LESSON 8 - HeartSafe First Aid Training
Contents
1. OFAL2 e position the patient for comfort do not allow the patient to move unassisted keep the patient as quiet and calm as possible e conduct a primary survey and administer oxygen at 10 lpm keep the patient comfortably warm e investigate the pain question the patient using the PPQRRST mnemonic e all patients with suspected heart attack require urgent medical attention e offer the patient two 80 mg of chewable ASA or one regular adult strength 325 mg ASA tablet to chew if available not Ibuprophen or Acetaminophen e assess and monitor vital signs en route or while waiting for transport The management for cardiac arrest is the delivery of good quality CPR until an Automated External Defibrillator is available WorkSafeBC May 2012 page 8 31 Occupational First Aid Level 2 Training Guide Lesson 8 WorkSafeBC May 2012 page 8 32 Occupational First Aid Level 2 Training Guide Name WorkSafeBC May 2012 Assignment Answer Sheet 11 12 13 14 15 16 17 18 19 20 Lesson 8 page 8 33 Occupational First Aid Level 2 Training Guide Lesson 8 WorkSafeBC May 2012 page 8 342. e offer the patient two 80 mg of chewable ASA or one regular adult strength 325 mg ASA tablet to chew it must be ASA not Ibuprofen or Acetaminophen e assess and monitor vital signs en route or while waiting for transport Management of Cardiac Arrest sudden cardiac arrest 8CA is an abrupt unexpected loss of heart pump function The Chain of Survival the Chain of Survival is a series of steps aimed at decreasing death and disability due to sudden cardiac arrest CHAIN OF SURVIVAL es ENS ELE ILI RE RE HII e Early recognition e Early access e Early CPR e Early defibrillation e Early advanced care OFAL2 early recognition of warning signs early access early CPR early defibrillation early advanced care WorkSafeBC May 2012 page 8 8 Occupational First Aid Level 2 Training Guide Lesson 8 Electrical Activity in the Heart the heart contains an electrical system that sends out impulses that tell the heart when to contract to pump blood the leader of this electrical system is the sino atrial SA node the SA node e is the body s pacemaker e sends out 60 to 100 impulses per minute in a resting adult types of rhythms that have no palpable pulse and are life threatening include ABNORMAL ELECTRICAL IMPULSES ee 1 ELE IRL IR RE REL EI e Ventricular Fibrillation VF e Ventricular Tachycardia VT e Pulseless electrical activity PEA e Asystole ventricular fibrillation VF ventricu
3. and turn on the AED follow voice prompts wait while the AED completes a self evaluation plug the cables into the AED ensure the AED pads are not expired or torn and are connected to the cables 17 attach the AED e prepare the patient s chest for the AED pads work around the helper doing the compressions remove the backing from the pads and place one pad below the patient s right clavicle and the other pad on the left side of the chest just inferior to nipple level 18 analyze the heart rhythm instruct the helper stop compressions and don t touch the patient ensure no one is touching the patient and everyone is standing clear follow voice prompts or press the analyze button WorkSafeBC May 2012 Lesson 8 Note the AED model at the workplace may operate differently Note the employer must ensure that the Attendant is trained on the specific model used at the workplace patient s chest is dry there is no chest hair there are no medication patches or any implanted medical devices the AED gives a Shock Advised prompt page 8 24 Occupational First Aid Level 2 Training Guide 19 deliver a shock e state I m clear everyone is clear do not touch the patient e press the shock button if the AED advises 20 administer 2 minutes of CPR e instruct a helper to resume compressions e ventilate the patient once every 6 to 8 seconds 21 repeat cycles of analyze shock or no
4. apprehension or uneasiness pallor shortness of breath WorkSafeBC May 2012 page 8 3 Occupational First Aid Level 2 Training Guide Lesson 8 Heart Attack the signs and symptoms associated with a heart attack are HEART ATTACK SIGNS amp SYMPTOMS e Pain does not ease with rest amp medication Usually lasts longer than 30 minutes e Apprehension e Denial e Marked weakness OFA L2 e pain is the classic symptom may occur suddenly or come on when the patient is at rest usually substernal and often radiates across the chest epigastric discomfort usually associated with belching gas and indigestion desire to defecate may radiate to one or both arms up to neck jaw or through to the back described as choking squeezing vice like burning or intense a feeling of pressure not affected by coughing movement or deep respiration usually lasts longer than 30 minutes and is constant rest and medication do not help e apprehension e denial e marked weakness especially in the arms WorkSafeBC May 2012 page 8 4 Occupational First Aid Level 2 Training Guide Lesson 8 HEART ATTACK SIGNS amp SYMPTOMS cont NN e Shortness of breath e Sweating e Pallor e Nausea vomiting e Desire to defecate e Weak amp rapid pulse OFAL2 shortness of breath or difficulty breathing sweating sometimes profuse pallor nausea or vomiting desire to defecate
5. pad place AED pad electrodes one inch away from implanted pacemakers or implanted defibrillators ensure AED pad electrodes are well applied to the chest shave pad area if chest is very hairy CONSIDERATIONS FOR AED USE cont d T D T LL e Wipe chest dry if wet e Move patient if in standing water e Place O cylinder amp tubing away from AED e Stop vehicle if used during transport e Read user manual for troubleshooting wipe the chest with towel or cloth before applying AED pad electrodes if the chest is wet if attendant or patient in standing water move to dry area place oxygen cylinder and tubing away from the chest and AED unit stop vehicle if AED is used during transport read user manual for troubleshooting WorkSafeBC May 2012 page 8 14 Occupational First Aid Level 2 Training Guide Lesson 8 Cardiopulmonary Resuscitation or CPR the patient s best chance for survival is the delivery of good quality CPR until an AED is available CPR ell e cardiac arrest caused by drowning 2 ventilations before compressions e AED is used as soon as available amp 7 breathing resumes patient moves patient regains consciousness e May stop if efforts ongoing for 30 minutes when patient is not hypothermic OFAL2 68 e If signs of life appear check pulse Kay WW e if the cardiac arrest is caused by drowning give 2 ventilations before starting compressions e the AED is used as soon as it is avai
6. relieved by rest and oxygen usually lasts less than 15 minutes e with a heart attack the pain is not relieved by rest oxygen or nitroglycerin lasts longer than 30 minutes the management for angina follows the priority action approach and includes MANAGEMENT OF HEART ATTACK ee EN 1 LL LL e Position of comfort e Primary survey amp oxygen e Investigate the pain e Send for ambulance e Offer 325 mg Aspirin ASA e Assess vital signs OFAL2 e place the patient in a comfortable position e perform a primary survey and apply oxygen at 10 lpm e investigate the pain because there is no history of trauma question the patient using the PPQRRST mnemonic e assist the patient in taking nitroglycerin medication if required e patients with chest pain not relieved by nitroglycerin rest and oxygen require urgent medical attention WorkSafeBC May 2012 page 8 30 Occupational First Aid Level 2 Training Guide Lesson 8 e known angina conditions where pain is relieved by taking medication and rest may be able to return to work depending on the type of tasks involved this may require discussion with the supervisor the management for heart attack follows the priority action approach and includes MANAGEMENT OF HEART ATTACK 1 EL ULL IR RE REL II e Position of comfort e Primary survey amp oxygen e Investigate the pain e Send for ambulance e Offer 325 mg Aspirin ASA e Assess vital signs
7. shock and 2 minutes of CPR until e aphysician assumes responsibility e patient is transferred to ambulance personnel e the attendant is physically exhausted and unable to continue e cycles of No Shock Advised followed by 2 minutes of CPR have been ongoing for 30 minutes without even the temporary return of a pulse in patients with normal temperatures not hypothermic after 30 minutes resuscitation efforts may be stopped follow the procedure outlined in the Reference and Training Manual on page 368 Appendix B Fatalities e Spontaneous circulation and breathing are restored WorkSafeBC May 2012 Lesson 8 Note if a No Shock prompt was given then 2 minutes of CPR is administered before the heart rhythm is re analyzed compress the chest 3 8 5 0 cm 1 to 2 inches at a rate of 100 per minute 1 second per breath just enough to see the chest rise Note in the case of a hypothermic patient in cardiac arrest assess pulse and respiration for 1 minute attach the AED administer 1 shock if advised keep the patient warm continue CPH until the ambulance arrives or signs of life appear page 8 25 Occupational First Aid Level 2 Training Guide Lesson 8 PARTICIPANT PRACTICE 8 04 Manage cardiac arrest with one rescuer AED immediately on scene manage a supine patient in cardiac arrest 1 scene assessment approach the patient from the front identify yourself and
8. the unit has a visual display necessary if it is to be used in a noisy environment e the loudness of the audio prompts if it is to be used in a noisy environment CONSIDERATIONS FOR AED PURCHASE cont 1111111111 e Method of keeping unit warm e Method of data storage amp retrieval Removable data card Internal memory Type of connection to a PC Software required Cost e Data to be reviewed by Medical Director OFAL2 65 e the method of keeping the unit warm in a cold environment e the method of incident data storage and retrieval removable data card internal memory type of connection to a PC software required cost e this data should be reviewed by the medical director for the AED program at the workplace WorkSafeBC May 2012 page 8 13 Occupational First Aid Level 2 Training Guide Lesson 8 Special Considerations and Circumstances for AED use CONSIDERATIONS FOR AED USE LL IRL RE RE 1 LI e Inspection amp maintenance protocols amp logs e Safe for pregnant patients e Carefully remove any patch medications e Place pads 1 away from implanted devices e Pads must be well secured to chest e Shave chest if hairy OFAL2 establish inspection and maintenance protocols and logs as required by manufacturer s directions AED use is safe for pregnant patients carefully remove any patch medications and wipe any excess medication from the chest with a clean cloth or gauze
9. what happened e did you fall or hurt your head or neck 2 explain that a resting position will be more comfortable and then position the patient at rest in the position of most comfort with support preferably supine 3 conduct the primary survey 4 apply oxygen and keep the patient calm and at rest 5 because there is no history of trauma the attendant must investigate the pain using the PPQRRST mnemonic Position Provokes Quality Radiates Relieves Severity Timing WorkSafeBC May 2012 on approach the patient is pale and complains of chest pain A large delivery arrived and my assistant Is off today My angina pain flared up sat down and took my nitro he boss sent me to see you No breathing is 24 shallow and effective skin is cool pale and dry radial pulse is present no pain anywhere else the patient has a known history of angina the pain is behind the breastbone feels squeezing 5 out of 10 and has lasted 4 minutes there is nothing different about this pattern of angina attack page 8 17 Occupational First Aid Level 2 Training Guide assess the patient s medication e ead instructions of use decision no need to transport patient to medical aid at this time continue assessment assess vital signs and continue to monitor patient patient can return to work inform supervisor to ensure no more moving of cartons or other strenuous work t
10. Occupational First Aid Level 2 Training Guide Lesson 8 LESSON 8 OBJECTIVE Each participant will identify circulatory emergencies and manage critical interventions Each participant will be able to identify and manage environmental emergencies Each participant will be able to identify common communicable diseases routes of transmission prevention of infection in particular of bloodbourne pathogens The procedures will follow the guidelines in the Occupational First Aid Reference and Training Manual LESSON OUTLINE e cardiac emergencies e cardiac emergency management Reference Part 5 Chapter 13 non traumatic cardiac emergencies Part 5 Chapter 14 cardiopulmonary resuscitation Part 11 Chapter 37 heat related emergencies Part 11 Chapter 38 cold injuries Part 13 Chapter 45 communicable diseases WorkSafeBC May 2012 page 8 1 Occupational First Aid Level 2 Training Guide Lesson 8 INSTRUCTOR ACTIVITY LECTURE AS THE WORK FORCE AGES THE INCIDENTS OF CARDIAC EMERGENCIES WILL BECOME MORE COMMON RECOGNITION AND PROPER MANAGEMENT MAY SAVE A CO WORKERS LIFE Cardiac Emergencies heart conditions can result from traumatic or non traumatic incidents heart conditions include HEART CONDITIONS LL LL e Angina e Heart attack e Cardiac arrest e angina the reduction of oxygen to the heart muscle due to a narrowing of the heart s arteries coronary arteries lack of oxygen may cause pain which is referred to as
11. angina pectoris e heart attack the lack of oxygen to the heart muscle due to a complete blockage of a coronary artery myocardial infarction e cardiac arrest the heart has stopped beating or beats too irregularly or too weakly to circulate blood effectively causes include cardiovascular disease most common cause blunt trauma violence to the chest severe blood loss drowning suffocation certain drugs electric shock Stroke or other types of brain damage WorkSafeBC May 2012 page 8 2 Occupational First Aid Level 2 Training Guide Lesson 8 Angina signs and symptoms may vary from person to person but for each individual the pain is of consistent intensity duration and location signs and symptoms of angina include ANGINA SIGNS amp SYMPTOMS LL I e Pain often eases with rest O or medication usually lasts less than 15 minutes e Nausea e Apprehension or uneasiness e Pallor e Shortness of breath OFAL2 e pain may occur suddenly or gradually usually located beneath the sternum may radiate in left or right arm neck jaw or back often assumed to be indigestion gas belching described as mild to moderate heavy pressure squeezing or vice like tightness not influenced by deep respiration coughing or movement usually brought on by stress or exertion often eased by rest oxygen or medication usually lasts less than 15 minutes 9 9 9 nausea
12. ardiac arrest must ventilations would be given receive CPR unless there is clear evidence that before starting compressions death has occurred for example if there is decapitation transection decomposition an adult patient who has been submerged in water for over 60 minutes or in certain triage situations 8 start CPR compress the chest at least 5 0 cm 2 inches at a rate of at e expose the chest as necessary least 100 per minute e instruct a helper to watch what you are doing push hard push fast as they will be doing the compressions after allow the chest to recoil after the next cycle each compression e place hands in the centre of the chest between the nipples interlock fingers lock elbows and perform 30 chest compressions 9 using a pocket mask ventilate the patient with 2 air goes in breaths 1 second per breath just enough to see the chest rise 10 instruct the helper to watch what you are doing regarding compression depth and timing and give 30 chest compressions 11 ventilate the patient with 2 breaths air goes in WorkSafeBC May 2012 page 8 22 Occupational First Aid Level 2 Training Guide 12 13 14 instruct the helper to kneel close to the side of the patient and place their hands in the centre of the chest interlock their fingers lock their elbows so their arms are straight and start compressing e ensure a depth of at least 5 cm a rate of at least 100 per minute and a full recoil
13. attempt to communicate with the patient activate the worksite emergency response procedures e instruct the person calling the ambulance to say there is an unresponsive adult and to report back open the airway with a head tilt chin lift and check for breathing move one hand up to the neck while maintaining the head tilt and assess for a carotid pulse request any other OFA attendants or workers trained in CPR to assist and instruct a helper to update the ambulance that the worker is in cardiac arrest WorkSafeBC May 2012 no danger one worker patient was found slumped over in a chair and was carefully positioned on floor by co workers the patient does not respond to verbal stimuli this patient is in the RTC this patient requires urgent medical attention there is no breathing the need for C spine control and jaw thrust will depend on the mechanism there is no pulse page 8 26 Occupational First Aid Level 2 Training Guide 7 ensure the patient is on a hard surface NOTE all patients who are in cardiac arrest must receive CPR unless there is clear evidence that death has occurred for example if there is decapitation transection decomposition an adult patient who has been submerged in water for over 60 minutes or in certain triage situations 8 prepare the AED e position the AED on the operator side of the patient so the unit and the entire patient can be seen e open and turn on the AED e
14. e patient in cardiac arrest 1 scene assessment 2 approach the patient from the front identify yourself and attempt to communicate with the patient 3 activate the worksite emergency response procedures e instruct the person calling the ambulance to say there is an unresponsive adult and to report back 4 open the airway with a head tilt chin lift and check for breathing WorkSafeBC May 2012 no danger one worker patient was found slumped over in a chair and was carefully positioned on floor by co workers the patient does not respond to verbal stimuli this patient is in the RTC this patient requires urgent medical attention there is no breathing the need for C spine control and jaw thrust will depend on the mechanism page 8 21 Occupational First Aid Level 2 Training Guide Lesson 8 5 move one hand up to the neck while maintaining there is no pulse the head tilt and assess for a carotid pulse Note the assessment of the breathing and pulse should not take longer than 10 seconds 6 request any other OFA attendants or workers trained in CPR to assist e instruct bystanders to go get the AED if one is a worker goes to get the AED available at the worksite and update the ambulance that the worker is in cardiac arrest Note the AED is used as soon as It is available 7 ensure the patient is on a hard surface Note if the cardiac arrest was caused by drowning 2 NOTE all patients who are in c
15. f Angina MANAGEMENT OF ANGINA e Position of comfort e Primary survey amp oxygen e Investigate the pain AMAN e Assist with medication e Decision e place the patient in a comfortable position e perform a primary survey and apply oxygen at 10 lpm e investigate the pain because there is no history of trauma question the patient using the PPQRRST mnemonic e assist the patient in taking nitroglycerin medication if required e patients with chest pain not relieved by nitroglycerin rest and oxygen are in the RTC e known angina conditions where pain is relieved by taking medication and rest may be able to return to work depending on the type of tasks involved this may require discussion with the supervisor Management of Heart Attack MANAGEMENT OF HEART ATTACK es EN LL LL e Position of comfort e Primary survey amp oxygen e Investigate the pain e Send for ambulance e Offer 325 mg Aspirin ASA e Assess vital signs OFA L2 e position the patient for comfort donot allow the patient to move unassisted keep the patient as quiet and calm as possible WorkSafeBC May 2012 page 8 7 Occupational First Aid Level 2 Training Guide Lesson 8 e conduct a primary survey and administer oxygen at 10 lom keep the patient comfortably warm e investigate the pain question the patient using the PPORRST mnemonic e all patients with suspected heart attack require urgent medical attention
16. follow voice prompts wait while the AED completes a self evaluation e plug the cables into the AED e ensure the AED pads are not expired or torn and are connected to the cables 9 attach the AED e expose the patients chest and prepare the chest for the AED pads e remove the backing from the pads and place one pad below the patient s right clavicle and the other pad on the left side of the chest just inferior to nipple level 10 analyze the heart rhythm e ensure no one is touching the patient and everyone is standing clear e follow voice prompts or press the analyze button WorkSafeBC May 2012 Lesson 8 Note the AED model at the workplace may operate differently Note the employer must ensure that the Attendant is trained on the specific model used at the workplace patient s chest is dry there is no chest hair there are no medication patches or any implanted medical devices the AED gives a Shock Advised prompt page 8 27 Occupational First Aid Level 2 Training Guide jm 12 deliver a shock e state I m clear everyone is clear do not touch the patient e press the shock button if the AED advises administer 2 minutes of CPR e instruct a helper to watch what you are doing as they will be doing the compressions after the next cycle e place hands in the centre of the chest between the nipples interlock fingers lock elbows and perform 30 chest compressions using a pocket
17. lable e if the patient shows any signs of life stop resuscitation efforts and assess the pulse e signs of life include breathing resumes patient moves patient regains consciousness e for patients with normal temperatures not hypothermic where there has not been even a temporary return of a pulse resuscitation efforts may be stopped when cycles of No Shock Advised followed by 2 minutes of CPR have been ongoing for 30 minutes CPR has been ongoing for 30 minutes e when an AED is not available CPR is continued and the AED is used as soon as it is brought to the scene WorkSafeBC May 2012 page 8 15 Occupational First Aid Level 2 Training Guide Lesson 8 Hypothermic Patients in Cardiac Arrest HYPOTHERMIC PATIENTS IN CARDIAC ARREST ee EN NN EU LL e Assess pulse amp respiration for up to 1 min e Administer 1 shock if advised e Resume CPR e Keep patient warm e Continue CPR until signs of life appear or ambulance arrives assess pulse and respiration for up to 1 minute if a Shock Advised prompt is given administer 1 shock resume CPR keep the patient warm continue CPR until signs of life appear or ambulance arrives WorkSafeBC May 2012 page 8 16 Occupational First Aid Level 2 Training Guide Lesson 8 PARTICIPANT PRACTICE 8 01 Manage chest pain walks to the first aid room manage a patient with chest pain walks to the first aid room 1 scene assessment modified e
18. lar tachycardia VT pulseless electrical activity PEA asystole Ventricular fibrillation VF VENTRICULAR FIBRILLATION 1 LL LL e Uncoordinated electrical impulses e No pumping action or pulse e Most frequent rhythm in SCA e Most effective treatment is defibrillation WorkSafeBC May 2012 page 8 9 Occupational First Aid Level 2 Training Guide Lesson 8 uncoordinated electrical impulses can occur at a rate of up to 300 times a minute no pumping action so no pulse most frequent rhythm in sudden cardiac arrest most effective treatment is defibrillation ventricular tachycardia VT is a heart rhythm that can be so fast that the heart does not have time to fill with blood between contractions leading to a loss of cardiac output and loss of pulse with pulseless electrical activity PEA the SA node sends a signal to contract but the heart does not respond or there is no blood in the system to pump asystole flat line occurs when there is no electrical activity in the heart Defibrillation DEFIBRILLATION LL 110 e VF amp VT require an immediate shock e Defibrillator shocks the heart Stops all electrical activity Allows SA node to regain control VF and pulseless VT are abnormal heart rhythms that need to be shocked immediately the defibrillator sends a shock through the heart that e stops all electrical activity e allows the SA node to regain its role in providing effective electrical im
19. mask ventilate the patient with 2 breaths instruct the helper to watch what you are doing regarding compression depth and timing and give 30 chest compressions ventilate the patient with 2 breaths instruct the helper to kneel close to the side of the patient and place their hands in the centre of the chest interlock their fingers lock their elbows so their arms are straight and start compressing e ensure a depth of at least 5 cm a rate of at least 100 per minute and a full recoil of the chest between compressions WorkSafeBC May 2012 Lesson 8 Note if a No Shock prompt was given then 2 minutes of CPH is administered before the heart rhythm is re analyzed compress the chest at least 5 0 cm 2 inches at a rate of at least 100 per minute push hard push fast allow the chest to recoil after each compression air goes in 1 second per breath just enough to see the chest rise air goes in Note if a helper is not available or cannot compress adequately cycles of 30 compressions and 2 ventilations are performed by the Attendant page 8 28 Occupational First Aid Level 2 Training Guide 17 ventilate the patient once every 6 to 8 seconds timed with the recoil phase of the compression 18 19 between ventilations insert an oral airway and apply oxygen switch to the bag valve mask for the ventilations with the oxygen at 15 Ipm have the helper giving the compressions switch wi
20. oday 10 complete the first aid record and follow up on the patient s condition throughout the day WorkSafeBC May 2012 Lesson 8 patient produces nitroglycerin spray and there are instructions on the container 1 dose every 5 minutes to a total of 3 doses since there is a known history Wait to see If medication will Work the patient is starting to feel better pain subsides in 5 minutes after taking 1 dose of medication vital signs are now normal page 8 18 Occupational First Aid Level 2 Training Guide Lesson 8 PARTICIPANT PRACTICE 8 02 Manage chest pain conscious walks to the first aid room manage a patient with chest pain who walks to the first aid room 1 Scene assessment modified e what happened e did you fall or hurt your head or neck explain that a resting position will be more comfortable and then position the patient at rest in the position of most comfort preferably supine conduct the primary survey apply oxygen keep the patient calm and at complete rest determine if the patient is on medication because there is no history of trauma the attendant must investigate the pain WorkSafeBC May 2012 patient is pale sweaty and very anxious I was shoveling snow all morning and started feeling pain in my chest No breathing 24 shallow and effective skin is cool pale and clammy radial pulse present no pain anywhere else no medications no
21. of the chest between compressions ventilate the patient once every 6 to 8 seconds timed with the recoil phase of the compression e between ventilations insert an oral airway and apply oxygen e switch to the bag valve mask for the ventilations with the oxygen at 15 Ipm e have the helper giving the compressions switch with another helper every 2 minutes continue with the sequence of continuous compressions performed by the helper and 1 ventilation every 6 to 8 seconds given by the Attendant until e the AED arrives e a physician assumes responsibility e patient is transferred to ambulance personnel e the attendant is physically exhausted and unable to continue e Spontaneous breathing and circulation are restored e CPR has been ongoing for 30 minutes without even the temporary return of a pulse in patients with normal temperatures WorkSafeBC May 2012 Lesson 8 Note if a helper is not available or cannot compress adequately cycles of 30 compressions and 2 ventilations are performed by the Attendant 1 second per breath just enough to see the chest rise the AED arrives after 1 v2 minutes of compressions page 8 23 Occupational First Aid Level 2 Training Guide 15 instruct the helper to continue with compressions while the AED is prepared and the pads are attached 16 prepare the AED position the AED on the operator side of the patient so the unit and the entire patient can be seen open
22. pment required to be supplied by the employer for BC workplaces WorkSafeBC May 2012 page 8 11 Occupational First Aid Level 2 Training Guide Lesson 8 Components of an AED unit in addition to the AED an AED unit should consist of COMPONENTS OF AN AED UNIT ll e Protective case weather proof e Extra battery e 2 sets of pads e Disposable razor e Cloth or towel e User manual e protective case weather proof if AED to be exposed to an outside environment if to be used in a cold environment approaching freezing a heated case may be a way of keeping the AED warm extra unexpired unused battery 2 sets of AED pad electrodes disposable razor a cloth or towel user or instruction manual Considerations when purchasing an AED CONSIDERATIONS FOR AED PURCHASE 11111111 e Ruggedness of the unit e Ease amp speed to replace battery e Length of pad wires e Ease of clearing debris from blocked pad sockets e Visual display e Loudness of audio prompts OFAL2 WorkSafeBC May 2012 page 8 12 Occupational First Aid Level 2 Training Guide Lesson 8 e the ruggedness of the unit in consideration to the area in which it will be stored and used e the ease and speed of the battery replacement e the length of the wires on the AED pad electrodes e the likelihood of the pad sockets where the pad electrodes plug into the AED unit becoming plugged with dirt or mud and the ease of clearing them e if
23. previous history of chest pain he pain is behind the breastbone feels vice like radiates down the arm severity is 7 out of 10 has lasted 40 minutes this patient is in the RTC page 8 19 Occupational First Aid Level 2 Training Guide Lesson 8 7 activate the worksite emergency response this patient requires urgent procedures medical attention e instruct the person calling the ambulance to chest pain lasting longer than say there is a responsive adult with chest pain 30 minutes lasting longer than 30 minutes and to report skin is cool pale and clammy back 8 offer the patient two 80 mg of chewable ASA or it must be ASA not one regular adult strength 325 mg ASA tablet to Acetaminophen or Ibuprofen chew ensure the patient does not have an allergy to ASA 9 reassess the ABCs every 5 minutes and continue record vital signs history and with the secondary survey while waiting for the patient s answers to PPQRRST ambulance on patient assessment chart WorkSafeBC May 2012 page 8 20 Occupational First Aid Level 2 Training Guide Lesson 8 PARTICIPANT PRACTICE 8 03 PN Safety Alert otudents are required to perform CPR compressions during this course Performing CPR compressions on a classmate for real could result in discomfort or injury Participants must only simulate compressions if practicing on a classmate Manage cardiac arrest with one rescuer AED not immediately on scene manage a supin
24. pulses the longer the time period between the onset of VF or VT to defibrillation the smaller the chances of patient survival the chance for survival decreases approximately 1096 for each minute delay in defibrillation PEA and asystole do not respond to defibrillation and so are called non shockable rhythms WorkSafeBC May 2012 page 8 10 Occupational First Aid Level 2 Training Guide Lesson 8 Automated External Defibrillators there are many models of AEDs available on the market AEDs L A 111111 e Differences exist between models Operational controls Protocols in programming may not be current Visual or audio capabilities Battery replacement Data collection method e Must have training for your specific model OFAL2 62 the operation of each is basically the same but there are some differences operational controls protocols in programming may not be current visual and audio capabilities battery replacement data collection method data collection is the electronic recording of patient information while protocols are performed when the AED is attached to the patient if an AED is supplied at your workplace the employer MUST ensure you receive training in the operation of that specific model where a defibrillation program exists in the workplace medical oversight is recommended but is not specifically required by the Occupational Health amp Safety Regulation AEDs are not on the list of equi
25. th another helper every 2 minutes after 2 minutes of CPR follow voice prompts to allow the AED to re analyze the heart rhythm repeat cycles of analyze shock or no shock and 2 minutes of CPR until a physician assumes responsibility patient is transferred to ambulance personnel the attendant is physically exhausted and unable to continue cycles of No Shock Advised followed by 2 minutes of CPR have been ongoing for 30 minutes without even the temporary return of a pulse in patients with normal temperatures not hypothermic after 30 minutes resuscitation efforts may be stopped follow the procedure outlined in the Reference and Training Manual on page 368 Appendix B Fatalities spontaneous circulation and breathing are restored WorkSafeBC May 2012 Lesson 8 1 second per breath just enough to see the chest rise Note in the case of a hypothermic patient in cardiac arrest assess pulse and respiration for 1 minute attach the AED administer 1 shock if advised keep the patient warm continue CPH until the ambulance arrives or signs of life appear page 8 29 Occupational First Aid Level 2 Training Guide Lesson 8 SUMMARY the attendant must be able to recognize and manage cardiac emergencies questioning should be thorough enough to gather all the relevant information about the patient s symptoms chest pain can be a symptom of angina or heart attack e with angina the pain is
26. weak and rapid pulse in some cases the pulse rate decreases Cardiac Arrest signs and symptoms of cardiac arrest e no breathing e no pulse Cardiac Assessment the nature of the heart condition must be investigated by the first aid attendant as soon as possible in order to identify that the condition is heart related ask the following questions INVESTIGATE THE PAIN ee EN LL LL e P P position provokes e e Q quality e e H R radiate relief P e S severity O e T timing WorkSafeBC May 2012 page 8 5 Occupational First Aid Level 2 Training Guide Lesson 8 e P position where is the pain can the patient point to the pain e P provokes what makes it worse movement coughing e Q quality describe the pain what does it feel like sharp squeezing etc does this pain differ from the normal pattern of pain e R radiate is the pain localized to one region does it radiate spread to another area e H relief does anything relieve the pain in any way does anything make it feel better e S Severity how severe is the pain ona scale of 1 10 how would the patient rate the pain e timing when did the pain start how long has it lasted what was the patient doing at the onset of the pain has the patient had this type of pain before 9 WorkSafeBC May 2012 page 8 6 Occupational First Aid Level 2 Training Guide Lesson 8 Management o
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