BLS-AED SRC manual

Information

• For First Responders, their own safety is first priority. An approach to the patient may only be made when it is clear that there is no danger (electricity, gas, traffic, etc.)
• In case of doubt, wait for the arrival of professional rescuers.
   

Information

• First Aid always begins with an assessment of the situation and the patient.
• It is about recognizing if the patient is acutely threatened and needs immediate life-saving measures.
• Patients can be divided in three groups:

Responsive patient

• Awake or alert and able to respond. Needs can be expressed.
• The patient is able to explain their symptoms.
• Patient may require an ambulance or needs to make an appointment at the doctor.

Unconscious Patient

• Patient is unconscious and does not respond to touch, but is breathing normally.
• Potentially life-threatening
• A recovery position can be life-saving. The aim is to keep the airways open.
• Breathing should be continuously monitored until EMS arrives.

Patient in cardiac arrest

• Unconscious and not breathing or not breathing normally (gasping).
• Immediately call for EMS and ask someone to bring an AED.
• Start chest compressions and / or rescue breathing and defibrillation.
   

• In case of serious medical emergencies, EMS is to be called immediately via phone number 144.
• The time between the onset of symptoms and medical assistance should be as short as possible!
• Further emergency numbers:
  117 police
  118 fire department
  145 poison emergency call
  1414 rega
  112 european emergency number

Information

• There are many causes for a cardiac arrest. Among the most common are: heart attack, lung embolism, foreign body airway obstruction (FBAO), stroke, serious injury, etc. 
• Some risk factors favor heart attack and stroke. Some of these can be influenced. This means that these diseases can be prevented to a certain extent.
• Increased blood lipids, smoking, high blood pressure, overweight, diabetes type 2 and lack of exercise, are avoidable and to a certain extent reduce the personal risk.

Information
Heart attack is one of the most common causes of death worldwide. In most cases, the blood supply to the heart is interrupted.

Recognition
Typical signs of a heart attack are

• severe chest pain, pressure or burning
• shortness of breath
• blue discoloration of the lips
• fear
• feeling of impending doom
• nausea, vomiting
• sweat breakout

Action

• For First Responders, recognition and alerting is most important. Do not lose any time!
• Patient should be cared for until EMS arrives.
   

Information
Strokes often end fatally or cause lifelong disabilities. Early detection and hospitalization can be life-saving.

Recognition
Typical signs of a stroke are

• facial paralysis (when smiling, one side of the face is not moving)
• hemiplegia (the affected person cannot keep the arms stretched out to the same side)
• speech disorders (the affected person cannot speak or is speaking unclearly)

Action

• For First Responders, recognition and alerting is most important. Do not lose any time!
• Patient should be cared for until EMS arrives.

Information

• Unconsciousness could be caused by injury, illness or poisoning.
• The biggest danger of an unconscious person is choking on their on vomit, blood or their tongue obstructing the airway while lying on their back.

Recognition

• Person lies motionless on the floor
• Does not respond to speech or touch
• Normal breathing is visible

Action

• Alerting of EMS via emergency number 144
• To keep the airways open, place the patient in the recovery position
• Heat retention, for example by means of a rescue blanket (gold-silver foil)
• Afterwards, continuously check if the patient is breathing until EMS arrives.

Information
Airway obstruction can be caused by any kind of foreign matter, especially food, but with small children also toys.

Recognition

• Sudden shortness of breath or coughing
• Possibly respiratory arrest
• Asphyxiation fear
• Pale and / or blue skin discoloration

Action
Children under 1 year 

• 5 back slaps
• 5 chest compressions alternating

Children over 1 and adults

• 5 back slaps
• If unsuccessful: Heimlich maneuver 
• and alternate
• For unconsciousness: Basic Life Support

Information

• In Switzerland there is about one cardiac arrest per 1000 inhabitants every year. 
• Worldwide only about 12% survive such an event.

Today we know that:

• immediate resuscitation (reanimation) doubles the chances of survival;
• basic life support including defibrillation within 3 to 5 minutes allow survival rates of over 50%;
• every minute delay in defibrillation reduces the chances of survival by about 10%.
• So, do not lose any time!

Information

• Defibrillation refers to when the patients heart receives a shock. Its' aim is to end ventricular fibrillation.
• Speed is of the essence: For every minute of delayed defibrillation, the chances of survival decrease by about 10%
• After turning on the device, the action steps are carried out to the voice instructions of the device. A single shock is applied, followed by two minutes of CPR. Every 2 minutes the heart rhythm is checked again by the device and, if necessary, another shock is delivered.

Action

•  To use a defibrillator, place the patient on a flat surface and dry of the chest if wet.
• Attach pads on to the bare chest as shown in the illustration and press firmly.
• Safety control and shock warning.
• Nobody must touch the patient.
• Perform Basic Life Support while defibrillation is being prepared.
• The interruption for defibrillation must be short.
• After defibrillation, proceed immediately with 30 chest compressions.

Safety instructions

• To ensure a safe defibrillation, some basic rules must be observed:
• Use only on an unconscious and not breathing patient.
• Do not use on conductive surfaces or in explosive environments.
• Defibrillation on snow or ice is not dangerous.
• Heavy chest hair may need to be shaved.
• If the patient has a recognizable pacemaker – attach pads beside it.
• If the patient is wearing medication patches on the chest – remove the patches and wipe the skin.
• With pregnant women, always use a defibrillator.
• Different pictograms are used to signal AED locations. The one shown here is recommended for Switzerland.

Resuscitation is carried out until

• professional rescuers take over the measures;
• the patient is breathing normally again;
• a physician or the rescue team interrupts resuscitation;
• or you become physically exhausted.

Information

• Recognizing if the patient is unconscious in adults and children is the same.

Action

• If the child is unresponsive, phone EMS immediately.
• Start with 5 rescue breaths.
• If there is no response after the 5 rescue breaths, start with 15 compressions, 2 rescue breaths.
• The depth of chest compression is one third of the diameter of the chest.
• Ventilation has a higher priority in resuscitation of children than in adults and should always be performed.
• Pediatric electrodes can be used, if available, when defibrillating children. If not available, normal adult pads should be used.

Information

• Art 128. of the Swiss Penal Code (StGB) makes it a punishable offense to fail to render assistance in cases of danger to life.
• Wrong or not indicated measures can injure the person concerned.

But:

• No injury is more serious than neglected resuscitation efforts.
• With BLS and AED to the best of one's knowledge and belief, legal consequences are practically excluded