Updates on first aid
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The 2010 guidelines from the American Heart Association and American Red Cross shift CPR protocol from A-B-C to C-A-B to reduce delays in treatment, emphasizing early and effective chest compressions. Key first aid recommendations include immediate use of aspirin for suspected cardiac events, avoiding oral intake for poisonings unless directed, and prioritizing direct pressure to control bleeding. Furthermore, specific treatment protocols are provided for jellyfish stings, advocating for vinegar wash and hot water immersion for pain relief and venom deactivation.
Updates on first aid
- 1. American Heart Association and American Red Cross Guidelines 2010 K S Chew School of Medical Sciences Universiti Sains Malaysia First Aid Updates
- 2. Why Change From A-B-C to C-A-B? Minimize delay (30 compressions should be accomplished in approx 18 seconds) The A-B-C sequence starts with the most difficult steps! (impediment to initiate CPR)
- 3. BLS Algorithm “ Look, listen, and feel for breathing” has been removed from algorithm. After delivery of 30 compressions, the rescuer opens the victim’s airway and delivers 2 breaths.
- 4. Positioning of Victim As a general rule a victim should not be moved The indications to move the victim include If the area is unsafe for the rescuer or victim If the victim is face down and is unresponsive If the victim has difficulty breathing because of copious secretions or vomiting If the victim shows evidence of shock
- 5. Chest Discomfort Assume all chest discomfort is cardiac origin until proven otherwise. The most important intervention is to CALL FOR THE EMS or AMBULANCE. Call EMS rather than drive themselves to hospital
- 6. Chest Discomfort While waiting for the EMS arrival, encourage victim to take a tablet of crushed aspirin provided the patient has no allergy to aspirin or contraindication such as bleeding tendencies, recent bleeding, or a stroke.
- 7. Aspirin ISIS-2 study clearly established the beneficial effects of aspirin within the first 24 hours to reduce mortality in patients with acute MI. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction. Lancet. 1988;2:349–360 Early pre-hospital administration of aspirin reduces mortality in acute MI
- 8. Poisoning Do not administer anything by mouth for any poison ingestion unless advised to do so by the Poison Center (Note: In Malaysia, the National Poison Center is located in Universiti Sains Malaysia Penang. Tel: +604-657 2924) There is insufficient evidence that dilution of the ingested poison with water or milk is of any benefit as a first aid measure.
- 9. Poisoning Do not administer activated charcoal to a victim who has ingested a poisonous substance unless you are advised to. There is insufficient evidence to recommend for or against the administration of activated charcoal in first aid setting although 2 small studies suggest that it may be safe to administer.
- 10. Bleeding Control Best controlled by applying pressure until bleeding stops Amount of pressure applied and the time the pressure is held are the most important factors affecting successful control of bleeding.
- 11. Bleeding Control Elevation and use of pressure points are no longer recommended to control bleeding. Why? hemostatic effect of elevation has not been studied no effect on distal pulses was found these unproven procedures may compromise the proven intervention of direct pressure
- 12. Wounds Superficial wounds and abrasions should be thoroughly washed. Irrigate with a large volume of warm or room temperature tap water from a reliable source (with or without soap).
- 13. Wounds Higher irrigation pressures are more effective than lower pressures Higher volumes are better than lower volumes (within a range of 100 to 1000 mL) Tap water is as good as (or better than) any other irrigation solution in reducing infection rates.
- 14. Wounds The wounds actually heal better with less infection if they are covered with an antibiotic ointment or cream and a clean occlusive dressing In first aid setting, this applies for abrasion or a superficial injury only. Ensure that the victim has no known allergies to the antibiotic – if in doubt, do not apply
- 15. Soft Tissue Injuries RICE remains the main components of symptomatic treatment. R= Rest (the affected extremity) I = Ice (cold) compression C = Compressive bandage E = Elevate the extremity
- 16. Soft Tissue Injuries Cold application is more effective than heat application Cold application by mixture of ice and water is more effective than ice alone Cold application by mixture of ice and water is more effective than refreezable gel pack.
- 17. Soft Tissue Injuries Cold application is more effective than heat application Cold application by mixture of ice and water is more effective than ice alone Cold application by mixture of ice and water is more effective than refreezable gel pack.
- 18. Soft Tissue Injuries Cold application decreases hemorrhage, edema, pain, and disability. To prevent cold injury, limit each application of cold to periods ≤20 minutes. If that length of time is uncomfortable, limit application to 10 minutes
- 19. Jellyfish Sting First aid for jellyfish stings consists of two important actions: preventing further nematocyst discharge and pain relief
- 20. Jellyfish Sting To inactivate venom load and prevent further envenomation, jellyfish stings should be liberally washed with vinegar (4% to 6% acetic acid solution) as soon as possible for at least 30 seconds. If vinegar is not available, a baking soda slurry may be used instead.
- 21. Jellyfish Sting For the treatment of pain, after the nematocysts are removed or deactivated, jellyfish stings should be treated with hot-water immersion when possible.
- 22. Jellyfish Sting Instruct victim to take a hot shower or immerse the affected part in hot water (temperature as hot as tolerated, or 45°C if there is the capability to regulate temperature), as soon as possible, for at least 20 minutes or for as long as pain persists. If hot water is not available, dry hot packs or, as a second choice, dry cold packs may be helpful in decreasing pain but these are not as effective as hot water.
- 23. Jellyfish Sting How does hot water immersion work? Marine venoms consist of multiple proteins and enzymes, and there is evidence that these become deactivated when heated to temperatures above 50 °C. Direct heat application leads to inactivation of the venom and deactivation of heat labile proteins. Hot water immersion causes modulation of pain receptors in the nervous system leading to a reduction in pain.
- 24. Jellyfish Sting The Portuguese Man O’ War is not a jellyfish Is a cluster of several organisms each highly specialized, cannot sustain themselves individually, dependent for survival on the others