Cardio Pulmonary Resuscitation (CPR)

CPR is a skills or technique used to compress the heart externally and breath to temporarily circulate oxygenated blood through the body of a person whose heart has stopped. CPR is early access in emergency situation, this is one of emergency medical services (EMS) action before ambulance or medical team arrive and defibrillator becomes available.

Cardio Pulmonary Resuscitation (CPR) Time Line :
- 0 - 4 minutes brain damage unlikely
- 4 - 6 minutes brain damage posssible
- 6 - 10 minutes brain damage probable
- over 10 minutes probable brain death.

CPR may be do not save the victim even you already performed properly, but if CPR started within 4 minutes of cardiac arrest & defibrillator available within 10 minutes we make a victim 40 % chance of survival. Clinical situation to perform CPR on victim with cardiac arrest cases we knew as clinical biological ( time 0-4-6) may we can safe the life, but up to 6 minutes may be we can but it may comes complication to the victim.

To learn about CPR you need to remember the A-B-C system. A (airway), B (breathing), C (Circulation). The most important step before doing CPR is call for help 9-1-1 (medical emergency staff or ambulance), this is depend on your country.

If you are alone with a victim, try to call for help as prior to perform CPR on adult and after a minute on a child. If there is someone with you, let him dial 911 immediatelly. Remember! don't leave the victim alone, don't try make the victim water, don't throw water on victim's face and don't prompt the victim into a sitting position.

CPR on Adult :

Cardio Pulmonary Resuscitation (CPR)

Check responsiveness, gently shake the victim by ask him "are you OK?" but if you think the victim suspect of spinal or neck injury, do not move or shake him.

Airway. Suppose the victim is unconsious and unresponsive make sure that his airway clear from any obstructions.

Breathing. Look, listen and feel to check whether the victim breathing or no. If no breathing, give him two full breaths and allow his lungs chance to relax between each breath

Circulation. Check on his carotid artery to determine his heart beating or no, suppose no pulse you will have perform chest compressions.

Chest Compressions, after 2 breaths giving no sign of normal breathing start chest compressions 30 times (3 compressions every 2 second). Do this cycles four times (30 compressions and 2 breaths)then observe the victim for pulse and sign of consiousness. If still there is no pulse, continue performing CPR action and checking his pulse every 4 cycles until EMS team arrives.

First Aid Kit

First aid kit is some medical's equipment supplies that use in giving first aid, particularly in a medical emergency services.

First Aid Kit
First aid kit items are use depend on situation may happened inside your home or others places (during traveling), such as Bactine (or other antiseptic), plasters, sterile dressings set (cotton & gauze), crepe bandages, scissors, alcohol swap, instant cold pack, gloves, eyewash solution, eye pads, breathing barrier (CPR face shield), mask, antihistamine cream, ect.

First Aid on Bite Wound

Bite wound cause by human, animal and insect may can make an infection. Dogs are more likely to bite than cats, but Cat bites are more likely to cause an infection. Bites from nonimmunized domestic animals and wild animals carry the risk of rabies, so it's necessary need a anti-rabies injection.

Insect bites if happened to the people with severe allergy to the insect's venom, it can be dangerous. Signs and symptoms of allergic reaction include swelling, redness or discoloration at the site of the bite, pain, itching, hives, decreased consciousness and difficult or noisy breathing.

Human bite sometimes more dangerous than others, because human saliva contains many bacteria may cause an infection. Anyhow, nursing interventions on the bite wound are you can see bellow :

Minor wounds, If the skin breaks and sure it's not danger for rabies. Wash the wound nicely, clean with soap and water. Apply an antibiotic ointment to prevent infection then cover the wound with a clean bandage and dressing frequently

Deep wounds, If the bite is deep as puncture wound and the skin is badly torn and bleeding, apply pressure with crepe bandage or clean and dry cloth to stop the bleeding and necessary see the doctor

Infection Wounds. If there is signs of infection such as swelling, redness, increased pain or oozing on the bite wound area, see your doctor immediately

Suspected rabies. Bites from nonimmunized animals may can cause the rabies, better to see the doctor immediately.

First Aid on Choking

First aid on choking really needed, because choking cuts off oxygen (O2)to the brain. Remember, if O2 is less or stop supplying to the brain more than 10 minutes probable can cause the victim death.

Choking occurs when a foreign body (food or small objects) becomes lodged in the throat or windpipe, blocking the flow of air. The person who get choking he will be panic, sudden inability to talk, gasp for breath, turn blue (Cyanosis, a blue coloring to the skin, can be seen earliest around the face, lips, and fingernail beds), and be unconscious. This is the reason why the victim needed quick first aid action to save his life.

The person can cough or speak, it's mean he or she is getting air. In an infant or baby when he get choking, attention must be paid to an infant's behavior (difficulty breathing and weak cry or weak cough or both) soon as possible give him first aid action.

First aid action on choking :

If choking is occurring and the person cannot cough or speak, begin to perform first aid action such as Heimlich maneuver (perform an abdominal thrust) immediately before calling 911 or local emergency number until the foreign body is expelled or the victim becomes unconscious.

If choking is happen to the pregnant or obese people, In theses case performing first aid with chest thrust may will help her.

If the airway clears and the person is still unresponsive, begin CPR as an emergency first aid procedure.

First Aid with Heimlich maneuver
Heimlich maneuver as the first aid action :
1. Choking occur when the person is sitting or standing

Stand behind the victim, Wrap your arms around the waist. Tip the person forward slightly.

Make a fist with one hand and place your fist, thumb side in, just below the person’s rib cage in the front

Grab your fist with your other hand. Press hard into the abdomen with four quick inward and upward thrusts such as if trying to lift the person up, repeat this several times until the obstructing object is coughed out.

2. First aid on the person lying down or unconscious

Straddle him or her and place the heel of your hand just above the waistline.

Place your other hand on top of this hand. Keeping your elbows straight, give four quick upward thrusts. Repeat until the blockage is dislodged.

What you will do if it is happen to you (choking) ? Place a fist slightly above your navel, grasp your fist with the other hand and bend over a hard surface (a countertop or chair) will do and shove your fist inward and upward.

First Aid on Choking
Heimlich Maneuver on an Infant :

Place the infant face down across your forearm, and support the infant’s head with your hand. Give four forceful blows to the back with the heel of your hand, repeat this action until the obstructing object is coughed out.

If still does not help, turn the baby over. With two fingers one finger width below an imaginary line connecting the nipples, give four forceful thrusts to the chest to a depth of 1 inch.

Success with the first aid action, it's mean you save a life.

First Aid on Bruises

What is definition of bruises? A bruise is an area of skin discoloration caused by blood seeping under the skin after small blood vessels near the surface of the skin have been broken.

Bruises are usually caused by bumping into hard objects, banging yourself against something or being hit (falling) off something. The main sign and symptoms are pain, tenderness, change in colour of the skin (red, purple of black) and swelling.

There are three types of bruises:
1. Subcutaneous bruise (beneath the skin)
2. Intramuscular bruise (within the belly of the underlying muscle)
3. Periosteal bruise (bone bruise)

Bruises
Most bruises are will get better and healing on their own over a period of about ten days, but if a bruise result caused by an injury on the lower back, and blood is present in the urine, Get help immediately to the doctor or medical services center (hospital or polyclinic). This could indicate injury to the kidneys or other organs.

First aid on bruises treatment you can remember as R.I.C.E

R : Rest the injured part, do not overworking your muscles in bruise area.

I : Ice or cold pack on the bruise to reduce the swelling also relieve the pain for 30 to 60 minutes at a time for a day or two after the injury.

C : Compression bandaging, Wrap a bandage firmly round the bruise area, but not too tight.

E : Elevate the injured area, Keep the bruised area raised above the heart to helps keep blood from pooling in the bruised tissue.

Bruises case most often in the patients with platelet or coagulation disorders. If you find unexplained bruising, It's may be a warning sign of child abuse or serious medical problems, such as leukemia and meningoccocal infection. This is should be evaluated by a doctor. Deficiency of Vitamin C also will make a person more susceptible to bruises from impacts.

First aid on Cuts & Scrapes

Cuts and scrapes it's can be happen when someone doing his work. Small cuts and scrapes are often viewed as part of childhood and growing up.

Cuts may result slice the skin open, but scrapes will hurt you only on the top part of skin. Scrapes also can hurt more than cuts, but they heal quicker. You can treat most cuts and scrapes if it is as minor wound and don't require a trip to the emergency room. But you should get emergency care if you are bleeding a lot, or if you are hurt very badly.

The first and possibly most important step when treating minor cuts and scrapes is to thoroughly clean the wound with mild anti-bacterial soap and water being careful to remove any foreign material, such as dirt or bits of grass, that might be in the wound to avoid infection or other complications.

If cuts and scrapes happened to the people who have diabetes, other long-term illnesses such as cancer, or are taking drugs that suppress the immune system such as steroids (cortisone medications like prednisone and prednisolone) or chemotherapy, are more likely to develop a wound infection and should be seen by a health care professional.

These are guidelines may can help you to do the first aid action on the minor cuts and scrapes wound :

Calm the victim and let him/her know you can help

Stop the bleeding, apply pressure with a clean cloth or bandage for several minutes. If the blood spurts or continues to flow after continuous pressure, seek medical assistance

Wash your hands thoroughly

Wash the cut or scrape area with soap and water, but do not scrub the wound. Remove any dirt particles from that area and let the water from the faucet run over it for several minutes, If dirt or debris remains in the wound after washing, use tweezers cleaned with alcohol to remove the particles

Apply an antiseptic lotion or cream such as Neosporin or Polysporin to help keep the surface moist

Cover the area with an adhesive bandage or gauze pad. Bandages can help keep the wound clean and keep harmful bacteria out, but after the wound has healed enough to make infection unlikely, exposure to the air will speed wound healing

Change the dressing at least daily or whenever it becomes wet or dirty

See your doctor if the wound isn't healing or you notice any redness, drainage, warmth or swelling (signs of infection)

First Aid on Electric Shock

First Aid on Electric Shock is an emergency medical services (EMS) that very important action to help the victim come out from serios problem. Learn about basic life support (LBS) like CPR procedure was usefull in this situation in which electrical shocks can stop a person's breathing, heart failure or unconsciousness, and also cause burns.

What should you do if someone gets shocked?
- Make sure for your self don't become the next casualty, If the victim is still touching a live electrical source, turn off the power to the source, or break the victim's contact with it by using a non-conductive object (wooden broom handles are commonly used)
- Call for help (ambulance or emergency medical services (EMS) team)
- Check for breathing and pulse, if the victim is not breathing, immediately begin mouth-to-mouth and if there is no pulse, as soon as start CPR procedure.
- Check his body, may be have sustained burns.
- If the victim does not appear serious injury but he looks pale and faint, it is mean may be he going into shock condition. Lay him down with his head slightly lower then his chest and make his feet elevated.
- Unconsciousness condition, no breathing and no pulse needed to do CPR for the basic life support till emergency medical services (EMS) team arrive.

First Aid on Fracture

First Aid on Fracture. Fracture is a break in the bone, generally caused by trauma, twisting, or weakened bone structure due to disease. There are two types of fractures, simple fracture (no wound around the fractured area) and compound fracture (underlying skin has been broken or damaged).

First aid action on these case are control of bleeding, care for shock, splint affected area to prevent further movement (without causing further pain to victim) and cold packs may help reduce pain and swelling.


How to do first aid action on broken bone caused by a major trauma or injury? Call the emergency medical services (EMS) or ambulance. When the victim is unresponsive, you need to check his breathing and heartbeat. Begin cardiopulmonary resuscitation (CPR) for the first aid action if there's no respiration or heartbeat until emergency personnel arrive.

First Aid on Puncture Wound

First Aid on Puncture Wound (small hole in the skin that may caused by an object piercing the skin, it can be on the surface of skin or may be deep in which depending on the source and cause).

Ussualy the wounds close fairly quickly on their own and does not result in excessive bleeding, but these wound can be dangerous case. A puncture wound also need a first aid treatment to prevent infection or tetanus.

First aid action on the puncture wound are :
- Stop bleeding by apply gentle pressure with a clean cloth or bandage. If the blood spurts or continues to flow after several minutes of pressure, call emergency medical services (EMS) team or ambulance.
- Check the wound, during the first aid action see that nothing is left from the object (may be a piece is missing and stuck in the wound).

- Clean the wound using clear water. If larger debris still remains more deeply embedded in the wound, see your doctor.

- Apply an antibiotic on the wound area (Neosporin, Polysporin) to discourage infection. Cover the wound with bandages to keep the wound clean and keep harmful bacteria out, try to do the dressing regularly.

- Monitor about signs of infection. See the doctor if the wound doesn't heal or if you notice any redness, drainage, warmth or swelling.

- If the puncture is deep, on the foot, dirty or contaminated object and the victim haven't had a tetanus injection within five years, the doctor may recommend a booster within 48 hours of the injury. Puncture is result of an animal (stray dog or a wild animal) or human bite, antibiotics is needed and suggest initiation of a rabies vaccination series.

First Aid on Heart Attack

Heart attacks are among the leading cause of death in the world. A heart attack occurs when one or more of the blood vessels that supply blood to the heart become blocked. The heart muscle becomes starved for oxygen and begins to die.

Heart attack symptoms which most often in adults may include:

Chest pain. The most significant sign of a heart attack is chest pain. Usually in the center of chest for a more than a few minutes or comes and goes, but some time pain may be felt in other areas of the upper body, such as the jaw, shoulder, one or both arms, back, and stomach area Pain May feel like pressure, squeezing, fullness.

Shortness of breath. The victim may felt difficult to breath.

Others symptom are cold sweat, nausea, lightheadedness.

What should you do if someone has a heart attack?
If someone has a cardiac arrest or heart attack, there are only a few minutes to act before it is too late. It is vital to know what to do beforehand as your first aid action.
Bellow are some of steps that you should do if you now the victim has a cardiac arrest or heart attack :
1. Comfort & reassure the victim. Have the person sit down, rest, and try to keep calm.
2. Loosen any tight clothing.
3. Ask if the person takes any chest pain medication for a known heart condition.
4. Help the person take the medication (usually nitroglycerin, which is placed under the tongue) to reduce chest pain when heart attack occur.
5. Call emergency medical help quickly if the pain does not go away promptly with rest or within 3 minutes of taking nitroglycerin.
6. If the person is unconscious and unresponsive, call 911 (or your local emergency number), then begin CPR.
7. If an infant or child is unconscious and unresponsive, perform 1 minute of CPR, then call 911.

All of us can reduce the risk of heart attack, Adults should take steps to control heart disease risk factors whenever possible. Controlling high blood pressure, limiting cholesterol in the diet, watching weight, exercising, giving up smoking and minimizing stress.

First Aid Action on Shock

What is shock in medical condition? Shock is a serious medical condition in which the body is not getting enough blood flow, So The tissue perfusion became insufficient to meet demand for oxygen and nutrients.

Treatment for shock in first aid condition are can be manage by acronim WARTS (W: Warmth A: ABC's (Airway, Breathing, Circulation or CPR) R: Rest and reassurance T: Treatment (treat the cause of shock) S: Semi-prone position, which is the same thing as recovery position).


First aid treatment of shock includes:
1. Immediately to give comfort position to the victims if they are conscious.
2. If you are alone, call for help. If not, send someone to call for help and have someone stay with the victim.
3. Ensure airway patency and assess breathing. If possible, place victim in the recovery position.
4. Apply direct pressure to the wound if there is any bleeding.
5. Cover him with a blanket or jacket, but not too thick to cause vasodilation.
6. Do not give him a drink; moisten his lips if requested.
7. If you notice the legs are uninjured, elevate them 20–30 cm (Trendelenburg position).
8. Reassure the victim, as they will be very anxious, frightened and possibly nauseated.
9. Prepare for cardiopulmonary resuscitation (CPR).
10.Once you've cared for the patient's immediate needs, gather a focused history: "What happened?" "Do you have medical problems?" "Do you take any medications?" "Do you have any allergies to medications?" Record this information if possible. The patient may lose consciousness, and this potentially valuable information may be lost.
11.Provide the gathered information to the ambulance personnel when they arrive.

The management of shock requires immediate intervention, even before a diagnosis is made. Re-establishing perfusion to the organs is the primary goal through restoring and maintaining the blood circulating volume ensuring oxygenation and blood pressure are adequate, achieving and maintaining effective cardiac function, and preventing complications

First Aid on Head Injury

Head injury is a trauma that leads to the head (injury of the scalp, skull, or brain). These cases are really needed quick action (first aid) to perform basic life support and save the victim's life.

Head injury most common cause by traffic accidents, falls, physical assault, and accidents at home, work, outdoors, or while playing sports.

Head injuries may result a minor bump on the skull to serious brain injury, So it is extremely important to pay close attention to the following symptom :
- Lost of consciousness
- Abnormal breathing (interruption of breathing)
- Bleeding or clear fluid from the nose, ear, or mouth
- Vomiting more than two to three times

If you find the victim of head injury with any symptom above, it's mean the victim having seriouse head trauma and will require profesional medical attention as the first aid action. Call 911 (ambulance) or emergency medical services (EMS) immediatelly.

Before the EMS team arrives, do the first aid action bellow :
- Stop any bleeding by firmly pressing a clean cloth on the wound
- Check the person's airway, breathing, and circulation. If necessary, begin rescue breathing and CPR.
- If possible, place the victim in a dim (quite area), but if the injury is serious, be careful not to move the person's head
- Do not leave the victim unattened
- If the person is vomiting, roll the head, neck, and body as one unit to prevent choking.
- Do not apply direct pressure to the wound area if there is suspect fractur of skull