the skin and extremities. Pro Tip #3: If you suspect shock, pinch a toenail or fingernail and measure the capillary response – the length of time it takes for blood to refill that nail. If it's more than a few seconds, your victim is likely in shock. How to Deal with a Shock Victim Your quick and competent response may be the difference between life and death. If you suspect the victim is in shock, proceed with the following steps. Call 911 or EMS. Depending on the cause of the shock, time is critical to get them to advance care. Always ensure scene safety for you and other bystanders. Maintain the victim's airway and help them breathe if they're not able to on their own. Begin CPR if unresponsive and not breathing. Help improve their circulation by controlling any bleeding. Start with the worst bleed, first, but all bleeding should be as controlled as possible. Place the victim flat on their back if possible. Do not elevate the legs if injury is suspected or if it causes discomfort. If a victim is breathing normally, but is unconscious with no concerns of spinal injury, another option is the recovery position. This is a great way to protect their airway. Cover the victim with a blanket or coat. Insulate them as best you can and keep them warm. This will help their bodies combat the effects of shock. Do not give shock victims anything to eat or drink as this could cause nausea and vomiting, which in turn can make the shock worse, not to mention this risk of blocking the airway. Stay with the patient and keep them calm. If you have oxygen available, it may be appropriate to provide supplemental oxygen. Always follow local protocols when administering oxygen. https://d3imrogdy81qei.cloudfront.net/video_images/13030/shock-bls-2025.jpg Yes 235 https://www.procpr.org/training/bls-first-aid/video/special-considerations-for-cpr-aed-choking https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7191.mp4 Special Considerations for CPR, AED, and Choking Many questions come in related to special considerations for performing CPR, using AEDs, and applying choking skills, so we decided to take the most common of the bunch and share them with you. Along with our recommendations of how to treat different types of patients in light of these considerations. Special Considerations for CPR The three most common concerns we hear when it comes to performing CPR are: The size of the patient. The crunching sound and feeling when performing chest compressions. Impaled objects in the chest. The Size of the Patient This has more to do with the size discrepancy between rescuer and patient than the size of the patient alone. Sometimes, when performing chest compressions, a patient will require more weight than a rescuer can muster. If this happens, ensure you are in the correct position with correct body mechanics or try to recruit a bystander to assist you while you guide them along. Teaching an untrained rescuer how to perform chest compressions isn’t difficult and you can rest easy, knowing that you did everything you can! Crunching and Popping Sounds These sound worse than they usually are. These sounds and crunching feelings could be related to a traumatic injury. But more likely, it's just due to the separation of cartilage from the sternum, which also sounds worse than it is. It may also be ribs that break, especially in older victims. Keep in mind that you're not going to hurt the victim any more, as they are already dead. Anything that you do to help the victim is giving them another chance at life, don’t fear trying to help someone. Impaled Chest Objects The only way an impaled object would keep you from performing chest compressions is if the object were in the exact location. If that's the case, all you can do is call 911, keep the scene safe, and do whatever you can do to control bleeding or other issues. However, if you can, just work around the impaled object and perform compressions to the best of your ability. This situation could also arise when it comes to giving rescue breaths, should the patient have an impaled object in the mouth, face, or airway. Special Considerations for AEDs It's important to understand that to get better use from an AED, you may have to understand and use a few workarounds. And when it comes to using AEDs, these are the four most common concerns we hear. How to handle jewelry. How to handle patches. How to handle underwire bras. How to handle breast tissue that's in the way. Jewelry As the types of jewelry change over the years, questions concerning jewelry also change. When it comes to necklaces, these are easy to move out of the way; no need to take them off. However, with piercings, location matters. If the piercing is directly where a pad would go, or if it appears like it would interfere with the pathway of the electricity, remove the piercing first. Otherwise, piercings shouldn't pose any problems. Patches Nitro patches, pain relief patches, and other types of medication patches come off easily. So, if a patch is resting where an AED patch should go, remove it, wipe the area so it's dry, and apply the pad as normal. Underwire Bras While removing clothing to expose the chest is best, studies have shown that leaving a bra in place is okay when using an AED. If neededimply adjust the bra as needed to place the AED pads on bare skin under the bra straps. The under wires have shown little to no interference with the electricity. It is far better to leave the bra in place and use an AED, than not helping at all. Breast Tissue If you encounter breast tissue where an AED pad should go – likely the mid auxiliary rib cage – simply move it and apply the pad. The AED pad should be placed on the rib cage itself. When the pad is placed on breast tissue, the effectiveness of the AED is reduced.> Special Considerations for Choking The three most common concerns we hear with choking incidents are: What if the choking victim is too large? What if the choking victim is pregnant? What if the obstruction won't come out? The Patient is Too Large Again, we see where a discrepancy in size between rescuer and victim matters. If after the 5 back blows the victim is still choking, but the person you're trying to help is too large for you to get your arms around, enlist the help of a bystander, and like before, you can guide the bystander through the abdominal thrust technique. Otherwise, if there are no bystanders and it's just you, after the back blows, consider using the inward thrusts directly on the sternum instead, just as you would a pregnant woman. Tuck in your thumb, go under the breast, and onto the sternum. Thrust inward, rather than up and inward like you would with abdominal thrusts. Worst case scenario:Perform continuous back blows if you can’t perform the abdominal or chest thrusts. If you cannot remove the object, the victim will eventually pass out, so do not leave them. If you can, safely help them down to the ground, and then continue helping them by beginning chest compressions for an unconscious patient, which can be effective at clearing obstructions as well. The Patient is Pregnant A pregnant patient is really two patients – one primary patient (mother) and one secondary patient (baby). If you suspect a conscious choking female adult to be pregnant, avoid performing abdominal thrusts, as these can injure the uterus or baby. Instead, after the 5 back blows, perform inward thrusts on the sternum as is described above. The Obstruction Won't Come Out This isn't common, but it's scary when it happens. And most of the time, it could have easily been avoided. Certain gooey foods, like marshmallows, can act almost like glue if inhaled. Other items that pose unusual risks include mylar and latex. Coins are also particularly hazardous. If they are swallowed just right, they can act like a one-way valve in the larynx – one that opens with a compression and closes with a rescue breath. In the event of emergencies like this, where difficult obstructions won't come out, EMS personnel also have special tools to assist them, such as suction equipment and forceps that can reach down the throat. https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/training/bls-first-aid/video/cold-related-emergncies https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7188.mp4 Cold-Related Emergencies Cold-related emergencies are typically the result of cold temperatures combined with a lack of insulation or protective clothing to deal with those temperatures. How We Lose Heat   Radiation is the most significant and it involves the emission of infrared waves from the skin to cooler surroundings, similar to heat radiating from a stove. Convection contributes the next most heat loss and occurs when warm air or water around the body is replaced by cooler air or water, carrying heat away.  Think of how nice a strong breeze is on a hot day. Conduction is when there is direct contact with other objects. This is often a smaller concern, however, if your skin is in contact with a surface that absorbs heat easily like water, metal or cemet, conduction becomes a much larger concern.  Evaporation is responsible for another large portion of heat loss under normal conditions and becomes the only effective cooling mechanism when the environment is warmer than the skin.  It includes sweat evaporation and moisture loss from the lungs during breathing.    Pro Tip #1:> Protecting yourself from as many of the methods of heat loss as possible will ensure you stay as warm as you can.   Hypothermia begins to set in around the time the patient begins to shiver. And once the core body temperature drops below 95 degrees Fahrenheit, serious side effects ensue, including: Dizziness Delirium/confusion Lethargy Fatigue and weakness Loss of consciousness How to Treat for a Cold-Related Emergency If at any point someone starts showing signs of hypothermia or frostbite, call 911 immediately to activate EMS. Attempt to find warm shelter to keep the patient as comfortable and as warm as possible until help arrives. Monitor for airway, breathing, and circulation issues. If at any point, the patient becomes unresponsive, goes unconscious, or is not able to breathe normally. Then begin CPR. Treatment for hypothermia is a simple concept of just keeping them warm. It can become difficult in different situations though. This following list includes our priorities, but the order of when we conduct them may change based on the circumstances. Insulate the patient's body as best you can until help arrives. Move the patient to a warmer environment if possible. Remove any wet clothing and cover with blankets. Pro Tip #2: One of your best tools for helping you achieve number one above is a mylar blanket. They're common in first aid and emergency kits, and for good reason. They work by reflecting the heat of the patient and are big enough to cover most adults from head to toe. Warning: Wrapping a patient in a mylar blanket should be done gently using the steps below. You want to make sure not to agitate any frost-bitten extremities. Plus, cardiac arrest is also a concern. Aggressive movements can put the heart into a fatal rhythm. Using a Mylar Blanket Unwrap the blanket and tuck it around the patient as much as possible as this can help with both convection and radiation heat losses. For smaller patients, blankets could be placed under the mylar so long as the blanket is dry and the mylar fits completely over the victim and blankets. Pro Tip #3: The patient may be in a fetal position to try and stay warm. This can help decrease heat loss from radiation, convection and conduction. Leave them in this position if they are comfortable and you can continue to assist them in staying warm such as covering them with blankets. Seal the blanket as best you can, but leave room for the patient to breathe, as mylar isn't breathable material. Put another blanket or coat over the patient. Cover the feet and tuck it in around the patient as best you can, including the top of the head. Pro Tip #4: We lose a ton of heat through our feet, hands, and head, so make sure these areas are covered. Top and sides of head, not the face. Warning: Don't forget to protect yourself. When dealing with cold-related emergencies, you're likely putting yourself in the same environment that felled the patient. And since you're likely kneeling on cold pavement, in snow, and may be working with your gloves off for reasons of manual dexterity, pay extra care that you don't also become a victim.> Rewarming Body Parts in the Field A clinical setting is the preferred location for rewarming, so don't worry about it, especially considering that frozen parts that have been warmed could re-freeze causing additional injury. However, it pays to know that you should only rewarm using water between 99 and 104 degrees Fahrenheit. Higher temperatures could burn the patient, not to mention the pain involved. Rewarming is very painful, as the nerve endings begin to come back and the patient begins feeling again. Which is why a setting that can offer analgesics is the best option. Also, rubbing or massaging the frostbitten portion could cause further injury, so it is best to let the body part warm up on its own. Recognizing Frost Nip and Frost Bite The most common body parts to freeze first are the nose, cheeks, ears, feet, hands, and especially the ends of fingers and toes. When frost bitten, these parts will appear white, hard to the touch, and numb or nearly numb to the patient. A Word About Cold-Related Contributing Factors When it comes to cold-related emergencies, there are several contributing factors to be aware of, including the environment and the age of the patient. Anyone can develop hypothermia; however, the risk factors below could put people at higher risk. A cold environment. Though, even if the ambient temperature isn't that low, it can quickly be made worse if the patient isn't properly protected from the cold, including the use of inappropriate clothing. A wet environment. The presence of moisture – perspiration, rain, snow, etc. – will increase the speed at which body heat is lost. Wind. Wind makes the environment a lot colder than the temperature indicates. The higher the wind chill effect, the lower the actual temperature. Age. The very young and very old usually have a harder time staying warm in cold conditions. Body mass, or lack thereof, is one concern, as is their ability to think clearly when it comes to removing themselves from that environment or better protecting themselves with proper clothing. And in older adults, impaired circulation may also be a concern. Medical conditions. People with certain medical conditions, such as hypoglycemia, shock, and head injury, may be at higher risk of developing hypothermia. Drugs and alcohol. Alcohol and certain types of drugs can reduce a person's ability to feel the cold, or can impair judgment and impede rational thought, preventing the patient from taking proper precautions to stay warm. Trauma. If a person is injured and they are facing issues with hypothermia, both conditions may worsen much quicker. Injured victims must be kept as warm as possible. https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/training/bls-first-aid/video/poison-control https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7190.mp4 Poison Control Some of the most dangerous areas of any home, especially for young, curious children, are the places where poisons are stored, such as cleaning products and medications. Limiting access to these areas will always be key to preventing catastrophe. Luckily, there are numerous procedures and products that can easily help secure cupboards, drawers, and cabinets that house these dangers. A couple simple ways to better secure household poisons include: Store all medications and dangerous chemicals up high, so they're out of reach for small children Purchase commercial made locks at the hardware store Warning: It's important to understand how a colorful liquid chemical looks to a child. Those bright colors probably look like Kool-Aid, fruit punch, or the latest soda, and appear more delicious than dangerous. Chemicals don't have to be in liquid form to be tempting to children. Another common threat lately are the dishwasher and laundry cleaning pods that children routinely mistake as candy. However, children consuming poisons is just part of the problem. Kids also don't know the difference between consuming a medication that will help them feel better when they're sick and over-consuming that same medication – something that could hurt them or even kill them. Then add to this the fact that these medications are often flavored to taste good so that children will take them. Which is why medicine cabinets deserve the same amount of precaution as those cabinets where poisons are stored. How to Treat for Poisoning Is you suspect poisoning, the first thing to do is look for clues to corroborate that suspicion, such as: Are there pills scattered about? Are there empty pill bottles or packages around? Does the victim have burns or redness around the lips and mouth? Does the victim have unusual stains or odors, particularly breath that smells like gasoline or paint thinner? Is the victim exhibiting signs of drowsiness or mental confusion? Is the victim having difficulty breathing? Has the victim vomited? Pro Tip #1: First aid treatments for poisoning have changed a lot over the years. Which is why if you suspect poisoning you should call the Poison Control Hotline at 1-800-222-1222. Keep this phone number in a prominent location for quick and easy access. Poison Control will work with you to first help identify the poison in question. And then will guide you in providing treatment for that poison. Pro Tip #2: You may have heard to induce vomiting for poisonings. This is rarely true. One more reason to call poison control and get the proper treatment advice based on the poison that was ingested. Warning: If at any point, the patient goes unconscious or stops showing signs of life (moving, breathing normally, etc.), call 911 immediately and activate EMS. A Word About How Poison Enters the Body There are four categories of poisons based on how they enter the body – ingestion, inhalation, absorption, and injection. Ingestion This category is for all the poisons that can be swallowed – common food poisoning culprits like mushrooms and shellfish, recreational drugs, medications, alcohol, and household items like cleaning supplies. Young children are most at risk, as everything they see looks like it should go into their mouths immediately and often does. Older adults are also more at risk, mostly due to medication errors. Inhalation Inhaled poisons are those gases and fumes that are poisonous. The most common inhaled poison is carbon monoxide, as it's odorless, colorless, and tasteless. To further complicate matters, exposure can lead to death in mere minutes. Carbon monoxide comes from car exhaust, tobacco smoke, fires, and defective gas cooking and heating equipment, like furnaces and hot water heaters. Other less common culprits in this category include carbon dioxide, chlorine gas, ammonia, sulfur dioxide, nitrous oxide, chloroform, dry cleaning solvents, fire extinguisher gases, industrial gases, and hydrogen sulfide. Absorption Absorbed poisons can enter the body through the skin or mucous membranes in the eyes, nose, and mouth. Plants are the biggest offenders when it comes to absorbed poisons, and most of us have probably had a run-in with poison ivy once or twice. Chemicals in fertilizers and pesticides are also commonly absorbed poisons, as are topically applied medications. Injection Injected poisons do include those administered by hypodermic needle, such as recreational and medicinal drugs. But more times than not, instances of poisoning by injection are perpetrated through bites and stings. Poisonous snakes, insects, spiders, and marine life are abundant in certain countries, like Australia, while others like their neighbor New Zealand, can boast a total of zero poisonous animals. https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/training/bls-first-aid/video/bleeding-control-capillary-bleeding https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2096.mp4 Capillary Bleeding While you're probably familiar with veins and arteries, capillaries may warrant a quick definition. Capillaries are tiny blood vessels linking arteries and veins that transfer oxygen and other nutrients from the blood to all body cells and remove waste products. Capillary bleeding has the classic appearance of a road rash type of wound. Anyone who has fallen off a bike or while playing sports likely has some experience with this type of bleeding injury. Capillary bleeding distinctions are: The blood tends to ooze or bubble up on the surface of the wound The pressure is very low and will usually clot on its own or with minimal pressure The blood is mixed with serous fluid Serous fluid is a yellowish liquid that is made up of proteins and water. It's the same fluid that fills a burn blister and is the body's attempt to heal the wound. How to Provide Care Capillary bleeding is usually not a concern in healthy people. The blood vessels are quite small, and the pressure is minimal. Some things to keep in mind with capillary bleeding are: Because it affects the epidermal layer where the nerve endings are located, it can be more painful than other types of bleeding injuries Infection is likely to be the biggest area of concern Thoroughly cleaning the wound is the greatest weapon against infection, particularly if the victim fell on a dirty surface As always, the first thing you should do is make sure the scene is safe. After that, proceed with the following steps. Put on latex-free gloves if available or wash your hands thoroughly using soap and water or a sanitizer of some kind, preferably with alcohol. Remove any visible debris from the wound – dirt, sand, pebbles, and shavings of glass or metal. Blot the area with a dressing pad and apply direct pressure if the bleeding hasn't stopped on its own. Thoroughly clean the wound with soap and water. Apply an over-the-counter triple antibiotic to the area using a clean dressing pad. Pro Tip 1: When cleaning off debris from the wound, if you notice that those things are embedded into the wound, the victim will need to make a trip to the ER, where the medical staff will probably need to numb the area before removing the debris. The nerve endings could be quite raw, and it's important to keep in mind that the victim may be in a good deal of pain. Once the wound is cleaned and the antibiotic has been applied, put a fresh dressing pad over the area. Make sure it's large enough to cover the wound completely with room to spare on all sides. Using medical grade tape, if you have it, hold the dressing pad in place with a couple strips of tape or however much is needed. Let the victim know that he or she can replace the pad with a large band aid after a day or two. Pro Tip 2: It's important to help the victim understand what the signs of infection are, as this is likely to be the biggest threat with capillary bleeding wounds. Signs of infection include: Puss oozing or draining from the wound The wound becomes puffy and more painful A wound that begins to turn red around the site Warning: Capillary bleeding is usually not a life-threatening injury, but infections could be. If the victim notices any of the above, it's important that he or she go to the ER or their doctor to avoid the chance of serious infection. However, keeping the wound area clean is often enough to avoid this complication. Also let the victim know what a healthy outcome of capillary bleeding looks like: The wound will begin to scab over after 48 – 72 hours After a couple of more weeks, it should be completely healed as the scab begins to fall off A Word About Life-Threatening Bleeding While capillary bleeding is often very easy to control, it's important to understand the concept of the Golden Hour – the critical first hour after a traumatic bleeding injury has occurred. During the Golden Hour: The risk of shock is at its highest Extensive blood loss can quickly result in death Quick action and proper intervention will result in the victim's best chance of survival As all bleeding injuries occur from arteries, veins, and capillaries, it's important to understand what a life-threatening bleeding incident looks like. Blood that is spurting out of a wound. Blood that won't stop coming out of a wound. Blood that is pooling on the ground. The victim's clothing is soaked with blood. Bandages that are soaked with blood. Loss of part, or all, of an arm or leg. Bleeding in a victim who is confused or unconscious. If you experience any of these situations while providing care, be aware that these can be life-threatening, and you should call 911 immediately and get EMS involved. Capillary bleeding is often the least severe type of bleeding injury, but don't get lulled into a false sense of security. Any bleeding situation can become serious. And it deserves repeating that with capillary bleeding, it's especially important to clean the wound well to reduce the chances of infection. https://d3imrogdy81qei.cloudfront.net/video_images/3751/bleeding-control-capillary-bleeding-2015.jpg Yes 235 https://www.procpr.org/training/bls-first-aid/video/eye-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7189.mp4 Eye Injuries Injuries to the eye can involve the eyeball, the bone, and the soft tissue surrounding the eye. Blunt objects, like a fist or a baseball, can injure the eye and/or the surrounding area. Or a smaller object could penetrate the eyeball. Care for open and closed wounds around the eye as you would for any other soft tissue injury. In this lesson, when we talk about treating an eye injury, assume we're referring to treating an injury from an object. Near the end we'll present some information on the other type of eye injury – chemical injuries.> How to Assess and Treat Eye Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Once you've ensured that the patient isn't suffering with airway, breathing, or circulation issues, the first thing you want to do is assess what type of eye injury you're dealing with – object or chemical? Both are serious! Pro Tip #1: Eye injuries are serious and always warrant a trip to the ER, whether by calling 911 and activating EMS or by private vehicle. Therefore, the job of the responder is to stabilize the wound, stop the damage, and ready the patient for safe transport. Sequence of Treatment for Eye Injuries Sit the patient down and facing you if possible. Place a small cup over the injured eye to eliminate any more damage or pressure. Ask the victim to hold the cup in place. Pro Tip #2: If you don't have a medical grade cup, a Dixie cup is a suitable alternative. And smaller is better as you'll have tape over it. Using a gauze bandage, begin wrapping over the cup and injured eye, while asking the patient to let go of the cup.  Cover the victim's head two to three times. Tuck or tape the end of the gauze to hold it in place. Pro Tip #3: The injured person has impaired eye sight with one eye covered. Be sure to be extra communicative and always talk to them as you're helping them. Having an eye covered can be disorienting. Make sure the victim's good eye is free and clear of the bandage to prevent even further impairement. Perform a secondary survey as you do the above. Assess the patient for secondary issues, from head to toe. And as always, continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. A Word About Chemical Eye Injuries This section will mirror the last lesson on the importance of, and strategies for, diluting chemical burns. Only with the eyes, and particularly the mucous membrane, damage can occur very quickly. Meaning your quick actions are essential. There are two types of chemical eye injuries – dry or wet. If you're dealing with dry chemicals, brush as much off the eye as you can before beginning to flush with a solution. If you're dealing with a wet chemical, go right into flushing the eye. Pro Tip #4: Ideally, you'll have a balanced pH solution for moments like this. Otherwise, use what you have access to – tap water, bottled water, etc. Flush the injured eye for at least 20 minutes. Your goal here is to stop the damage from the chemical. Warning: Always rinse from the inside of the eye to the outside of the eye. Flushing the eye the other way – from the outside in – could lead to cross-contamination of the other eye. While readying the patient for transport, and during your secondary survey, make sure the victim didn't get any chemicals into their mouth, nose, ears, etc. if they did, treat accordingly. Prevent Eye Injuries The single most effective measure for both chemical and foreign object injuries is wearing appropriate protective eyewear — ANSI-approved safety glasses or goggles have been shown to reduce workplace eye injuries by up to 90%. For environments involving chemicals, the CDC and OSHA recommend using sealed, indirect-vent goggles rather than standard safety glasses, since chemical splashes can travel around unprotected frames; additionally, knowing the location of the nearest eyewash station and flushing affected eyes with clean water for a minimum of 15–20 minutes is critical to minimizing damage after exposure. https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/training/bls-first-aid/video/head-neck-and-back-injuries https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2098.mp4 Head, Neck, and Back Injuries If you come upon a patient who appears to have taken a fall, or was injured in an accident, and there are no bystanders around who witnessed the accident, you'll need to figure out the mechanism of injury. Hopefully the victim will be able to help, who in this lesson, we are assuming is conscious, alert, and not exhibiting more serious issues involving airway, breathing, circulation, etc. The most important thing to keep in mind as you deal with someone who has sustained potential injuries to their head, neck, and/or back, is minimizing movement, as you inquire more into what happened and how the patient is feeling. Pro Tip #1: Part of your job is to figure out if EMS is required as you tend to them. It may be a situation where the victim is able to get up and has no significant injuries. Or it could be a situation that doesn't appear serious initially, but suddenly becomes serious. If at any point the situation warrants it, call 911 immediately. How to Handle a Patient with Head, Neck, and Back Injuries As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim. Are you OK? Can you hear me? If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment. When dealing with potential back and neck injuries, it's best not to touch the patient while you assess them. Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions; try not to nod. Answer with yes or no. And try not to move other parts of your body." "Do you remember what just happened?" "Do you know if you hit your head?" "Do you know what day it is?" "Do you know what year it is?" If the victim answers the last two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. This altered mental state is enough of a concern to call 911 and activate EMS if you haven't already done so. The fact that you're able to talk with the patient is a good sign. It indicates that they're awake, breathing normally, and have a pulse, all of which indicate a lack of an immediate emergency. However, that doesn't mean the situation cannot suddenly change. As you're talking with the victim, you're also looking them over for injuries, beginning with their head. Is there blood in the ears? Is there blood in the nose? Does the patient have any broken teeth? Are the pupils equal size and responsive to light? Pro Tip #2: Put your hand over the victim's eyes for a second or two then remove it and see if their pupils react. If they do not, it could be due to a concussion and swelling in the brain. Determine how injured they are by seeing how much they can move and with open-ended questions. "Can you tell me what hurts?" "Can you wiggle your fingers?" "Can you wiggle your toes?" A victim in paralysis is prone to going into spinal shock. Remember, shock is a progressive condition in which the circulatory system fails to adequately circulate oxygenated blood to all parts of the body. Early signs of shock to look for include: Nervousness Rapid heart rate or breathing Anxiousness Sweaty Fearful Clammy skin Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock. Warning: Should you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call. If at any point during your assessment, the patient goes unresponsive, appears to be having trouble breathing normally, or goes into full cardiac arrest, activate EMS and treat the patient accordingly until help arrives, an AED arrives, or the patient is responding positively. A Word About Injuries to the Neck and Spine Injuries to the neck and spine can damage soft tissue and bone, including the spinal cord. Unfortunately, assessing the level of this damage on the scene, and without proper diagnostic equipment, is very difficult. Which is why you should always proceed with caution. Some common situations in which serious neck and spine injuries tend to be seen include: Swimming pool diving accidents Vehicular accidents Accidents that include a broken hard hat or helmet Some common symptoms for serious neck injury are: Obvious lacerations or swelling Impaled object Excessive external bleeding Difficulty speaking Air escaping through the trachea and/or larynx An airway obstruction Some common symptoms for serious spine injury are: Back pain or pressure Pain with movement Numbness, weakness, tingling in limbs or extremities Loss of feeling in limbs or extremities Breathing problems Loss of bladder and bowel control https://d3imrogdy81qei.cloudfront.net/video_images/3755/head-neck-and-back-injuries-2015.jpg Yes 229 https://www.procpr.org/training/bls-first-aid/video/diabetes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2100.mp4 Diabetes In this lesson, you'll learn how to treat a patient with a blood sugar emergency. Some things to keep in mind about blood sugar problems: Signs and symptoms are the same for low blood sugar and high blood sugar Blood sugar issues will get worse without treatment Without treatment, a patient could become unresponsive and die The three most common signs and symptoms of someone experiencing a blood sugar issue are: Confusion Coordination issues Talking nonsense A person with a blood sugar issue might also randomly fidget with something and appear quite out of it. Pro Tip #1: Even though the signs of high blood sugar are the same as those for low blood sugar, in patients suffering from high blood sugar, those symptoms will come on much more slowly and will likely be less intense. How to Treat a Blood Sugar Event As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim. "Hi, my name's _____. I'm a paramedic. I'm going to help you." Pro Tip #2: When a patient has high blood sugar, the body will try to rid itself of it through urination, and failing that, through hyperventilation. Which is why, in patients with high blood sugar, you'll often notice a hint of fruit or cheap wine on their breath. The reason for this is called ketoacidosis – a byproduct of unused sugars in the body that become toxic. Pro Tip #3: If a patient is showing signs of a blood sugar issue, rule it out using sugar – either over-the-counter products like soda or professional glucose products specifically for diabetic events. Follow the pro tip above as long as the patient is coherent enough to follow commands and isn't getting agitated or aggressive. Then begin encouraging the consumption of sugar or glucose. Warning: A patient can only consume a glucose or sugar product if they are able to swallow safely. If their sugar event has escalated to the point where they cannot control their swallow reflex, it's too late. Sugar will need to be administered through an IV or by intermuscular injection. If the patient did have low blood sugar, you should notice improvements in 10 to 15 minutes. If the symptoms aren't improving after 15 minutes, there could be something else going on; call 911 and activate EMS. Professional glucose products like tabs and gels are your best bet, as they're designed for quick absorption. They're also encased in more stable packaging, meaning they can withstand freezing temperatures and other environmental threats. If you don't have any glucose products available, a full-sugar soda is your best option. Candy bars aren't a bad option either. However, more fibrous snacks will take too long to be absorbed by the body. Pro Tip #4: Most patients with sugar problems will know the dosage of sugar or glucose they need in emergencies like this. Read labels on the packaging and multiply or divide as needed to get the proper dosage. Keep in mind that high fructose corn syrup burns much more quickly compared to the longer-acting dextrose you'll find in many glucose products. If this was the patient's first sugar event, follow up with EMS to make sure they get the help they need moving forward. If this wasn't the patient's first sugar event, and they can explain what likely caused it, help them get back on their plan to avoid it happening again. And encourage them to check-in with their physician to make sure everything is all right. A Word About Diabetic Emergencies Diabetes mellitus is one of the leading causes of death and disability in the U.S. In 2016, 29 million Americans had diabetes, while another 86 million had prediabetes – a condition that increases your risk for developing type 2 diabetes and other chronic diseases like kidney disease, heart disease, gum disease, stroke, and amputations. The Two Types of Diabetes Type 1 Diabetes – Also known as juvenile diabetes or insulin-dependent diabetes, this condition results in a body that produces little to no insulin. Which is why most people who have type 1 diabetes inject themselves with insulin daily. Type 2 Diabetes – More common than type 1 diabetes, type 2 is characterized by a body that produces insulin, but either the cells can't use it effectively or not enough is being produced. People with type 2 diabetes can often improve their symptoms and regulate their blood glucose levels with dietary changes and sometimes medications. High Blood Glucose High blood glucose, or hyperglycemia, is when the body's insulin level is too low, and the sugar level is too high. However, the body cannot transport that sugar into the cells without insulin. Which results in a body that's about to have an energy crisis. The body then attempts to meet its need for energy by using other stored food and energy sources, such as fats. However, converting fat to energy is less efficient, produces waste products, and increases the acidity level in the blood, causing a condition known as diabetic ketoacidosis (DKA), which could ultimately result in a diabetic coma. Low Blood Glucose The exact inverse of the above – Low blood glucose, or hypoglycemia, occurs when the body's insulin level is too high, and the sugar level is too low. This can happen for a number of reasons, including when the patient: Takes too much insulin Fails to eat adequately Over-exercises and burns off sugar faster than normal Experiences great emotional stress Regardless of whether you're dealing with a patient who has type 1 diabetes or type 2 diabetes, the signs and symptoms are the same: Dizziness, drowsiness, or confusion Irregular breathing Abnormally weak or rapid pulse Feeling and looking ill Abnormal skin characteristics https://d3imrogdy81qei.cloudfront.net/video_images/3759/diabetes-2015.jpg Yes 500 https://www.procpr.org/training/bls-first-aid/video/child-aed-practice https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/2128.mp4 Practice: Child AED Learn how to give CPR with an AED to a child who is unconscious and not breathing by watching the procedure performed on a mannequin. https://d3imrogdy81qei.cloudfront.net/video_images/3815/child-aed-practice-2015.jpg Yes 256 https://www.procpr.org/training/bls-first-aid/video/child-aed https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7278.mp4 Child AED The methods of defibrillating a child are basically the same as defibrillating an adult. One important distinction involves AED pad size. AED pads come in an adult size and a pediatric size, for patients less than 8 years old or 55 pounds - roughly 25 kilograms. Pro Tip #1: If you do not have pediatric pads and the patient is less than 8 years old or 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forgo using an AED. Warning: Remember that when using an AED, there are a couple of important things to keep in mind as it relates to your surroundings. Are there combustible gases or liquids at the scene? Are there any liquids that could connect the victim with yourself, the responder, or someone else, that could result in electrocution? If for some reason the scene isn't safe enough to use an AED, move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED. Pro Tip #2: It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it. How to Provide Care As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive. Are you OK? Can you hear me? If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps. Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions. Check for breathing and a pulse. Use the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse. If you've determined at this point that the victim is unresponsive, not breathing normally, and has no pulse, continue immediately with your AED. AED Technique for Children Turn on the AED. Remove the patient's clothing to reveal a bare chest. Attach the AED pads to the patient's chest. The pads should have a diagram on placement if you need a reminder. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side mid axillary, under the left breast. For small children, attach one AED pad to the center of the child’s chest, roll the child onto his or her side, and attach the second pad to the center of the back, between the shoulder blades.  Plug the cable into the AED and be sure no one is touching the patient, including yourself. The AED should now be analyzing the rhythm of the patient's heart. If it is a shockable rhythm, it will charge automatically and be ready to shock. If the scene is clear and no one is touching the patient, push the flashing shock button. Then go right into CPR. It's OK to perform CPR over the pads, so don't worry about moving them. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them. Consider the size of the child when doing compressions, use one hand for a smaller child and two hands to perform compressions on older children. It also depends on the size and strength of the rescuer if one or two hands are needed to supply the proper chest compressions. Conduct compressions that go 1/3 the depth of the child's chest, and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second. Perform 30 chest compressions. If you have two rescuers, the compression to ventilation ratio is 15:2. Grab the rescue mask and seal it over the victim's face and nose. Lift the victim's chin and tilt his or her head back slightly. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath. After two minutes of CPR, the AED will analyze the patient’s heart rhythm again. If the AED advises you to perform another shock, make sure no one is touching the patient and press the shock button. Go right back into CPR. If the AED says no shock advised, immediately start CPR with compressions unless there are signs of life. Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until help arrives, the patient is responsive and breathing normally, or the next level of care takes over. A Word About Special AED Situations Some special considerations should be given when using an AED in certain situations. These include using an AED on a patient who has an implantable device and a patient who's suffering from hypothermia. Implantable Devices Implantable devices, like pacemakers, are sometimes located below one of the collarbones in the area where one of the AED pads should go. This can be problematic as the device could interfere with shock delivery. An ICD (Implantable Cardioverter-Defibrillator) is another common implantable device you may encounter. It's sort of like a mini version of an AED, as it detects abnormal heart rhythms and restores them to normal. If one of these devices is visible – a small lump can sometimes be seen or felt – or if you know the patient has one in a specific location, do not place the AED pad on top of it. Instead, adjust the placement of the pad to avoid the device, usually 1 inch away from the device is appropriate.  Hypothermia As already mentioned, patients who are wet pose no problems when using an AED, provided they are not submerged in water, water is not connecting the patient with the responder or anyone else, and the wet clothing is removed from the upper torso and the chest is dried off. Patients who are suffering from hypothermia do not require rewarming before using the device. However, you will want to handle them gently, as shaking them could result in V-fib. https://d3imrogdy81qei.cloudfront.net/video_images/13096/child-aed-bls-2025v2.jpg Yes 256 https://www.procpr.org/training/bls-first-aid/video/2025-guidelines-updates-bls-and-first-aid https://d3imrogdy81qei.cloudfront.net/videos/course_videos/en/7287.mp4 2025 Guidelines Updates - BLS and First Aid In this lesson, we're going to summarize and highlight the latest information from the 2025 American Heart Association Emergency Cardiovascular Care guidelines as they relate to Healthcare Provider CPR. Just like in previous updates, the goal of these guideline changes is simple: to improve the survival of our patients by improving early recognition, high-quality CPR, and early defibrillation. Despite decades of public education, bystander CPR and AED use uremain inconsistent, and outcomes for out-of-hospital cardiac arrest still depend heavily on what happens in the first few minutes. The 2025 ECC updates continue to emphasize that early action by healthcare providers is what truly saves lives. Many of the changes you'll see focus on improving CPR quality, reducing delays, and removing barriers that prevent people from stepping in to help. Initiation of Resuscitation for Adults The ECC continues to reinforce the importance of performing CPR with breaths. If a rescuer is not trained or does not have the ability to safely give breaths, hands-only CPR can be used, as providing compressions alone is still better than doing nothing at all. Whenever feasible, and without delaying chest compressions, CPR should be performed where the person is found, as long as high-quality CPR can be delivered safely and effectively. It's preferred that the patient be in the supine position — meaning on their back — on a firm surface, since firm surfaces improve compression depth and effectiveness. Delays caused by unnecessary movement of the patient are associated with worse outcomes. Chest compressions should be performed with the patient's torso positioned approximately at the level of the rescuer's knees. This positioning improves rescuer body mechanics and reduces fatigue. Rescuers may also consider placing their dominant hand on the sternum when performing compressions, which may further improve overall CPR quality. Pro Tip #1:The key takeaway here is don't delay chest compressions. High-quality CPR, including breaths, can significantly increase the chance of survival. When providing ventilations with a bag-mask device during adult cardiac arrest, it's reasonable for one rescuer to use two hands to open the airway and seal the mask, while a second rescuer squeezes the bag to improve ventilation effectiveness AED Use and Patient Dignity The 2025 guidelines re-emphasized an important barrier to public access defibrillation, particularly for women. Evidence suggests that the need to expose the chest may contribute to lower rates of AED use in female patients. While proper pad placement is always preferred, current evidence shows that successful defibrillation can still occur even when pad placement is not exactly perfect. Because of this, it is reasonable to apply AED pads directly to the skin by simply adjusting clothing or undergarments rather than removing them entirely, when appropriate. The priority remains rapid pad placement and early defibrillation, while maintaining patient dignity and reducing hesitation that can delay care. Mechanical CPR Devices In adult cardiac arrest, the use of a mechanical CPR device should only be considered in specific settings where delivering high-quality manual compressions may be challenging or dangerous. When mechanical CPR is used, rescuers must strictly limit interruptions in chest compressions during deployment and removal of the device. High-quality manual CPR should never be delayed while preparing or positioning a mechanical device. Foreign Body Airway Obstruction For conscious adults and children with severe foreign body airway obstruction, rescuers should perform repeated cycles of 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unresponsive. This sequence reflects evidence suggesting that back blows may be more effective and cause fewer injuries than abdominal thrusts alone. In special circumstances — such as late-stage pregnancy or when abdominal thrusts are impractical — chest thrusts should be used instead. For infants, abdominal thrusts are still not recommended. Instead, back blows and chest thrusts continue to be used. Pro Tip #2: A key update in 2025 is that chest thrusts for infants should now be performed using the heel of one hand, placed in the center of the chest, rather than the previously recommended two-finger technique. This change is based on evidence showing improved compression depth and effectiveness during severe airway obstruction. Cardiac Arrest Following Drowning For adults and children in cardiac arrest following drowning, CPR with breaths should be started before AED application. Drowning-related cardiac arrest is typically hypoxic in nature, meaning oxygen deprivation is the primary issue. Early ventilations are critical, and applying an AED first may delay the initiation of effective CPR with breaths — especially since shockable rhythms are less common in drowning cases. Eye Injuries with an Embedded Foreign Object A small but important update: when caring for a person with a foreign object embedded in the eye, rescuers should now cover only the affected eye rather than both eyes. This change is intended to reduce anxiety in the patient by allowing them to maintain vision in the unaffected eye. The previous concept was that if you covered both eyes, then that would reduce the movement of the good and the injured eye. Data shows that with the increased anxiety and potential for further injury caused by the temporary blindness, it would be safe to just bandage the injured eye.  ProTip #3: Our goal is to prevent any further injury to the eyes. Protect the injured eye(s) from any excessive pressure with a shield or cup and seek immediate medical attention. Managing Shock When caring for a person showing signs of shock who remains alert, it is reasonable to place or maintain them on their back. If the person is at risk for airway obstruction — such as decreased alertness or active vomiting — or if they cannot be continuously monitored, it is reasonable to place them in the recovery position, on their side. While elevating the feet has been shown occasionally to help the patient, the effects are often short lasting only a few minutes. Pro Tip #4: In situations where there is no evidence of trauma or injury, such as fainting or dehydration, some studies suggest that raising the feet approximately 6 to 12 inches may still be beneficial. The priority remains placing the patient safely on the ground, keeping them warm, and monitoring for airway compromise or the need for CPR A Unified Chain of Survival The 2025 guidelines introduce a single, standardized Chain of Survival that now applies to infants, children, and adults. It excludes neonates, who follow a separate neonatal chain of survival. This unified approach emphasizes early recognition, early CPR, early defibrillation, and advanced care, as well as recovery as a continuous process across all age groups. CPR in Infants and Children In infants and children, studies consistently show that CPR with both compressions and breaths provides the best chance of survival. However, if providers are unable to give breaths to an infant or child in cardiac arrest due to safety concerns, compression-only CPR is reasonable. Large observational studies show that compression-only CPR is far better than no CPR at all, and significantly improves survival outcomes compared to no bystander intervention. A Word About Left Ventricular Assist Devices (LVADs) An LVAD, or left ventricular assist device, is a mechanical pump that is surgically implanted to help the heart's main pumping chamber — the left ventricle — circulate blood throughout the body. It is used for patients with end-stage heart failure. In unresponsive adults and children with durable LVADs, chest compressions should be performed when there are signs of impaired perfusion. The presence of an LVAD does not eliminate the need for CPR during cardiac arrest. Closing Thoughts The 2025 ECC CPR guideline updates continue to reinforce a simple but powerful message: early recognition, early CPR, and early defibrillation saves lives. These updates are designed to improve CPR quality, reduce delays, and remove the barriers that prevent rescuers from acting — whether that rescuer is a parent, a bystander, or a trained professional. Guidelines will continue to evolve as science advances, but the mission remains the same: recognize the emergency, take action, and do the best you can. CPR doesn't need to be perfect to save a life. Doing something is always better than doing nothing, and confident, informed rescuers make all the difference. https://d3imrogdy81qei.cloudfront.net/video_images/13116/2025-guidelines-updates-bls-and-first-aid.jpg Yes 472 https://www.procpr.org/es/training/bls-first-aid/video/picaduras-de-escorpiones-garrapatas-y-aranas https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6491.mp4 Picaduras de escorpiones, garrapatas y arañas Ahora discutiremos el tratamiento de primeros auxilios para picaduras de arañas, picaduras de garrapatas y picaduras de escorpiones. Estos encuentros pueden ser alarmantes, pero conocer los pasos adecuados puede ayudar a garantizar una respuesta rápida y efectiva. Primero, sepa que millones de personas son mordidas o picadas cada año solo en los Estados Unidos. y la mayoría de estas son inofensivas. Queremos enfocarnos en el tratamiento generalizado y en qué observar en casos más graves. La prioridad siempre es la seguridad. Una vez que usted y la víctima estén a salvo, vea si hay una forma de identificar qué lo mordió o picó, ya que esto puede ayudar a identificar el tratamiento adecuado si es necesario. Dado que todas estas mordeduras o picaduras habrán perforado la piel, se recomienda siempre lavar suavemente con jabón y agua. Si se notan picaduras o signos o síntomas preocupantes, busque ayuda médica de inmediato. En ese caso, observe si hay decoloración o ampollas en la piel, náuseas, dolor abdominal, dificultad para respirar, cambio en la capacidad de respuesta, o dolor significativo. Si no hay preocupaciones inmediatas, aquí es cómo podemos manejar estos casos de manera independiente siempre y cuando no se noten síntomas preocupantes. Para las arañas: Si se encuentra en un área conocida por las arañas venenosas, aléjese del lugar para evitar más mordeduras. Es importante identificar la araña responsable de la mordedura. Luego, lávese con jabón suave y agua. Para reducir el dolor y la hinchazón, eleve la extremidad mordida y aplique una compresa fría o una bolsa de hielo envuelta en un paño delgado en el lugar de la mordedura. Déjelo actuar durante unos 10-15 minutos cada hora. Para mordeduras sospechosas o confirmadas de arañas venenosas como las viudas negras o las arañas reclusas pardas, es crucial buscar atención médica inmediata. Llame a los servicios de emergencia o diríjase al hospital más cercano. Ahora hablemos de las garrapatas. Si encuentra una garrapata adherida a su piel, retírela rápidamente ya que cuanto más tiempo estén adheridas, más probable es que transmitan enfermedades. Use unas pinzas de punta fina para agarrar la garrapata lo más cerca posible de la superficie de la piel. Tire de ella alejándola de la piel de manera constante y lenta con firmeza, evitando torcer o aplastar la garrapata. La piel se tensará y la garrapata finalmente se soltará. Limpie el área con agua y jabón suave. Si está preocupado por las enfermedades transmitidas por garrapatas, puede conservar la garrapata en un recipiente sellado o una bolsa de plástico. Esto puede ayudar a los profesionales de la salud a identificar la garrapata y determinar el riesgo de transmisión de enfermedades. Tenga en cuenta que si la cabeza se desprende y queda incrustada en la piel, esto es una llamada al profesional médico para pedir ayuda. Ahora hablemos de los escorpiones. Aléjese del área para prevenir más picaduras. Limpie el sitio de la picadura con jabón suave y agua, similar a las mordeduras de araña, y aplique una compresa fría o una bolsa de hielo envuelta en un paño en el sitio de la picadura para ayudar con el dolor. Aunque la mayoría de las picaduras de escorpión son inofensivas, buscar atención médica es esencial para estar seguro, ya que las especies venenosas pueden ser mortales para los humanos. Llame a los servicios de emergencia o diríjase el hospital más cercano inmediatamente. Recuerde, la prevención es clave, así que tome precauciones revisando su ropa y vistiendo la indumentaria adecuada siempre que estas criaturas sean comunes. Mantenga la calma y siga estos pasos si se encuentra con una mordedura o picadura. Y siempre busque ayuda médica profesional cuando sea necesario. https://d3imrogdy81qei.cloudfront.net/video_images/11616/picaduras-de-escorpiones-garrapatas-y-aranas.jpg Yes 211 https://www.procpr.org/es/training/bls-first-aid/video/ataque-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2019.mp4 Accidente cerebrovascular Hay dos tipos principales de apoplejía. El más común es cuando un coágulo bloquea una arteria que lleva la sangre al cerebro. Esto es causado por una Trombosis Cerebral o Embolia Cerebral. El segundo golpe más común es un sangrado. Esto es cuando un vaso sanguíneo se rompe en el cerebro, también llamado derrame hemorrágico. Los primeros signos de un derrame cerebral son entumecimiento, dificultad para hablar, debilidad, parálisis en un lado del cuerpo, visión borrosa o pérdida repentina de la visión, brazo o pierna caídos, caída de la cara o boca que gotea, inestabilidad, confusión hablando o entendiendo el habla. https://d3imrogdy81qei.cloudfront.net/video_images/3599/stroke-2015.jpg Yes 409 https://www.procpr.org/es/training/bls-first-aid/video/ataques-cardiacos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2018.mp4 Ataques cardiacos Es importante reconocer el problema antes de que el corazón se detenga. Usted puede notar signos y síntomas como sudoración, dificultad para respirar, dolor en el pecho y náuseas. Lo mejor que puedes hacer es prevenir un ataque al corazón. La enfermedad cardiovascular es el asesino número uno en América y es lo que conduce a ataques al corazón. Puede prevenir enfermedades cardiovasculares con una dieta saludable, ejercicio regular, controlar el estrés, controlar la diabetes, controlar la presión arterial alta y dejar de fumar. Si cree que alguien está teniendo un ataque al corazón, llame al 911 inmediatamente. Es importante sentarle y tranquilizarlo para reducir su nivel de ansiedad hasta que llegue la ayuda. https://d3imrogdy81qei.cloudfront.net/video_images/3597/heart-attacks-2015.jpg Yes 477 https://www.procpr.org/es/training/bls-first-aid/video/cinco-temores-parte-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2017.mp4 Los cinco temores La mayoría de las personas son muy reacias a involucrarse en proveer CPR y Primeros Auxilios. La razón principal de esta reticencia es el miedo. La gente tiende a tener cinco temores relacionados con el rescate. 1. Demandas judiciales: No tengas miedo de intentar salvar una vida que necesite ahorrar debido al temor de ser demandado. Cada estado tiene leyes del Buen Samaritano que le protegen de la responsabilidad cuando usted voluntariamente proporciona ayuda de emergencia a otro individuo. No se puede herir a alguien que ya está en peligro de morir haciendo algo para salvar sus vidas. 2. No está seguro de las habilidades: Entender que la RCP sólo ralentiza el progreso de la muerte clínica a la muerte biológica, pero no lo detendrá! Sabemos que cualquier combinación de números durante las respiraciones de rescate a las compresiones ayudará a ganar tiempo para que el EMS use un AED y ACLS para administrar medicamentos. Los números son pautas, no la regla. (Lo cual es parte de la razón por la cual la RCP de manos únicas se ha convertido en una alternativa tan popular para rescatar la respiración). 3. Puede herir o matar al paciente: Esto va de la mano con el número dos. La persona ya está muerta. ¿Cuánto peor puede hacer el paciente físicamente? Incluso la Reanimación Cardiopulmonar es mejor que no hacer nada. Sólo ayudará a la persona a hacer algo en lugar de nada. 4. Enfermedad: Este temor ha existido desde hace algún tiempo y se puede resolver ordenando un anillo de llave u otro escudo accesible de RCP y guantes protectores. De esta forma, siempre estás preparado para las peores circunstancias. La RCP con manos solamente puede ser una buena alternativa si no tiene equipo de protección personal o si no se siente cómodo dando respiraciones de rescate. 5. Escena Insegura: El único temor que los rescatistas deben tener miedo es el miedo de una escena insegura. No te conviertas en otro paciente. Asegúrese de que, si va a entrar en un área para rescatar a alguien, que el área circundante es lo suficientemente seguro para que no se convierta en otra víctima. https://d3imrogdy81qei.cloudfront.net/video_images/3595/five-fears-part-1-2015.jpg Yes 308 https://www.procpr.org/es/training/bls-first-aid/video/precauciones-universales-lugar-de-trabajo-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2020.mp4 Precauciones universales en el lugar de trabajo Siga las Precauciones Estándar. Al igual que las Precauciones Universales que incluyen la identificación de sangre y algunos fluidos corporales como el potencial de contener patógenos transmitidos por la sangre, las Precauciones Estándar significan tratar toda la sangre, fluidos corporales, piel intacta (como abrasiones, espinillas o llagas abiertas) (Dentro de los ojos, la boca, la nariz) como si pudieran llevar patógenos transmitidos por la sangre y enfermedades infecciosas. Esto incluye prácticas seguras de inyección, manipulación segura de equipo o superficies potencialmente contaminadas en el ambiente del paciente y etiqueta respiratoria o de tos. La clave es eliminar la exposición a toda la sangre, fluidos corporales y otros materiales potencialmente infecciosos. https://d3imrogdy81qei.cloudfront.net/video_images/3601/reduce-risk-of-bloodborne-pathogens-2015.jpg Yes 338 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-agonica-no-respirar-normalmente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2022.mp4 Respiración agónica (no respirar normalmente) Un signo de parada cardiaca se describe como respiración agonal. Esto ocurre cuando una persona está haciendo un jadeo o tragarse el movimiento y no está respirando normalmente. La respiración agónica ocurre en el 40% de los paros cardiacos tempranos. Saber cuándo una persona es respiratoria agonal puede prevenir intentos agresivos de RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3603/agonal-respiration-not-breathing-normally-2015.jpg Yes 92 https://www.procpr.org/es/training/bls-first-aid/video/rcp-solo-manos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2029.mp4 RCP solo con manos La RCP de manos únicas ayuda a alentar a los rescatistas a involucrarse que de otra manera no podrían ayudar. Los equipos de rescate entregan compresiones de 2-2.4 pulgadas de profundidad a una velocidad de 100-120 compresiones por minuto sin la necesidad de entregar respiraciones de rescate en el medio. La RCP con manos únicas elimina el temor de transmitir enfermedades al eliminar el componente boca a boca de la RCP. https://d3imrogdy81qei.cloudfront.net/video_images/3617/hands-only-cpr-2015.jpg Yes 199 https://www.procpr.org/es/training/bls-first-aid/video/cuando-rcp-no-funciona-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2041.mp4 Cuando la RCP no funciona La RCP es un intento de compensar la circulación en el corazón que no está sucediendo normalmente. La RCP no detiene el proceso de morir; Simplemente disminuye la muerte celular biológica. La esperanza es que este procedimiento puede comprar tiempo para que el ccsme llegue a probar otros métodos de restaurar la circulación apropiada de la sangre oxigenada por todo el cuerpo para comprar aún más tiempo de modo que la razón subyacente por la cual la persona entró en paro cardiaco en el primer lugar puede ser Explorado Si la RCP no funciona, recuerde que le dio a esa persona la mejor oportunidad de sobrevivir. https://d3imrogdy81qei.cloudfront.net/video_images/3641/preview.png Yes 632 https://www.procpr.org/es/training/bls-first-aid/video/conmocion-cerebral-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2038.mp4 Conmoción cerebral https://d3imrogdy81qei.cloudfront.net/video_images/3635/concussion-2015.jpg Yes 190 https://www.procpr.org/es/training/bls-first-aid/video/valoracion-secundaria-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2051.mp4 Valoración secundaria https://d3imrogdy81qei.cloudfront.net/video_images/3661/secondary-survey-2015.jpg Yes 169 https://www.procpr.org/es/training/bls-first-aid/video/conclusion-rcp-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2039.mp4 Conclusión ¡Felicitaciones por completar su programa ProTrainings! Ahora usted está listo para tomar su prueba. Vea este video para obtener más información sobre nuestros servicios de soporte adicionales y productos diseñados pensando en usted. https://d3imrogdy81qei.cloudfront.net/video_images/3637/conclusion-2015.jpg Yes 87 https://www.procpr.org/es/training/bls-first-aid/video/como-acceder-sem-con-tecnologia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2040.mp4 Cómo acceder a los SEM mediante la tecnología Cuando intente acceder a Servicios de Medicina de Emergencia a través del 911, aquí hay algunas cosas a considerar. La mensajería de texto es una buena manera de ponerse en contacto con el servicio de mensajería instantánea (EMS) cuando se encuentra en un área alta o tiene problemas de audición; Sin embargo, tenga en cuenta que no está disponible en todas partes. La forma preferida de acceder a EMS es marcar 911 a través de un teléfono celular. La ubicación de un teléfono fijo debe ser precisa para que la operadora sepa de dónde está llamando. https://d3imrogdy81qei.cloudfront.net/video_images/3639/how-to-access-ems-through-technology-2015.jpg Yes 269 https://www.procpr.org/es/training/bls-first-aid/video/agentes-hemostaticos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2049.mp4 Agentes hemostáticos https://d3imrogdy81qei.cloudfront.net/video_images/3657/hemostatic-agents-2015.jpg Yes 105 https://www.procpr.org/es/training/bls-first-aid/video/mecanismo-lesion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2050.mp4 Mecanismo de lesión https://d3imrogdy81qei.cloudfront.net/video_images/3659/mechanism-of-injury-2015.jpg Yes 226 https://www.procpr.org/es/training/bls-first-aid/video/torniquetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2048.mp4 Cómo aplicar un torniquete https://d3imrogdy81qei.cloudfront.net/video_images/3655/tourniquets-2015.jpg Yes 363 https://www.procpr.org/es/training/bls-first-aid/video/amputacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2047.mp4 Amputación https://d3imrogdy81qei.cloudfront.net/video_images/3653/amputation-2015.jpg Yes 463 https://www.procpr.org/es/training/bls-first-aid/video/introduccion-avanzada-primeros-auxilios-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2071.mp4 Introducción a primeros auxilios avanzados https://d3imrogdy81qei.cloudfront.net/video_images/3701/first-aid-advanced-intro-2015.jpg Yes 49 https://www.procpr.org/es/training/bls-first-aid/video/svb-bls-neonatal-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2080.mp4 Soporte vital básico (BLS) neonatal Aunque la reanimación neonatal no es necesariamente parte del programa normal de BLS (Soporte Vital Básico), creemos que es importante que aquellos que tienen un bebé de menos de un mes o aquellos que trabajan con neonatos, comprendan la diferenciación entre la RCP infantil o del bebé y la reanimación neonatal. https://d3imrogdy81qei.cloudfront.net/video_images/3719/neonatal-bls-2015.jpg Yes 376 https://www.procpr.org/es/training/bls-first-aid/video/asma-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2062.mp4 Asma https://d3imrogdy81qei.cloudfront.net/video_images/3683/asthma-2015.jpg Yes 264 https://www.procpr.org/es/training/bls-first-aid/video/posicion-lateral-seguridad-recuperacion-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2063.mp4 Posición lateral de seguridad https://d3imrogdy81qei.cloudfront.net/video_images/3685/recovery-position-2015.jpg Yes 227 https://www.procpr.org/es/training/bls-first-aid/video/emergencias-relacionadas-calor-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2064.mp4 Emergencias relacionadas con el calor https://d3imrogdy81qei.cloudfront.net/video_images/3687/heat-cold-emergencies-2015.jpg Yes 220 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-rescate-bebe-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2074.mp4 Respiración de rescate en bebés https://d3imrogdy81qei.cloudfront.net/video_images/3707/infant-rescue-breathing-2015.jpg Yes 132 https://www.procpr.org/es/training/bls-first-aid/video/sobredosis-opioides-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2075.mp4 Sobredosis de opioides https://d3imrogdy81qei.cloudfront.net/video_images/3709/opioid-overdose-2015.jpg Yes 290 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-adulto-inconsciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2091.mp4 Asfixia en adulto inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/3741/unconscious-adult-choking-2015.jpg Yes 216 https://www.procpr.org/es/training/bls-first-aid/video/rcp-ninos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2077.mp4 RCP en niños https://d3imrogdy81qei.cloudfront.net/video_images/3713/child-cpr-2015.jpg Yes 112 https://www.procpr.org/es/training/bls-first-aid/video/rcp-adultos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2076.mp4 RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3711/adult-cpr-2015.jpg Yes 243 https://www.procpr.org/es/training/bls-first-aid/video/es-control-hemorragia-sangrado-arterial https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2094.mp4 Sangrado arterial https://d3imrogdy81qei.cloudfront.net/video_images/3747/bleeding-control-arterial-bleeding-2015.jpg Yes 300 https://www.procpr.org/es/training/bls-first-aid/video/abordaje-en-equipo-rcp-adulto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2090.mp4 Abordaje en equipo para RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3739/adult-cpr-team-approach-2015.jpg Yes 448 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-rescate-ninos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2073.mp4 Respiración de rescate en niños https://d3imrogdy81qei.cloudfront.net/video_images/3705/child-rescue-breathing-2015.jpg Yes 153 https://www.procpr.org/es/training/bls-first-aid/video/control-hemorragia-sangrado-venoso https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2095.mp4 Sangrado venoso https://d3imrogdy81qei.cloudfront.net/video_images/3749/bleeding-control-venous-bleeding-2015.jpg Yes 214 https://www.procpr.org/es/training/bls-first-aid/video/hogar-a-prueba-ninos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2068.mp4 Hogar a prueba de niños https://d3imrogdy81qei.cloudfront.net/video_images/3695/child-proofing-the-home-2015.jpg Yes 140 https://www.procpr.org/es/training/bls-first-aid/video/rcp-adultos-2-rescatistas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2086.mp4 RCP en adultos 2 rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3731/adult-cpr-2-rescuer-2015.jpg Yes 237 https://www.procpr.org/es/training/bls-first-aid/video/rcp-ninos-2-rescatistas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2087.mp4 RCP en niños 2 rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3733/child-cpr-2-rescuer-2015.jpg Yes 229 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-nino-inconsciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2092.mp4 Asfixia en niño inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/3743/unconscious-child-choking-2015.jpg Yes 180 https://www.procpr.org/es/training/bls-first-aid/video/seguirdad-piscina-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2069.mp4 Seguridad en la piscina https://d3imrogdy81qei.cloudfront.net/video_images/3697/pool-safety-2015.jpg Yes 340 https://www.procpr.org/es/training/bls-first-aid/video/abuso-infantil-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2070.mp4 Abuso y abandono infantil https://d3imrogdy81qei.cloudfront.net/video_images/3699/child-abuse-2015.jpg Yes 896 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-rescate-adultos-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2072.mp4 Respiración de rescate en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3703/adult-rescue-breathing-2015.jpg Yes 144 https://www.procpr.org/es/training/bls-first-aid/video/bolsa-valvula-mascarilla-adulto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2085.mp4 Ventilación con bolsa válvula mascarilla https://d3imrogdy81qei.cloudfront.net/video_images/3729/adult-bag-valve-mask-2015.jpg Yes 415 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-rescate-adultos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2121.mp4 Práctica: Respiración de rescate en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3801/adult-rescue-breathing-practice-2015.jpg Yes 82 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-rescate-ninos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2122.mp4 Práctica: Respiración de rescate en niños https://d3imrogdy81qei.cloudfront.net/video_images/3803/child-rescue-breathing-practice-2015.jpg Yes 64 https://www.procpr.org/es/training/bls-first-aid/video/respiracion-rescate-bebe-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2123.mp4 Práctica: Respiración de rescate en bebés https://d3imrogdy81qei.cloudfront.net/video_images/3805/infant-rescue-breathing-practice-2015.jpg Yes 68 https://www.procpr.org/es/training/bls-first-aid/video/rcp-solo-manos-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2114.mp4 Práctica: RCP solo con manos Al hacer las manos solamente o la compresión solamente RCP, usted no hace la respiración del ciclo. Simplemente continúe las compresiones torácicas hasta que llegue el ccsme. Aprenda esta habilidad viendo el procedimiento ser realizado en un maniquí. https://d3imrogdy81qei.cloudfront.net/video_images/3787/hands-only-cpr-practice-2015.jpg Yes 85 https://www.procpr.org/es/training/bls-first-aid/video/rcp-adulto-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2124.mp4 Práctica: RCP en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3807/adult-cpr-practice-2015.jpg Yes 92 https://www.procpr.org/es/training/bls-first-aid/video/dea-dos-personas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2130.mp4 Práctica: DEA dos personas https://d3imrogdy81qei.cloudfront.net/video_images/3819/two-person-aed-practice-2015.jpg Yes 247 https://www.procpr.org/es/training/bls-first-aid/video/rcp-adultos-dos-rescatistas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2131.mp4 Práctica: RCP en adultos dos rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3821/adult-cpr-two-rescuer-practice-2015.jpg Yes 188 https://www.procpr.org/es/training/bls-first-aid/video/rcp-ninos-dos-rescatistas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2132.mp4 Práctica: RCP en niños dos rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3823/child-cpr-two-rescuer-practice-2015.jpg Yes 141 https://www.procpr.org/es/training/bls-first-aid/video/rcp-bebes-dos-rescatistas-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2133.mp4 Práctica: RCP en bebés dos rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/3825/infant-cpr-two-rescuer-practice-2015.jpg Yes 148 https://www.procpr.org/es/training/bls-first-aid/video/convulsiones https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2101.mp4 Convulsiones https://d3imrogdy81qei.cloudfront.net/video_images/3761/seizure-2015.jpg Yes 246 https://www.procpr.org/es/training/bls-first-aid/video/como-usar-epipen https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2102.mp4 Cómo usar un Epipen https://d3imrogdy81qei.cloudfront.net/video_images/3763/how-to-use-an-epipen-2015.jpg Yes 140 https://www.procpr.org/es/training/bls-first-aid/video/rcp-nino-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2125.mp4 Práctica: RCP en niños https://d3imrogdy81qei.cloudfront.net/video_images/3809/child-cpr-practice-2015.jpg Yes 104 https://www.procpr.org/es/training/bls-first-aid/video/dea-adulto-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2127.mp4 Práctica: DEA en adultos https://d3imrogdy81qei.cloudfront.net/video_images/3813/adult-aed-practice-2015.jpg Yes 240 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-adulto-inconsciente-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2135.mp4 Práctica: Asfixia en adulto inconsciente (asistencia médica) https://d3imrogdy81qei.cloudfront.net/video_images/3829/unconscious-adult-choking-practice-2015.jpg Yes 102 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-nino-inconsciente-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2136.mp4 Práctica: Asfixia en niño inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/3831/unconscious-child-choking-practice-2015.jpg Yes 97 https://www.procpr.org/es/training/bls-first-aid/video/desvanecimiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2056.mp4 Desvanecimiento https://d3imrogdy81qei.cloudfront.net/video_images/3671/fainting-2015.jpg Yes 234 https://www.procpr.org/es/training/bls-first-aid/video/mordeduras-animales-y-humanos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2370.mp4 Mordeduras de animales y humanos https://d3imrogdy81qei.cloudfront.net/video_images/4229/animal-and-human-bites.jpg Yes 249 https://www.procpr.org/es/training/bls-first-aid/video/lesiones-del-oido https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6488.mp4 Lesiones del oído https://d3imrogdy81qei.cloudfront.net/video_images/11620/treating-ear-injuries.jpg Yes 150 https://www.procpr.org/es/training/bls-first-aid/video/reversa-auto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2067.mp4 Reversa / marcha atrás en auto https://d3imrogdy81qei.cloudfront.net/video_images/3693/car-backing-2015.jpg Yes 110 https://www.procpr.org/es/training/bls-first-aid/video/lesiones-dentales-y-bucales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6489.mp4 Lesiones dentales y bucales https://d3imrogdy81qei.cloudfront.net/video_images/11622/dental-and-oral-injuries.jpg Yes 176 https://www.procpr.org/es/training/bls-first-aid/video/traumatismos-penetrantes https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6490.mp4 Traumatismos penetrantes https://d3imrogdy81qei.cloudfront.net/video_images/11624/penetrating-trauma.jpg Yes 222 https://www.procpr.org/es/training/bls-first-aid/video/lava-tus-manos https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/1234.mp4 Lavado de manos El lavado de manos es la técnica de control de infección más importante. Después de quitarse el equipo de protección personal, lávese siempre bien las manos frotándolas con un jabón antimicrobiano o usando un gel a base de alcohol. https://d3imrogdy81qei.cloudfront.net/video_images/2097/handwashing-2013.jpg Yes 182 https://www.procpr.org/es/training/bls-first-aid/video/reacciones-alergicas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2060.mp4 Reacciones alérgicas https://d3imrogdy81qei.cloudfront.net/video_images/3679/allergic-reactions-2015.jpg Yes 464 https://www.procpr.org/es/training/bls-first-aid/video/lesiones-musculoesqueleticas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2053.mp4 Lesiones musculoesqueléticas https://d3imrogdy81qei.cloudfront.net/video_images/3665/musculoskeletal-injuries-2015.jpg Yes 388 https://www.procpr.org/es/training/bls-first-aid/video/mordeduras-serpiente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2059.mp4 Mordeduras de serpiente https://d3imrogdy81qei.cloudfront.net/video_images/3677/snake-bites-2015.jpg Yes 185 https://www.procpr.org/es/training/bls-first-aid/video/dea-adulto-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2081.mp4 DEA para adultos Ahora vamos a cubrir DEA en un adulto con un único rescatista para el profesional de la salud. https://d3imrogdy81qei.cloudfront.net/video_images/3721/adult-aed-2015.jpg Yes 353 https://www.procpr.org/es/training/bls-first-aid/video/hemorragias-nasales https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/6487.mp4 Hemorragias nasales https://d3imrogdy81qei.cloudfront.net/video_images/11618/nosebleeds.jpg Yes 188 https://www.procpr.org/es/training/bls-first-aid/video/cadena-de-supervivencia-cardiaca https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7171.mp4 Cadena de supervivencia cardiaca https://d3imrogdy81qei.cloudfront.net/video_images/13002/cardiac-chain-of-survival-2025.jpg Yes 128 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-adulto-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7179.mp4 Asfixia en adulto consciente https://d3imrogdy81qei.cloudfront.net/video_images/13018/conscious-adult-choking-2025.jpg Yes 350 https://www.procpr.org/es/training/bls-first-aid/video/rcp-bebes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7173.mp4 RCP en bebés https://d3imrogdy81qei.cloudfront.net/video_images/13006/infant-cpr-bls-2025.jpg Yes 204 https://www.procpr.org/es/training/bls-first-aid/video/rcp-bebes-2-rescatistas-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7175.mp4 RCP en bebés 2 rescatistas https://d3imrogdy81qei.cloudfront.net/video_images/13010/infant-cpr-2-rescuer-bls-2025.jpg Yes 191 https://www.procpr.org/es/training/bls-first-aid/video/lesion-espinal-traccion-mandibular-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2084.mp4 Lesión espinal - tracción mandibular Tenemos una persona aquí que parece que se cayó por las escaleras. No había espectadores alrededor para darnos un testimonio ocular de qué pasó exactamente. No sabemos si se golpeó la cabeza, no sabemos cuántos escalones cayó, lo que sí sabemos es que está tendido en la base de una serie de escalones, un tramo de escalera y parece estar dolorido. Lo que vamos a hacer es intentar minimizar el movimiento del paciente a medida que comenzamos a averiguar más sobre lo que pudo haber ocurrido y qué está pasando. Recuerda, el objetivo de hacerlo es para averiguar si necesitamos llamar al 911 y obtener ayuda en camino o si esta persona está lo suficientemente bien para poder volver a la vida normal y simplemente salir de ello. https://d3imrogdy81qei.cloudfront.net/video_images/3727/spinal-injury---jaw-thrust-2015.jpg Yes 386 https://www.procpr.org/es/training/bls-first-aid/video/puntos-de-referencia-bebes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7174.mp4 Puntos de referencia en lactantes (bebés) https://d3imrogdy81qei.cloudfront.net/video_images/13008/infant-landmarks-bls-2025.jpg Yes 195 https://www.procpr.org/es/training/bls-first-aid/video/dea-bebe-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7177.mp4 DEA para bebés https://d3imrogdy81qei.cloudfront.net/video_images/13014/infant-aed-bls-2025.jpg Yes 271 https://www.procpr.org/es/training/bls-first-aid/video/dea-2-personas-1-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7178.mp4 DEA - 2 personas https://d3imrogdy81qei.cloudfront.net/video_images/13016/2-person-aed-bls-2025.jpg Yes 295 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-nino-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7180.mp4 Asfixia en niño consciente https://d3imrogdy81qei.cloudfront.net/video_images/13020/conscious-child-choking-2025.jpg Yes 222 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-bebe-consciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7181.mp4 Asfixia en bebé consciente https://d3imrogdy81qei.cloudfront.net/video_images/13022/conscious-infant-choking-2025.jpg Yes 213 https://www.procpr.org/es/training/bls-first-aid/video/asfixia-bebe-inconsciente-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7183.mp4 Asfixia en bebé inconsciente https://d3imrogdy81qei.cloudfront.net/video_images/13026/unconscious-infant-choking-bls-2025.jpg Yes 238 https://www.procpr.org/es/training/bls-first-aid/video/quemaduras https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7187.mp4 Quemaduras https://d3imrogdy81qei.cloudfront.net/video_images/13034/burns-bls-2025.jpg Yes 345 https://www.procpr.org/es/training/bls-first-aid/video/conmocion-shock https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7185.mp4 Conmoción https://d3imrogdy81qei.cloudfront.net/video_images/13030/shock-bls-2025.jpg Yes 235 https://www.procpr.org/es/training/bls-first-aid/video/consideraciones-especiales-RCP-DEA-asfixia-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7191.mp4 Consideraciones especiales para la RCP, DEA, y asfixia https://d3imrogdy81qei.cloudfront.net/video_images/13042/special-considerations-for-cpr-aed--choking-2025.jpg Yes 621 https://www.procpr.org/es/training/bls-first-aid/video/emergencias-relacionadas-frio-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7188.mp4 Emergencias relacionadas con el frío https://d3imrogdy81qei.cloudfront.net/video_images/13036/cold-related-emergencies-2025.jpg Yes 339 https://www.procpr.org/es/training/bls-first-aid/video/control-envenenamiento-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7190.mp4 Control de envenenamiento https://d3imrogdy81qei.cloudfront.net/video_images/13040/poison-control-2025.jpg Yes 175 https://www.procpr.org/es/training/bls-first-aid/video/es-control-hemorragia-sangrado-capilar https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2096.mp4 Sangrado capilar https://d3imrogdy81qei.cloudfront.net/video_images/3751/bleeding-control-capillary-bleeding-2015.jpg Yes 235 https://www.procpr.org/es/training/bls-first-aid/video/lesiones-oculares-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7189.mp4 Lesiones oculares https://d3imrogdy81qei.cloudfront.net/video_images/13038/eye-injuries-2025.jpg Yes 230 https://www.procpr.org/es/training/bls-first-aid/video/lesiones-cabeza-cuello-espalda https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2098.mp4 Lesiones de cabeza, cuello y espalda https://d3imrogdy81qei.cloudfront.net/video_images/3755/head-neck-and-back-injuries-2015.jpg Yes 229 https://www.procpr.org/es/training/bls-first-aid/video/diabetes-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2100.mp4 Diabetes https://d3imrogdy81qei.cloudfront.net/video_images/3759/diabetes-2015.jpg Yes 500 https://www.procpr.org/es/training/bls-first-aid/video/dea-nino-practica https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/2128.mp4 Práctica: DEA en niños https://d3imrogdy81qei.cloudfront.net/video_images/3815/child-aed-practice-2015.jpg Yes 256 https://www.procpr.org/es/training/bls-first-aid/video/dea-nino-es https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7278.mp4 DEA para niños https://d3imrogdy81qei.cloudfront.net/video_images/13096/child-aed-bls-2025v2.jpg Yes 256 https://www.procpr.org/es/training/bls-first-aid/video/2025-guidelines-updates-bls-and-first-aid-ES https://d3imrogdy81qei.cloudfront.net/videos/course_videos/es/7287.mp4 Actualizaciones de las Guías 2025: Soporte Vital Básico y Primeros Auxilios https://d3imrogdy81qei.cloudfront.net/video_images/13116/2025-guidelines-updates-bls-and-first-aid.jpg Yes 472