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To try and make sense of the vast assortment of (and often contradictory) figures regarding the survival rates of cardiac arrest, the British Heart Foundation, NHS England and the Resuscitation Council (UK) have published a Consensus Paper on Out-of-Hospital Cardiac Arrest in England. The paper estimates that there are approximately 60,000 cases of out of hospital cardiac arrest (OHCA) in the UK.
The paper summaries that off the 28,000 EMS treated OHCA in England, approximately 8.6% survive.
Improving survival rates from out of hospital cardiac arrest is a major priority for the Resuscitation Council (UK), the British Heart Foundation and NHS England. One of the reasons the paper identifies for such a low survival rate is the rate of initial bystander CPR (First Aid), which in England is approximately 43%.
These cases happen every day, and most of the time, nurses are expected to provide first aid care.
Keep DRS in mind: Danger (check the scene for danger), Response (check for the victim’s consciousness) and Send someone to call for help. Remember that you have to stop bleeding by applying gauze or a clean piece of cloth to the wound firmly but gently.
Puncture wounds, cuts, scrapes or amputations may cause external bleeding that needs immediate medical attention. Prior to giving care, make sure that you don protective gloves or any barrier between you and the patient that can minimize transmission of disease.
Nosebleeds are very common, and are usually caused by dryness, allergies, infection, increased blood pressure and aggressive nose picking among others. Bleeding from the nose for more than twenty (20) minutes may be considered a medical emergency and immediate medical attention is necessary. Squeezing the soft part of the nose using the thumb and the index finger for about ten to fifteen minutes or placing an icepack on the bridge of the nose may also help stop the bleeding. There are two types of airway obstruction, one of which is the partial airway obstruction wherein the breathing is labored or noisy and some air may be felt from the mouth. If it is a complete airway obstruction and the victim is conscious, you have to call for help first (Call 911) before performing up to five back blows with the heel of one hand in the middle of the victim’s back, just between the shoulder blades. If the back blows did not work, you can move on to performing up to five chest thrusts (or the Heimlich maneuver), which is similar to chest compressions, but sharper and must be delivered at a slower pace.
Otherwise, place the victim on a side-lying position to promote drainage of secretion from the mouth.
When the organs and tissues in a person’s body are not receiving enough flow of blood, that person is susceptible to shock. Make sure to manage any bleeding, if present, by applying direct pressure and elevating the site. If possible, let the victim raise his legs and feet (shock position) and make sure to keep the patient warm and comfortable. A head trauma may cause a temporary loss or altered level of consciousness which occurs after an impact to the skull area. If the patient is not responding, but is breathing adequately, put him in a side-lying position. If the victim is not responding, but is breathing adequately, assist him to a side-lying position.
Try to identify what has been taken, how much and when it was taken, while making sure that you maintain your safety. If the victim is experiencing difficulty of breathing, abdominal pain, facial swelling and has signs and symptoms of shock, the first thing you should do is to call for help (Call 911), and assess the patient’s ABCDs. Assist the victim to a side-lying position to prevent him from choking if ever he vomits or bleeds through the mouth. A person can still be revived during a cardiac arrest, but the more time that passes, the more unlikely that the victim will be revived. Before performing CPR, make sure that you have already asked for immediate medical attention (Call 911) and that you have assessed the patient’s ABCDs. A person in cardiac arrest will lie motionless without breathing, and will not be able to respond to any questions or stimulation. If the victim is unresponsive, turn him on his back and assess if breathing is completely absent.
If the bite is actively bleeding, apply direct pressure with a clean, dry cloth until the bleeding subsides. Cats don’t normally bite though, unless they are restrained or when you attempt to intervene in a cat fight. The first aid involves controlling the bleeding and washing the wound thoroughly under running water for a few minutes. Near drowning is when a person suffers from severe oxygen deprivation while submerged in water, but not resulting in death. When a person suffers near drowning, water may enter the lungs, causing them to cease transferring oxygen to the blood. The eyes are well-protected from injury by the structure of our face and with the help of our eyelids.
Before helping a person with eye injury, make sure to seek for medical attention (Call 911) immediately.
If the injury is caused by a blunt impact, ice packs may help reduce swelling and ease pain. Do not rub or apply any pressure to the eye either, as this may cause further damage to the injured eye. While waiting for help, cover both eyes with sterile dressings to minimize the injured eye’s movement. If the victim stops breathing and becomes unresponsive, follow DRS, assess ABCDs and immediately perform CPR. You have to assume that a person has a spinal injury if there is an evidence of head injury. If you suspect that a person has a spinal injury, make sure to seek for medical attention (Call 911) immediately.
Check the victim’s ABCDs and keep the person still by placing towels on the sides of the neck to prevent movement. You will need help from another person if it is vital to move the victim because he is vomiting or choking on blood, or if he is at risk of further injury.
About the Author: Mary Elizabeth Velarmino Francisco earned her Bachelor of Science in Nursing Degree from the Ateneo de Zamboanga University, Philippines. Most ViewedRecent Posts100 Funniest Nursing Memes on Pinterest - Our Special Collection 50 Best Bible Verses for Nurses Top 10 Nursing Schools in the US 20 Greatest Florence Nightingale Quotes For Nurses 20 Short But Effective Prayers for Surgery 25 Cutest Gifts for Nurses You'll Also Want 50 Vintage Photos of Nurses Being Awesome 25 Medical Slang Terms Nurses Use Today's Meme: Brace Yourselves 7 Easy Stain Removal Tips Every Nurse Needs To Know 5 Things You Should Know Before Becoming a Vocational Nurse Today's Meme: Am I Going Crazy? Sudden cardiac arrest is the unexpected and complete cessation of effective heart activity with presence or absence of bioelectrical activity.
Cardiac arrest or, as doctors would say, “the state of clinical death”, may occur as a result of accidents (e.g.
The symptoms of cardiac arrest are: loss of consciousness, absence of pulse on large vessels, including the neck, cessation of spontaneous breathing, sudden blanching of the skin, occurrence of rare convulsive breaths, dilated pupils and their lack of response to light. External cardiac massage and artificial respiration should not be performed if the victim is unconscious but breathing and the heart still works. Artificial respiration cannot be performed in case of an open chest injury or in case of suspicion of ribs fracture, as blood vessels may be injured, thus increasing bleeding. Clinical death first-aid (cardiopulmonary resuscitation measures or CPR) includes external cardiac massage and artificial respiration (2 breaths at every 30 cardiac compressions). The signs of correct performance of chest compressions and of artificial respiration are the narrowing of the pupils and appearance of their response to light.
If resuscitation actions prove successful, the victim must be taken to the hospital, taking special care as there may be repeated respiratory and cardiac arrest (in this case, all resuscitation measures would have to be repeated). The victim is placed with the face up on any smooth, hard surface (soft surfaces reduce the effectiveness of chest compressions).
While performing the external cardiac massage it is worth remembering that, in a state of clinical death, due to a sharp decrease of muscle tone, the chest has an increased mobility. After clipping the victim’s nose and after a deep inhale, the mouth of the rescuer is pressed tightly to the victim’s open mouth, forming a seal, and a strong exhale is made into the mouth of the victim (mouth-to-mouth respiration).


According to the American Heart Association (AHA, 2010), when performing CPR, artificial respiration may not be provided, especially if there is only one rescuer or for hygienic reasons. Massage movements and artificial respiration require physical strength and endurance; therefore the persons providing assistance should change places every 5-7 minutes.
If there are three persons surrounding the victim, the two most enduring ones should begin performing artificial respiration and chest compressions, while the third person should call an ambulance and help deliver the victim to the hospital. Resuscitation measures must continue until professional help arrives or the victim regains consciousness, provided that the rescuer is not tired and is able to continue resuscitation. Chest compressions and artificial respiration must not be interrupted during the way to the hospital. In some cases, sudden cardiac arrest can be reversible, if the resuscitation measures were applied correctly and in time. Whatever your working environment; from teaching in the classroom to running the DofE Expedition. Parliament were last week discussing and filibustering over the Compulsory Emergency First Aid Education (State-funded Secondary Schools) Bill. At Training Expertise we firmly believe that Compulsory Emergency First Aid Education is of utmost importance in all schools and that this will work toward saving countless lives. For Teaching Staff: Incident management in First Aid situations, how to look after young people that have become ill or injured while under your care. All our courses are tailored to suit your needs and those with whom you are working, be it students or staff, lab technicians or sports coaches – we have your interests at the core of our training. For more information and advice on our First Aid, Water Safety,Fieldwork Safety courses, please don’t hesitate to get in touch. This entry was posted in First Aid, Outdoor first aid on November 26, 2015 by trainingexpertise. Working in Remote Environments is an amazing experience but it comes with inherent risks, one of which is poor communications. One very quick and easy way of dealing with weak signal is to register your phone to contact the Emergency Services by SMS. When you add other compounding factors associated with dealing with an emergency in remote locations, getting all the information down into a clear concise text message makes the situation much easier to deal with. For more information and advice on who to contact in an emergency or how to deal with situations in remote environments, book onto one of our Outdoor or Expedition First Aid Courses. This entry was posted in Expedition and Outdoor Skills, Expedition Training, Field Safety, First Aid on November 26, 2015 by trainingexpertise.
We’ve just launched our new forest schools outdoor first aid course specifically focused on those working with young people in the outdoors. You are running a forest schools session when an 8 year old trips and falls, putting his arm into a fire.
Obviously aside from the medical issue there is the matter of how you handle the fact that the student is saying they are fine. There are also the practical considerations which will depend on the circumstances of the age of the students, the number of staff or other responsible people available etc. If its time for you to update your risk management, water safety, field safety or outdoor first aid skills then just get in touch. This entry was posted in Expedition and Outdoor Skills, First Aid, Outdoor first aid, Outdoor Training and tagged dynamic risk assessment, field safety, first aid training, outdoor first aid, outdoor safety, outdoor skills, risk assessment, risk management for adventure on August 22, 2014 by trainingexpertise. This entry was posted in First Aid, Outdoor first aid and tagged first aid training, outdoor first aid on May 9, 2014 by trainingexpertise.
Our Training Manager Dom Hall spent two days last week as a member of Nature’s Marketing Department!
The Wild Network is a growing group of people concerned about the loss of access we all (but especially kids) have to the great outdoors and their increasingly disappearing connection to nature. So please have a look at the work of the Wild Network, and also it seemed apt to share another article published recently in the Guardian emphasising how important time outdoors is. This entry was posted in Expedition and Outdoor Skills, Field Safety, Outdoor first aid, Outdoor Training and tagged field safety, mountain safety, outdoor adventure for kids, outdoor first aid, outdoor safety, risk management for adventure on April 29, 2014 by trainingexpertise.
2 – Downtime – management of what the students do when not in the program of study is a tricky business which needs some thinking about!
3 – Slips and falls in a mountainous environment – here we have both the common and relatively non-severe twists, sprains and breaks, and of course more serious falls from height.
4 – Weather – any factor which is as changeable and sometime unpredictable as the weather can be a major hazards.
5 – Wolves and bears – interesting one, the chances of a wolf or bear attack is really pretty slim, but clearly the consequences could be great so that’s snuck it into our top 5!
This entry was posted in Field Safety, First Aid, Outdoor first aid, Uncategorized and tagged dynamic risk assessment, field safety, fieldwork, outdoor first aid, outdoor safety, outdoor skills on March 5, 2014 by trainingexpertise. Amid the thrills and spills of the winter olympics there was a timely reminder of the importance of wearing a helmet when skiing and snowboarding.
These symptoms can be subtle and may develop over time, so you may see none of them intially.
If you experience any of the symptoms above in the days following a head injury you should seek medical attention. The Headway charity provides hugely valuable resources and information on head injuries including more on the effects of brain injury, and a collection of further resources on recognising sport concussion injuries.
If you would like to update your risk management,  field safety or outdoor first aid skills then just get in touch. This entry was posted in First Aid, Outdoor first aid and tagged first aid training, outdoor first aid, outdoor safety, skiing first aid, snowboarding first aid on February 13, 2014 by trainingexpertise. Following some great feedback on our New Year Quiz we plan to make the quiz a regular feature. On returning to the youth hostel after a long day on the hills you come across an adult casualty collapsed in the car park who is unconscious and unresponsive, and not breathing. You are leading a 5 day trek with a group of 10 sixth form students and one teacher in the Corcovado National Park in Costa Rica.  You are accompanied by two local guides.
2 –  To send the teacher and the local guide back with the sick girl and continue with the rest of the team.
There’s never a hard and fast right or wrong here – it will depend on the experience of the teacher – the quality of the guides, the terrain you have passed through on day one and if you have time to extend the trek by a day, perhaps taking a rest day and seeing how she is on the following day.  Of course it will depend on how sick the girl is – are we happy that given a day’s rest she could walk back slowly with the teacher?  Of course we also have to consider the rest of the group – whilst we don’t want to cut short everyone’s experience we don’t want to push the group on with inadequate staffing and have to deal with a secondary issue.
A key thing is to ensure you have fully explained to everyone in advance that situations like this may occur and discuss what will happen.  If the only option which has ever been discussed is a 5 day trek from A to B, then it is far harder to deal with this situation when it comes up. For the answers to both questions just follow the link to our first aid and field safety blog.
If its time for you to update your risk management,  field safety or outdoor first aid skills then just get in touch. This entry was posted in First Aid, Outdoor first aid, Uncategorized on February 6, 2014 by trainingexpertise. You are the first on the scene of a rock fall in the mountains.  You are an hour’s fast walk from the nearest road and have no phone reception.  You have the following casualties… what would you do? Firstly make sure it is safe for you to approach and shout for help, just in case anyone is nearby. Casualty 3 – Is OK in the short term but needs the cut treating, and monitoring for signs of a compression injury. Casualty 4 is probably going to be busy monitoring casualties 1 to 3 whilst you go and get help!
If you would like to update your skills check out our outdoor first aid and expedition first aid courses. Expedition training and preparation is also important to ensure that all team members are aware of any specific hazards and can manage a first aid or other emergency. Finally dynamic risk assessment is crucial – what if it turns out the terrain is far worse, or the mobile reception far more patchy… then we may have to rethink the plan, for example getting the whole team to work together. Flexibility is the key and a constant eye on whether or not the existing safety measures are sufficient.
If its time for you to update your risk management,  field safety or outdoor first aid skills then just get in touch.


This entry was posted in Field Safety, First Aid, Outdoor first aid, Uncategorized and tagged expedition training, field safety, first aid training, outdoor first aid, risk assessment, risk management for adventure on December 30, 2013 by trainingexpertise. The week in Kenya represented the next step in that work, supporting the charity staff, to develop new Kenyan trainers and then together running a bespoke Wilderness First Aid course for 30 Community Health Workers. If you would like to know more about our work in Kenya, or our field safety, risk management and outdoor first aid training in the UK, don’t hesitate to get in touch to discuss your plans. This entry was posted in First Aid, Outdoor first aid and tagged first aid training, outdoor first aid, travel safety, wilderness first aid on November 12, 2013 by trainingexpertise. This was identified by the Department of Health in the Cardiovascular Disease Outcomes Strategy (2013). For instance, we should all know what to do with a victim of a road accident or someone with an injury as simple as a burnt finger.
We should learn not only how to stay as calm as possible, but also what to do while waiting for help to arrive.
Is the victim’s airway (mouth and throat) free from foreign objects that may cause blockage? If you can stop, or at least lessen, the bleeding until help arrives (Call 911), the patient’s chances of surviving may increase tremendously. This will help in reducing the blood pressure in the veins of the nose, thus, minimizing the bleeding. The other type is the complete airway obstruction wherein no air can be felt escaping the mouth. Make sure that the site is free from jewelries and clothing that may be contaminated by chemicals. Stings may be considered an emergency, especially if the victim experiences an allergic reaction.
You can use the “look, listen and feel” approach: Look if the person’s chest is moving up and down, listen to any sounds of breathing and feel for air passing through the victim’s nose or mouth. It is a very life-threatening condition that results in extremely high body temperature, thus causing many organ systems to fail. Domestic animals like horses, pigs and cows, do not bite often, but when they do, serious wounds may result. Otherwise, the proper authorities must be notified so that they can observe the animal for signs of rabies. Nonetheless, injuries are still possible, some to the extent that vision is lost, or, in rare cases, the eye must be surgically removed. Upper Respiratory Tract Infection, stress, pollen, molds and changes in air temperature are only a few.
Fractures may cause pain at the injury site, bleeding, deformities, tenderness, swelling and, often, inability to move.
This may result to unresponsiveness, headache, nausea and vomiting, paralysis or convulsions. Both of you should work together to keep the victim’s head aligned with the neck and the back while rolling him onto his side.
Many of them could have lived longer, if only those around them would have had some basic first-aid skills. With every minute of inactivity, the chance of survival from sudden cardiac arrest is reduced by 7-10%. The majority of cardiac arrests involve ventricular fibrillation, which can be suppressed by electrical defibrillation with an automatic external defibrillator at the hospital.
A roll must be placed under the shoulders to allow holding up the head and prevent the obstruction of airways with the tongue, which also impedes performance of artificial respiration. In this way, the victim’s heart is squeezed between the thorax and the spine, and the blood is ejected from the cavities of the heart into the blood vessels; in the interval between the pressings, the heart is passively straightened and filled with blood.
The lower part of the victim’s sternum should bend with 3-4 cm, and in overweight people – 5-6 cm. If assistance is provided by two people, the second rescuer shall perform artificial respiration during this time. For this purpose, it is necessary to stand up to the right side of the victim, to take the right hand under his neck, to impose the left one on the forehead and to tilt the head back at a maximum so that the chin is in line with the neck (usually when tilting the head back the victim’s mouth will spontaneously open).
Artificial respiration can be performed by another method: by holding the victim’s mouth and blowing air through the nose (mouth-to-nose respiration).
Instead, chest compressions must be applied, since this measure is more important for the sufficient blood and oxygen supply to the victim’s brain. Once arrived at the hospital, advanced resuscitation measures will continue, including defibrillation and intravenous administration of all required drugs.
Otherwise, when untreated or when the victim’s body doesn’t respond anymore to the measures performed, it may cause death within minutes. This Bill was to decide whether Emergency First Aid should be included into the compulsory comprehensive curriculum. We have been delighted to support and help develop this long term, sustainable plan to cascade training. If the bite is not bleeding severely, wash the wound thoroughly with mild soap and running water for 3 to 5 minutes.
Cat bites, on the other hand, involve deep puncture wounds that, most of the time, become infected.
Asthma attacks are characterized by difficulty of breathing and speaking, shortness of breath, cyanosis and wheezing.
With coffee running through her veins, she enthusiastically battles each day, one article at a time.
Only 10 minutes are available for anyone trying to save a person’s life before death occurs. The state of clinical death usually lasts 4 to 5 minutes, after which irreversible changes begin to develop in the body of the victim, against which medicine is powerless (biological death). The probability of successful defibrillation decreases with time, by approximately 2-7% every minute, but first aid measures slow down this process, delaying the development of asystole (absence of cardiac electrical activity). If possible, the victim’s legs should be lifted about 0.5 m up, in order to ensure a better blood flow to the heart from the lower body. This is enough for the blood to be supplied to all body organs and tissues and to maintain the victim’s life. If assistance is provided by a single person, it is recommended to alternate the measures as follows: after two quick insufflations of air into the lungs 30 chest compressions must follow, with an interval of 1 second. The mouth and nose of the victim are cleared from any blood, mucus, foreign bodies or liquids, dentures are removed (with gauze, handkerchiefs, etc.).
Artificial respiration is effective when the victim’s respiratory movements of the chest reappear in the same rhythm with air insufflations.  Artificial respiration can also be given through a handkerchief or several layers of gauze.
In this case, the person performing cardiac massage must perform 70–100 chest compressions per minute in a continuous way. It is very important for the person performing the first aid in cardiac arrest to stay calm and self-confident for the maximal and quick use of his knowledge and forces. If you are in the woods and not immediately by a tap, tipping water over it and catching the water in a bucket and then repeating can be a good way of keeping water running over the area with a limited supply. Over the next 24 to 48 hours, observe the bite for signs of infection (increasing skin redness, swelling, and pain).
After each compression, hands should be held in the position reached for about one-third of a second, in order to allow the chest to straighten without taking off the hands. If assistance is provided by two people, the more experienced of the two should perform the cardiac massage, and the second rescuer should provide artificial respiration. It is also important for every person to know what CPR measures in cardiac arrest imply, so that, in case of an emergency, someone’s chances to survive can increase.



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