KIN 308 Test 1

Explain how you lower the risk for infection while performing first aid.

*Providing this care can put you in close contact with another person's body fluids (such as saliva, mucus, vomit or blood), which may contain pathogens (harmful microorganisms that can cause disease). Pathogens can be spread from person to person through direct or indirect contact. There are two main steps you can take to limit your exposure to pathogens and your risk for contracting a communicable disease while giving first aid care: 1. Use personal protective equipment (PPE) -disposable gloves -CPR breathing barriers. -Face masks and protective eyewear are other types of PPE that may be used in a first aid situation 2. Wash your hands after giving care.

List things in a typical first aid box

2 pairs of latex-free gloves ■ Latex-free adhesive bandages (3 of each of the following sizes): m 1 × 3 inches m ¾ × 3 inches m Large fingertip m Knuckle ■ 8 sterile gauze pads (2 × 2 inches) ■ 8 sterile gauze pads (4 × 4 inches) ■ 1 roll of adhesive cloth tape (2½ yards × 3⁄8 inch) ■ 4 roller bandages (2 inches or 3 inches × 4 yards) ■ 4 roller bandages (4 inches × 4 yards ■ 1 elastic bandage (3 inches or 4 inches × 5 yards) ■ 3 or 4 triangular bandages (40 inches × 40 inches × 56 inches) ■ 1 36" malleable radiolucent splint ■ 1 unit antibiotic ointment, cream or wound gel ■ 4 sealable plastic bags (1 quart) or 2 chemical cold packs ■ 5 antiseptic wipe packets ■ 2 hydrocortisone ointment packets (approximately 1 gram each) ■ 2 packets of chewable aspirin (81 mg each) ■ 1 space blanket ■ 1 CPR breathing barrier (with one-way valve ■ 1 pair of utility shears or scissors ■ Oral thermometer (nonmercury/nonglass) ■ Tweezers ■ First aid manual

________________ occurs when blood flow to part of the heart muscle is blocked (e.g., as a result of coronary artery disease). Because the cells in the affected area of the heart muscle are not receiving the oxygen and nutrients they need, they die, causing permanent damage to the heart muscle (Figure 3-1). Seeking advanced medical care as soon as you recognize the signs and symptoms of a heart attack can minimize

A heart attack

What are causes for respiratory distress?

A number of different conditions can cause respiratory distress, including acute flare-ups of chronic respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD); lung and respiratory tract infections (such as pneumonia or bronchitis); severe allergic reactions (anaphylaxis); heart conditions (such as a heart attack or heart failure); trauma; poisoning; drug overdose; electrocution; and mental health conditions (such as panic disorder).

What are Signs and Symptoms of Fainting?

A person who is about to faint often becomes pale, begins to sweat and may feel weak or dizzy. The person may sense that he or she is about to faint and may attempt to sit down to prevent a fall.

What are signs and symptoms of respiratory distress?

A person who is experiencing respiratory distress is, understandably, often very frightened. The person may feel like he or she cannot get enough air and may gasp for breath. Because the person is struggling to breathe, speaking in complete sentences may be difficult. You might hear wheezing, gurgling or high-pitched noises as the person tries to breathe. You may also notice that the person's breathing is unusually slow or fast, unusually deep or shallow, or irregular. The person's skin may feel moist or cool, and it may be pale, ashen (gray), bluish or flushed. Lack of oxygen can make the person feel dizzy or light-headed.

What are signs and symptoms of shock?

A person who is going into shock may show any of the following signs and symptoms: ■ Restlessness or irritability ■ Altered level of consciousness ■ Nausea or vomiting ■ Pale, ashen (grayish), cool, moist skin ■ Rapid breathing ■ Rapid, weak heartbeat ■ Excessive thirst

How do you do a throwing assist?

A throwing assist involves throwing a floating object to the person so that he or she can grasp it and be pulled to safety. A floating object with a line attached (such as a ring buoy) is ideal for a throwing assist; however, a line or an object that floats (such as a life jacket or cooler) can also be used alone.

How do you do a wading assist?

A wading assist involves wading into the water and using a reaching assist to help pull the person to safety. Only use a wading assist in water that is less than chest deep. If a current or soft bottom makes wading dangerous, do not enter the water. For your own safety, wear a life jacket if one is available and take something to extend to the person, such as a ring buoy, branch, pole or paddle.

A chronic illness in which certain substances or conditions, called triggers, cause inflammation and narrowing of the airways, making breathing difficult. Common triggers include exercise, temperature extremes, allergies, air pollution, strong odors (such as perfume, cologne and scented cleaning products), respiratory infections, and stress or anxiety. The trigger causes inflammation and swelling, which causes the opening of the airways to become smaller and makes it harder for air to move in and out of the lungs. People who have asthma usually know what can trigger an attack and take measures to avoid these triggers.

Asthma

____________________is not the same as a heart attack. Remember, a heart attack occurs when blood flow to part of the heart muscle is blocked, causing part of the heart muscle to die. This on the other hand, occurs when the heart stops beating or beats too ineffectively to circulate blood to the brain and other vital organs. A network of special cells in the heart muscle conducts electrical impulses that coordinate contraction, causing the heart to beat rhythmically. In cardiac arrest, the electrical impulses become abnormal and chaotic. This causes the heart to lose the ability to beat rhythmically, or to stop beating altogether

Cardiac arrest

What are signs of an emergency?

Unusual Sounds ■ Screaming, moaning, yelling or calls for help ■ Sudden, loud noises such as breaking glass, crashing metal or screeching tires ■ A change in the sound made by machinery or equipment ■ Unusual silence Unusual Sights ■ A stopped vehicle on the roadside or a car that has run off of the road ■ Downed electrical wires ■ Sparks, smoke or fire ■ A person who suddenly collapses or is lying motionless ■ Signs or symptoms of illness or injury, such as profuse sweating for no apparent reason or an uncharacteristic skin color Unusual Odors ■ A foul or unusually strong chemical odor ■ The smell of smoke ■ The smell of gas ■ An unrecognizable odor ■ An inappropriate odor (e.g., a sickly sweet odor on a person's breath) Unusual Behaviors ■ Confusion in a person who is normally alert ■ Unusual drowsiness ■ Personality or mood changes (e.g., agitation in a person who is normally calm, irritability in a person who is normally pleasant)

An ________________is an illness that strikes suddenly and usually only lasts for a short period of time

acute illness

An _______________is a medication that counteracts the effects of histamine, a chemical released by the body during an allergic reaction. Antihistamines are supplied as pills, capsules or liquids and are taken by mouth.

antihistamine

Some people suggests offering someone who is experiencing early signs of an heart attack an _____________

aspirin

A _______________ is an illness that a person lives with on an ongoing basis and that often requires continuous treatment to manage.

chronic illness

Before giving first aid care, you must obtain from the injured or ill person (or the person's parent or guardian if the person is a minor)

consent

If a person suddenly loses consciousness and then "comes to" after about a minute, he or she may simply have ________________. This is caused by a sudden decrease in blood flow to the brain. Usually the cause of it is not serious. For example, being dehydrated (not having enough fluid in the body), being too hot, being in a crowded room or feeling intense emotion can cause a person to faint. After the person faints, the head is at the same level as the heart. This helps blood flow return to the brain and the person quickly recovers

fainted.

_______________is the result of abnormal electrical activity in the brain, leading to temporary and involuntary changes in body movement, function, sensation, awareness or behavior. They can have many different causes. One common cause is epilepsy, a chronic seizure disorder that can often be controlled with medication. Other causes of seizures include fever, infection, diabetic emergencies, heat stroke and injuries to the brain tissue

seizure

A________________occurs when blood flow to part of the brain is interrupted by a blood clot, resulting in the death of brain cells. It can also be caused by bleeding into the brain tissue. They can cause permanent brain damage, but with quick action, sometimes the damage can be stopped or reversed. Although they are most common in older adults, a person of any age, even a child, can have a stroke.

stroke

Some people experience __________________, or "mini-strokes." They cause signs and symptoms similar to those of a stroke, but the signs and symptoms go away after a short period of time. A person who has had this is at very high risk for having a stroke in the near future. In fact, more than 10 percent of people who have a this will have a stroke within 3 months, with half of these strokes happening within 48 hours of the TIA. For this reason, whenever a person experiences signs and symptoms of stroke, even if the signs and symptoms seem to go away, the person should seek immediate medical attention.

transient ischemic attacks (TIAs)

Explain the difference in signs of a heart attack in women and men.

Men -often, but not always, experience the "classic" signs and symptoms of a heart attack -Chest pain, pressure, squeezing, tightness, aching or heaviness that lasts longer than 3-5 minutes or goes away and comes back -Radiating pain to arm(s), shoulder or neck -Secondary signs and symptoms may include dizziness, loss of consciousness, sweating, nausea or shortness of breath Women -may experience the "classic" signs and symptoms but they are often milder and may be accompanied by more general signs and symptoms such as shortness of breath, nausea, vomiting or diarrhea, fatigue, dizziness, sweating, and back or jaw pain -Because these signs and symptoms are so general and nonspecific, women may experience them for hours, days or even weeks leading up to the heart attack but dismiss them as nothing out of the ordinary.

__________delivers a measured dose of medication in mist form directly into the person's lungs. The person gently presses down the top of the inhaler. This causes a small amount of pressurized gas to push the medication out quickly.

Metered Dose Inhalers (MDIs)

_____________ are trained to give the highest level of advanced medical care at the scene of an emergency, including the administration of medications and advanced airway support.

Paramedics

Equipment used to prevent pathogens from contaminating your skin, mucous membranes or clothing

Personal protective equipment (PPE)

_______________________, or difficulty breathing, is evidenced by signs and symptoms such as shortness of breath, gasping for breath, hyperventilation (breathing that is faster and shallower than normal), or breathing that is uncomfortable or painful. Respiratory distress can lead to respiratory arrest (absence of breathing).

Respiratory distress

_________ is a progressive, life-threatening condition in which the circulatory system fails to deliver enough oxygen-rich blood to the body's tissues and organs. As a result, organs and body systems begin to fail. Common causes of this include severe bleeding and severe allergic reactions (anaphylaxis), but shock can develop quickly after any serious injury or illness. A person who is showing signs and symptoms of this needs immediate medical attention.

Shock

Give the Signs and Symptoms of a Stroke

The signs and symptoms of stroke can vary from person to person. A person who is having a stroke may suddenly develop one or more of the following signs and symptoms: ■ Trouble with speech and language, including slurring of words, being unable to form words or being unable to understand what others are saying ■ Drooling or difficulty swallowing ■ Drooping of the features on one side of the face (for example, the eyelid and the corner of the mouth) ■ Trouble seeing in one or both eyes ■ Weakness ■ Paralysis or numbness of the face, arms or legs, especially on one side of the body ■ A sudden, severe headache ■ Dizziness or loss of balance ■ Confusion ■ Loss of consciousness

-Airborne infection -Is a bacterial infection of the lungs that is spread through the air from one person to another. -Although it primarily affects the lungs, it can also affect the bones, brain, kidneys and other organs. -If not treated, it can be fatal. Treatment is complex and involves taking many different medications over an extended period of time

Tuberculosis

Explain how you check the scene and the person in an emergency situation.

*First, check the scene. Then check the person. Check the Scene Before rushing to help an injured or ill person, conduct a scene size-up and form an initial impression. Try to answer these questions: ■ Is the scene safe to enter? Check for hazards that could jeopardize your safety or the safety of bystanders, such as fire, downed electrical wires, spilled chemicals, an unstable building or traffic. Do not enter bodies of water unless you are specifically trained to perform in-water rescues (Box 1-7). Avoid entering confined areas with poor ventilation and places where natural gas, propane or other substances could explode. Do not enter the scene if there is evidence of criminal activity or the person is hostile or threatening suicide. If these or other dangers threaten, stay at a safe distance and call 9-1-1 or the designated emergency number immediately. Once professional responders make the scene safe, you can offer your assistance as appropriate. ■ What happened? Take note of anything that might tell you the cause of the emergency. If the person is unresponsive and there are no witnesses, your check of the scene may offer the only clues as to what happened. Use your senses to detect anything out of the ordinary, such as broken glass, a spilled bottle of medication or an unusual smell or sound. Keep in mind that the injured or ill person may not be exactly where he or she was when the injury or illness occurred—someone may have moved the person, or the person may have moved in an attempt to get help. ■ How many people are involved? Look carefully for more than one injured or ill person. A person who is moving or making noise or who has very visible injuries will likely attract your attention right away, but there may be a person who is silent and not moving or a person obscured by debris or wreckage that you do not notice at first. It also is easy to overlook a small child or an infant. In an emergency with more than one injured or ill person, you may need to prioritize care (in other words, decide who needs help first). ■ What is your initial impression about the nature of the person's illness or injury? Before you reach the person, try to form an initial impression about the person's condition and wh

Describe first aid for sudden illness.

*Fortunately, you do not need to know exactly what is wrong to provide appropriate first aid care. If your initial check of the person reveals any life-threatening conditions, make sure that someone calls 9-1-1 or the designated emergency number right away, and then provide care according to the signs and symptoms that you find and your level of training. Follow the same general guidelines as you would for any emergency: ■ Do no further harm. ■ Monitor the person's breathing and level of consciousness. ■ Help the person rest in the most comfortable position. ■ Keep the person from getting chilled or overheated. ■ Reassure the person that you will help and that EMS personnel have been called (if appropriate). ■ Give care consistent with your knowledge and training as needed, and continue to watch for changes in the person's condition.

Describe the first aid for choking.

*If you are with a person who starts to choke, first ask the person if he or she is choking, or check to see if an infant is crying or making other noises. If the person can speak or cry and is coughing forcefully, encourage him or her to keep coughing. A person who is getting enough air to speak, cry or cough forcefully is getting enough air to breathe. But be prepared to act if the person's condition changes. *If the person is making high-pitched noises or coughing weakly, or if the person is unable to speak or cry, the airway is blocked and the person will soon become unresponsive unless the airway is cleared. Have someone call 9-1-1 or the designated emergency number immediately while you begin to give first aid for choking. When an adult or child is choking, give a combination of 5 back blows (blows between the shoulder blades) followed by 5 abdominal thrusts (inward and upward thrusts just above the navel) (Figure 4-1). The goal of giving back blows and abdominal thrusts is to force the object out of the airway, allowing the person to breathe. ■Back blows. To give back blows, position yourself to the side and slightly behind the person. For a child, you may need to kneel. Place one arm diagonally across the person's chest (to provide support) and bend the person forward at the waist so that the person's upper body is as close to parallel to the ground as possible. Firmly strike the person between the shoulder blades with the heel of your other hand. Each back blow should be separate from the others. ■Abdominal thrusts. To give abdominal thrusts, stand behind the person, with one foot in front of the other for balance and stability. If possible, place your front foot between the person's feet. Wrap your arms around the person's waist. Alternatively, if the person is a child, you can kneel behind the child, wrapping your arms around the child's waist. Find the person's navel by placing one finger on the person's navel, and the adjacent finger above the first. Make a fist with your other hand and place the thumb side just above your fingers. Cover your fist with your other hand and give quick, inward and upward thrusts into the person's abdomen. Each abdominal thrust should be separate from the others. *

Explain how to give CPR to an adult

*If you check a person and find that he or she is unresponsive and not breathing or only gasping, begin CPR immediately, starting with chest compressions. *First, make sure the person is lying face-up on a firm, flat surface. For example, if the person is on a soft surface like a sofa or bed, quickly move him or her to the floor before you begin. Kneel beside the person. ■ Position your hands. Place the heel of one hand in the center of the person's chest on the person's breastbone (sternum). If you feel the notch at the end of the breastbone, move your hand slightly toward the person's head. Place your other hand on top of your first hand and interlace your fingers or hold them up so that your fingers are not on the person's chest. If you have arthritis in your hands, you can grasp the wrist of the hand positioned on the chest with your other hand instead. The person's clothing should not interfere with finding the proper hand position or your ability to give effective compressions. If it does, loosen or remove enough clothing to allow deep compressions in the center of the person's chest. ■ Give a set of 30 compressions. Position your body so that your shoulders are directly over your hands. This will let you push on the chest using a straight up-and-down motion, which moves the most blood with each push and is also less tiring. Keeping your arms straight, push down at least 2 inches, and then let the chest completely return to its normal position. Push hard and push fast! You want to go at a rate of 100-120 compressions per minute. As you give compressions, count out loud up to 30. Maintain a smooth, steady down-and-up rhythm and do not pause between compressions. ■ Give a set of 2 rescue breaths. Once you have given 30 compressions, give 2 rescue breaths. First, open the airway using the head-tilt/chin-lift maneuver. Place one of your hands on the person's forehead and two fingers of your other hand on the bony part of the person's chin. Tilt the person's head back and lift the chin. For an adult, tilt the head to a past-neutral position (see Table 3-1). If possible, use a CPR breathing barrier when you are giving rescue breaths, but do not delay rescue breaths to find a breathing barrier or learn how to

What steps should you take to make it easier for EMS personnel and others to help you should an emergency occur?

*Keep a current list of emergency telephone numbers in your mobile phone, by the telephones in your home and workplace, and in your first aid kit. Most communities are served by the emergency telephone number 9-1-1. -Make sure your house or apartment number is large, easy to read and well lit at night. Numerals are easier to read than spelled-out numbers. -Keep relevant medical information, such as a list of the medications that each family member takes, in an accessible place (for example, on the refrigerator door and in your wallet or mobile phone). -If you have a chronic medical condition such as diabetes, epilepsy or allergies, consider wearing a medical identification tag to alert responders to the presence of the condition in case you are not able to. You can also create a digital medical identification tag in your mobile phone that can be accessed without unlocking the phone (Figure 1-1). In addition to information about chronic medical conditions, blood type and so on, you can enter contact information for the person you would want contacted on your behalf in case of an emergency.

What should you do to rescue someone in water or ice?

*Never go into water or onto ice in an attempt to rescue a person who is in trouble. Instead, get help from a trained responder, such as a lifeguard, to get the person out of the water as quickly and safely as possible. Reaching and throwing assists are the safest assists for responders who are not professionally trained lifeguards to use to help a person who is in trouble in the water. When doing a reaching or throwing assist: ■ Talk to the person and let the person know help is coming. ■ Tell the person what he or she can do to help with the rescue, such as grasping a line or other floating device. Use gestures to communicate with the person if it is too noisy or if the person is too far away to hear. ■ Encourage the person to move toward safety by kicking his or her legs or stroking with his or her arms. Some people are able to reach safety by themselves with calm encouragement from a person on the deck or shore.

When a person is responsive but not fully awake, put the person in a recovery position if the person has no obvious signs of injury. List the importance of this and how to put someone in recovery position.

*The recovery position helps to lower the person's risk for choking and aspiration (the inhalation of foreign matter, such as saliva or vomit, into the lungs). You should also use the recovery position if a person with an injury begins to vomit, or if it is necessary to leave the person alone to call 9-1-1 or the designated emergency number. To place an adult or child in a recovery position: ■ Extend the person's arm that is closest to you above the person's head. ■ Roll the person toward yourself onto his or her side, so that the person's head rests on his or her extended arm. ■ Bend both of the person's knees to stabilize the body For an infant: ■ You can place an infant on his or her side as you would an older child, or you can hold the infant in a recovery position by positioning the infant face-down along your forearm, supporting the infant's head and neck while keeping the mouth and nose clear

When should you activate the EMS System?

*The sooner emergency personnel arrive, the better the chance for a positive outcome. At times you may be unsure if advanced medical personnel are needed. You will have to use your best judgment—based on the situation, your assessment of the injured or ill person, and information gained from this course and other training you may have received—to make the decision to call. When in doubt, make the call. *Call 9-1-1 or the designated emergency number for any of the following emergency situations and conditions Emergency Situations ■ An injured or ill person who needs medical attention and cannot be moved ■ Fire or explosion ■ Downed electrical wires ■ Swiftly moving or rapidly rising flood waters ■ Drowning ■ Presence of poisonous gas ■ Serious motor-vehicle collision Emergency Conditions ■ Unresponsiveness or an altered level of consciousness (LOC), such as drowsiness or confusion ■ Breathing problems (trouble breathing or no breathing) ■ Chest pain, discomfort or pressure lasting more than a few minutes that goes away and comes back or that radiates to the shoulder, arm, neck, jaw, stomach or back ■ Persistent abdominal pain or pressure ■ Severe external bleeding (bleeding that spurts or gushes steadily from a wound) ■ Vomiting blood or passing blood ■ Severe (critical) burns ■ Suspected poisoning that appears to be life threatening ■ Seizures ■ Signs or symptoms of stroke (e.g., drooping of the face on one side; sudden weakness on one side of the body; sudden slurred speech or difficulty speaking; or a sudden, severe headache) ■ Suspected or obvious injuries to the head, neck or spine ■ Suspected or obvious broken bone

Explain how you assist with an Epinephrine Auto Injector

*You may assist a person with using an epinephrine auto injector when the person has a previous diagnosis of anaphylaxis and has been prescribed an epinephrine auto injector; the person is having signs and symptoms of anaphylaxis; the person requests your help using an auto injector; and your state laws permit giving assistance. 1. Check the label on the auto injector. If the medication is visible, check to make sure the medication is clear, not cloudy. ■ If the medication is expired or cloudy, do not use it. 2. Determine whether the person has already given him- or herself a dose of the medication. If the person has, help him or her administer a second dose only if emergency responders are delayed and the person is still having signs and symptoms of anaphylaxis 5 to 10 minutes after administering the first dose 3. Have the person locate the outer middle of one thigh to use as the injection site. ■ Make sure there is nothing in the way, such as seams or items in a pocket. 4. Grasp the auto injector firmly in one fist and pull off the safety cap with the other hand. 5. Have the person hold the tip of the auto injector (the end with the needle) against his or her outer thigh so that the auto injector is at a 90-degree angle to the thigh. 6. Have the person quickly and firmly push the tip straight into his or her outer thigh. You may hear a click. Have the person hold the auto injector firmly in place for the recommended amount of time. 7. Have the person remove the auto injector from his or her thigh. Massage the injection site for several seconds (or have the person massage the site). 8. Check the person's condition and watch to see how he or she responds to the medication. ■ If the person is still having signs and symptoms 5 to 10 minutes after administering the first dose and emergency responders have not arrived, help the person to administer a second dose. 9. Place the used auto injector in its plastic carrying case or another hard plastic container with the tip facing down. Give it to the emergency responders when they arrive.

How should you clean and disinfect surfaces and equipment?

-Reusable equipment and surfaces that have been contaminated by blood or other potentially infectious materials need to be properly cleaned and disinfected before the equipment is put back into service or the area is reopened. Clean and disinfect surfaces and equipment as soon as possible after the incident occurs. Remember to wear appropriate PPE. -If blood or other potentially infectious materials have spilled on the floor or another surface, prevent others from accessing the area. If the spill contains a sharp object (e.g., shards of broken glass), do not pick the object up with your hands. Instead, use tongs, a disposable scoop and scraper, or two pieces of cardboard to remove and dispose of the object. Wipe up or absorb the spill using absorbent towels or a solidifier (a fluid-absorbing powder). After wiping up the spill, flood the area with a freshly mixed disinfectant solution of approximately 1½ cups of bleach to 1 gallon of water (1 part bleach to 9 parts water, or about a 10 percent solution). When using a bleach solution, always ensure good ventilation and wear gloves and eye protection. Let the bleach solution stand on the surface for at least 10 minutes. Then use clean absorbent materials (such as paper towels) to wipe up the disinfectant solution and dry the area. Dispose of all materials used to clean up the blood spill in a labeled biohazard container. If a biohazard container is not available, place the soiled materials in a sealable plastic bag or a plastic container with a lid, seal the container and dispose of it properly.

When should you stop performing CPR?

. Once you begin CPR, continue giving sets of 30 chest compressions and 2 rescue breaths until: ■ You notice an obvious sign of life, such as movement. (If the person shows an obvious sign of life, stop CPR, place the person in the recovery position and continue to monitor the person's condition until EMS personnel take over.) ■ An AED is ready to use and no other trained responders are available to assist you with the AED. ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2) and another trained responder is available to take over compressions. Giving chest compressions correctly is physically tiring. If more than one responder is available and trained in CPR, the responders should switch responsibility for compressions every 2 minutes, or whenever the responder giving compressions indicates that he or she is tiring. Switching responsibility for giving chest compressions frequently reduces responder fatigue, which improves the quality of chest compressions and leads to a better chance of survival for the person. ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2), you are alone and caring for a child, and you need to call 9-1-1 or the designated emergency number. ■ EMS personnel take over. ■ You are alone and too tired to continue. ■ The scene becomes unsafe

In any emergency situation, what are the three simple steps to take to guide your actions.

1. CHECK the scene and the person. 2. CALL 9-1-1 or the designated emergency number. 3. CARE for the person.

List the steps to check consciousness.

1. Check if the person is awake and responsive. If so, ask for consent and begin to gather information about the person's illness or injury. Be sure to talk to the person appropriately, considering her age and if she has any disability. 2. If the person seems to be unresponsive, shout using the person's name if you know it. If there is no response and the person is an adult or child, tap her shoulder. If the unresponsive person is an infant, tap the bottom of her foot. While doing this, shout again and check for normal breathing. If the person is gasping, she is not considered to be breathing normally. Do not check for responsiveness or breathing for more than five to ten seconds. 3. If the person does not respond to you in any way, which could include moving, moaning, or opening her eyes, and the person is either not breathing or is only gasping, she is deemed unresponsive. Assign someone to call 9-1-1. Get a first aid kit and an Automated External Defibrillator (AED). As soon as possible, perform CPR and use the AED. 4. If the person responds and is breathing regularly, even if she is not fully awake, she is deemed responsive. Assign someone to call 9-1-1. Get a first aid kit and an AED. Perform a head-to-toe check. If the person does not have any injuries, put the person in the recovery position.

What are two common types of CPR breathing barriers?

1. Face Shield -The most basic and portable type of breathing barrier is a face shield, a flat piece of thin plastic that you place over the person's face, with the opening over the person's mouth. The opening contains a filter or a valve that protects you from coming into contact with the person's body fluids and exhaled air. 2. Pocket Mask -A pocket mask is a transparent, flexible device that creates a tight seal over the person's nose and mouth to allow you to give rescue breaths without making mouth-to-mouth contact or inhaling exhaled air. Breathing barriers sized specifically for children and infants are available. Always use equipment that is sized appropriately for the injured or ill person.

List the steps of assisting someone with an asthma inhaler

1. Help the person to sit up and lean slightly forward to make breathing easier. 2. Verify with the person that the medication is for "quick relief" or "acute attacks." Also check the expiration date on the inhaler. ■ If the medication is not for "quick relief" or "acute attacks," do not use it. ■ If the medication is expired, do not use it. 3. Shake the inhaler. 4. Remove the mouthpiece cover. If the person uses a spacer, attach it to the mouthpiece 5. Ask the person to breathe out as much as possible through the mouth. 6. Help the person to take the medication. ■ No spacer. Position the mouthpiece of the inhaler according to the method the person uses. Some people may close their lips tightly around the mouthpiece of the inhaler. Others may hold the mouthpiece an inch or two away from the mouth. Have the person take a long, slow breath (about 3 to 5 seconds) while pressing down on the top of the canister. Then have the person hold his or her breath for a count of 10. ■ Spacer. Have the person close his or her lips tightly around the spacer and push the button on the top of the canister to release the medication into the spacer. Have the person take a long, slow breath (about 3 to 5 seconds), and then hold the breath for a count of 10. ■ Spacer with mask. Position the mask over the person's nose and mouth. Have the person push the button on the top of the canister to release the medication into the spacer. Have the person breathe in and out normally about 5 or 6 times. 7. Note the time. The person's breathing should improve within 5 to 15 minutes. More than one dose of medication may be needed to stop the asthma attack. The label will tell you how long to wait between doses. ■ If the person's breathing does not improve or the person becomes unresponsive, call 9-1-1 or the designated emergency number.

What is your role in the emergency medical services (EMS) system?

1. Recognizing that an emergency exists. -Sometimes it will be obvious that an emergency exists-Signs of an emergency may be more subtle, such as a slight change in a person's normal appearance or behavior, or an unusual silence. Your eyes, ears, nose and even your gut instincts can alert you that an emergency situation exists. 2. Deciding to take action.-Once you recognize an emergency situation, you must decide to take action. In an emergency, deciding to act is not always as simple as it sounds.-Some people are slow to act in an emergency because they panic, are not exactly sure what to do or think someone else will take action. But in an emergency situation, your decision to take action could make the difference between life and death for the person who needs help.-Your decision to act in an emergency should be guided by your own values and by your knowledge of the risks that may be present. However, even if you decide not to give care, you should at least call 9-1-1 or the designated emergency number to get emergency medical help to the scene. 3. Activating the EMS system.-Activating the EMS system (Box 1-5) will send emergency medical help on its way as fast as possible. The sooner emergency personnel arrive, the better the chance for a positive outcome. -At times you may be unsure if advanced medical personnel are needed. You will have to use your best judgment—based on the situation, your assessment of the injured or ill person, and information gained from this course and other training you may have received —to make the decision to call. When in doubt, make the call.4. Giving care until EMS personnel take over. -First aid care can be the difference between life and death. Often it makes the difference between complete recovery and permanent disability -In general, you should give the appropriate care to an injured or ill person until: ■ Another trained responder or EMS personnel take over. ■ You are too exhausted to continue.■ The scene becomes unsafe.-Before giving first aid care, you must obtain consent

Give the steps of performing the CPR on an infant

1. Verify that the infant is choking by checking to see if the infant is crying or coughing forcefully. ■ If the infant is crying or coughing forcefully: Allow the infant to keep coughing, but be prepared to give first aid for choking if the infant's condition changes. ■ If the infant is unable to cry or is coughing weakly: Send someone to call 9-1-1 or the designated emergency number and to obtain an AED and first aid kit. Continue to step 2 after obtaining consent. 2. Position the infant. ■ Place your forearm along the infant's back, cradling the back of the infant's head with your hand. ■ Place your other forearm along the infant's front, supporting the infant's jaw with your thumb and fingers. ■ Turn the infant over so that he or she is face-down along your forearm. ■ Lower your arm onto your thigh so that the infant's head is lower than his or her chest. Note: Always support the infant's head, neck and back while giving back blows and chest thrusts. 3. Give 5 back blows. ■ Firmly strike the infant between the shoulder blades with the heel of your hand. Keep your fingers up to avoid hitting the infant's head or neck. 4. Reposition the infant. ■ Place one hand along the infant's back, cradling the back of the infant's head with your hand. ■ While continuing to support the infant's jaw with the thumb and fingers of your other hand, support the infant between your forearms and turn the infant over so that he or she is face-up along your forearm. ■ Lower your arm onto your other thigh so that the infant's head is lower than his or her chest. 5. Give 5 chest thrusts. ■ Place the pads of two fingers in the center of the infant's chest on the breastbone, just below the nipple line. ■ Press down about 1½ inches and then let the chest return to its normal position. 6. Continue giving sets of 5 back blows and 5 chest thrusts until: ■ The infant can cough forcefully, cry or breathe. ■ The infant becomes unresponsive. Note: If the infant becomes unresponsive, lower him or her to a firm, flat surface and begin CPR if you are trained, starting with compressions. After each set of compressions and before attempting rescue breaths, open the infant's mouth, look for the object and remove it if seen. Never p

Give the steps of performing CPR on an adult

1. Verify that the person is choking by asking the person to speak to you. ■ If the person is able to speak to you or is coughing forcefully: Encourage the person to keep coughing, but be prepared to give first aid for choking if the person's condition changes. ■ If the person is unable to speak to you or is coughing weakly: Send someone to call 9-1-1 or the designated emergency number and to obtain an AED and first aid kit. Continue to step 2 after obtaining consent. 2. Give 5 back blows. ■ Position yourself to the side and slightly behind the person. Place one arm diagonally across the person's chest (to provide support) and bend the person forward at the waist so that the person's upper body is as close to parallel to the ground as possible. ■ Firmly strike the person between the shoulder blades with the heel of your hand 3. Give 5 abdominal thrusts. ■ Have the person stand up straight. Stand behind the person with one foot in front of the other for balance and wrap your arms around the person's waist. ■ Using two fingers of one hand, find the person's navel. With your other hand, make a fist and place the thumb side against the person's stomach, right above your fingers. ■ Cover the fist with your other hand. ■ Pull inward and upward to give an abdominal thrust 4. Continue giving sets of 5 back blows and 5 abdominal thrusts until: ■ The person can cough forcefully, speak, cry or breathe. ■ The person becomes unresponsive. Note: If the person becomes unresponsive, gently lower him or her to the floor and begin CPR if you are trained, starting with compressions. After each set of compressions and before attempting rescue breaths, open the person's mouth, look for the object and remove it if seen. Never put your finger in the person's mouth unless you actually see the object.

Describe the Cardiac Chain of Survival's five actions that, when performed in rapid succession, increase the person's likelihood of surviving cardiac arrest.

Adult ■ Recognition of cardiac arrest and activation of the emergency medical services (EMS) system. The sooner someone recognizes that a person is in cardiac arrest and calls 9-1-1 or the designated emergency number, the sooner people capable of providing advanced life support will arrive on the scene. ■ Early CPR. CPR circulates oxygen-containing blood to the brain and other vital organs, helping to prevent brain damage and death. ■Early defibrillation. Defibrillation (delivery of an electrical shock using an AED) may restore an effective heart rhythm, significantly increasing the person's chances for survival. ■Early advanced life support. Provided by EMS personnel at the scene and en route to the hospital, early advanced life support gives the person access to emergency medical care delivered by trained professionals. ■Integrated post-cardiac arrest care. After the person is resuscitated, an interdisciplinary team of medical professionals works to stabilize the person's medical condition, minimize complications, and diagnose and treat the underlying cause of the cardiac arrest to improve survival outcomes Pediatric ■Prevention. Because cardiac arrest in children often occurs as the result of a preventable injury (such as trauma, drowning, choking or electrocution), the Pediatric Cardiac Chain of Survival has "prevention" as the first link. ■ Early CPR. CPR circulates oxygen-containing blood to the brain and other vital organs, helping to prevent brain damage and death. ■ Activation of the emergency medical services (EMS) system. The sooner someone recognizes that a person is in cardiac arrest and calls 9-1-1 or the designated emergency number, the sooner people capable of providing advanced life support will arrive on the scene. ■ Early advanced life support. Provided by EMS personnel at the scene and en route to the hospital, early advanced life support gives the person access to emergency medical care delivered by trained professionals ■ Integrated post-cardiac arrest care. After the person is resuscitated, an interdisciplinary team of medical professionals works to stabilize the person's medical condition, minimize complications, and diagnose and treat the underlying cause of the cardiac arrest to i

_____________ are EMTs who have received additional training that qualifies them to perform certain advanced life support skills and administer some medications at the scene of an emergency.

Advanced EMTs (AEMTs)

What are signs and symptoms of allergic reactions and anaphylaxis?

An allergic reaction can range from mild to very severe. A person who is having a mild to moderate allergic reaction may develop a skin rash, a stuffy nose, or red, watery eyes. The skin or area of the body that came in contact with the allergen usually swells and turns red. A person who is having a severe, life-threatening allergic reaction (called anaphylaxis) may develop one or more of the following signs and symptoms within seconds or minutes of coming into contact with the allergen: ■ Trouble breathing ■ Swelling of the face, neck, tongue or lips ■ A feeling of tightness in the chest or throat ■ Skin reactions (such as hives, itchiness or flushing) ■ Stomach cramps, nausea, vomiting or diarrhea ■ Dizziness ■ Loss of consciousness ■ Signs and symptoms of shock (such as excessive thirst; skin that feels cool or moist and looks pale or bluish; an altered level of consciousness; and a rapid, weak heartbeat)

Many different fears and concerns can cause a person to hesitate to respond in an emergency. List some of the fears and concerns.

Being uncertain that an emergency actually exists. - Sometimes people hesitate to take action because they are not sure that the situation is a real emergency and do not want to waste the time of the EMS personnel. If you are not sure what to do, err on the side of caution and call 9-1-1 or the designated emergency number Being afraid of giving the wrong care or inadvertently causing the person more harm. -Getting trained in first aid can give you the confidence, knowledge and skills you need to respond appropriately to an emergency. If you are not sure what to do, call 9-1-1 or the designated emergency number and follow the EMS dispatcher's instructions. The worst thing to do is nothing. Assuming that the situation is already under control. -Although there may be a crowd of people around the injured or ill person, it is possible that no one has taken action. If no one is giving care or directing the actions of bystanders, you can take the lead. If someone else is already giving care, confirm that someone has called 9-1-1 or the designated emergency number and ask how you can be of help. Squeamishness related to unpleasant sights, sounds or smells. Many people feel faint or nauseated when confronted with upsetting sights, sounds or smells, such as blood, vomit or a traumatic injury. You may have to turn away for a moment and take a few deep breaths to regain your composure before you can give care. If you still are unable to give care, you can volunteer to help in other ways, such as by calling 9-1-1 or the designated emergency number and bringing. Fear of catching a disease. In today's world, the fear of contracting a communicable disease while giving care to another person is a real one. However, although it is possible for diseases to be transmitted in a first aid situation, it is extremely unlikely that you will catch a disease this way. Taking additional precautions, such as putting on latex-free disposable gloves and using a CPR breathing barrier, can reduce your risk even further Fear of being sued. -Sometimes people hesitate to get involved because they are worried about liability. In fact, lawsuits against lay responders (nonprofessionals who give care in an emergency situation) are highly

What are some pathogens that you could be exposed to when providing first aid care that could pose a particular risk because of their long-term effects on your health?

Bloodborne pathogens -Spread when blood from an infected person enters the bloodstream of a person who is not infected. -Bloodborne illnesses that are of particular concern include human immunodeficiency virus (HIV) infection and hepatitis B, C and D. -Fortunately, although bloodborne pathogens can cause serious illnesses, they are not easily transmitted and are not spread by casual contact. Remember, for infection to occur, an infected person's blood must enter your bloodstream. This could happen through direct or indirect contact with an infected person's blood if it comes in contact with your eyes, the mucous membranes that line your mouth and nose, or an area of broken skin on your body. You could also become infected if you stick yourself with a contaminated needle (a "needlestick injury") or cut yourself with broken glass that has been contaminated with blood. Airborne pathogens -Pathogens that are expelled into the air when an infected person breathes, coughs or sneezes. Infection spreads when a person who is not infected inhales respiratory droplets containing the pathogens. Examples of airborne illnesses include tuberculosis and influenza

These are used to protect you from contact with saliva and other body fluids, such as blood, as you give rescue breaths. They also protect you from breathing the air that the person exhales.

CPR breathing barriers

____________________ is a chronic condition characterized by the body's inability to process glucose (sugar) in the bloodstream. An organ called the pancreas secretes insulin, a hormone that causes glucose to be moved from the bloodstream into the cells, where it is used for energy. In a person with diabetes, either the pancreas fails to make enough insulin or the body's cells are unable to respond to insulin. Either situation causes glucose levels in the bloodstream to increase. A person with diabetes may manage the condition with insulin injections or oral medications. Diet and exercise also play an important role. To keep blood glucose levels within an acceptable range, food intake, exercise and medication must be balanced. A person with diabetes must follow a well-balanced diet, with limited sweets and fats. The timing of meals and snacks relative to exercise and medication is important as well. If food intake, exercise and medication are not in balance, the person may experience a diabetic emergency.

Diabetes

__________delivers a measured dose of medicine in a dry powder form directly into the person's lungs.

Dry Powder Inhalers (DPIs)

Activating the _________ will send emergency medical help on its way as fast as possible

EMS system

__________________, such as police officers, fire fighters, ski patrol personnel, park rangers and athletic trainers, are trained in some of the most time-sensitive lifesaving measures, such as using an AED or an epinephrine auto injector. (Unlike lay responders, EMRs have a legal duty to act in an emergency

Emergency medical responders (EMRs)

________________ are qualified to provide more comprehensive basic life support care at the scene of an emergency, in addition to performing the duties of an EMR.

Emergency medical technicians (EMTs)

What are signs and symptoms of an asthma attack?

Even when a person takes steps to manage his or her asthma by avoiding triggers and taking prescribed long-term control medications, he or she may still experience asthma attacks occasionally. Signs and symptoms of an asthma attack include: ■ Wheezing or coughing. ■ Rapid, shallow breathing (or trouble breathing). ■ Sweating. ■ Being unable to talk without stopping for a breath in between every few words. ■ Feelings of tightness in the chest or being unable to get enough air into the lungs. ■ Anxiety and fear

Explaiin the "FAST" check for a stroke

Face • Ask the person to smile. Notice if there is any sagging or weakness on a particular side of the person's face. This could include sagging at the corner of the mouth or eyelid. • The patient might experience numbness or paralysis of the face. • The patient might have difficulty seeing out of one or both eyes. Arm • Ask the person to raise both arms. Notice if one arm tends to shift downwards or seems weak. • The patient could experience paralysis or numbness of the arms or legs (typically on one side of the body). Speech • Ask the person to repeat a simplistic phrase. This could be as simple as "The grass is green." A sign of a stroke is if the person has difficulty speaking or begins slurring words . • The person may seem confused and have trouble comprehending what others are saying. • The person may be unable to form words. • The person may experience difficulty swallowing or begin drooling. Time • Other symptoms could include overall weakness, dizziness, loss of balance, a severe headache, and even loss of consciousness . • Take note of the time a person's signs and symptoms start. This is essential information to give to the EMS because medications that work for strokes are time sensitive. Some of the medications work only within a certain time frame of the person's initial signs and symptoms . • It is important to call 9-1-1 or designated emergency as soon as any symptoms of a stroke are observed. The faster the person receives medical care the more likely the stroke will not be as debilitative.

True or False: Put something between the teeth of person who is having a seizure to prevent the person from biting or swallowing his or her tongue.

False. This practice is unsafe and unnecessary. It is impossible to swallow one's own tongue. And although the person may bite down on his or her tongue, causing it to bleed, this is a minor problem compared with the problems that can be caused by attempting to put an object in the mouth of a person who is having a seizure. You could chip a tooth or knock a tooth loose, putting the person at risk for choking. The person may also bite down with enough force to break the object and then choke on a piece of the object. Additionally, attempting to place an object in the person's mouth puts you at risk for getting bitten.

What are Good Samaritan Laws?

Good Samaritan laws, which protect the responder from financial liability, were developed to encourage people to help others in emergency situations. They assume a responder will do his or her best to save a life or prevent further injury. Good Samaritan laws require the responder to use common sense and a reasonable level of skill and to give only the type of emergency care for which he or she is trained. Good Samaritan laws usually protect responders who act the way a "reasonable and prudent person" would act if that person were in the same situation. For example, a reasonable and prudent person would: ■ Move a person only if the person's life were in danger. ■ Ask a responsive person (or the parent or guardian of a minor) for permission to help (consent) before giving care. ■ Check the person for life-threatening conditions before giving further care. ■ Call 9-1-1 or the designated emergency number. ■ Continue to give care until more highly trained personnel take over. *If a lay responder's actions were grossly negligent or reckless, or if the responder abandoned the person after starting care, Good Samaritan laws may not protect the responder.

-Bloodborne Pathogen -Is a virus that invades and destroys the cells that help us to fight off infections. -A person who is infected with this may look and feel healthy for many years. However, during this time, the virus is breaking down the person's immune system. -Eventually, a person who is infected with this may develop acquired immunodeficiency syndrome (AIDS). A person with AIDS is unable to fight off infections that a healthy person would be able to resist or control. The person dies from one of these infections. Although medications have been developed to help slow the progression of this infection, currently there is no cure.

HIV

-Is inflammation of the liver, an organ that performs many vital functions for the body. There are many different types and causes of hepatitis. Hepatitis B, hepatitis C and hepatitis D are caused by infection with bloodborne viruses. Chronic infection with the viruses that cause hepatitis B, C or D can lead to liver failure, liver cancer and other serious conditions.

Hepatitis

________________ (excessively high blood glucose levels) can result if a person eats too much food, takes too little medication, exercises less than usual or experiences physical or emotional stress

Hyperglycemia

______________________ (excessively low blood glucose levels) can result if a person misses a meal or snack, eats too little food, exercises more than usual, vomits or takes too much medication.

Hypoglycemia

When giving CPR, what do you do if the person becomes unresponsive?

If a person who is choking becomes unresponsive, carefully lower him or her to the ground and, if you are trained, begin CPR, starting with chest compressions. After each set of chest compressions and before attempting rescue breaths, open the person's mouth and look for the object. If you see an object in the person's mouth, remove it using your finger. Never put your finger in the person's mouth unless you actually see the object. If you cannot see the object and you put your finger in the person's mouth, you might accidentally push the object deeper into the person's throat.

__________ is bleeding that occurs inside the body, into a body cavity or space. Can be a consequence of traumatic injury and may be life threatening.

Internal bleeding

What are signs and symptoms of a heart attack?

Signs and symptoms of a heart attack vary from person to person, and can be different in women than they are in men. Even people who have had a heart attack before may not experience the same signs and symptoms if they have a second heart attack. A person who is having a heart attack may show any of the following signs and symptoms: ■ Chest pain, which can range from mild to unbearable. The person may complain of pressure, squeezing, tightness, aching or heaviness in the chest. The pain or discomfort is persistent, lasting longer than 3 to 5 minutes, or going away and then coming back. It is not relieved by resting, changing position or taking medication. It may be difficult to distinguish the pain of a heart attack from the pain of indigestion, heartburn or a muscle spasm. ■ Discomfort or pain that spreads to one or both arms, the back, the shoulder, the neck, the jaw or the upper part of the stomach ■ Dizziness or light-headedness ■ Trouble breathing, including noisy breathing, shortness of breath or breathing that is faster than normal ■ Nausea or vomiting ■ Pale, ashen (gray) or slightly bluish skin, especially around the face and fingers ■ Sweating ■ A feeling of anxiety or impending doom ■ Extreme fatigue (tiredness) ■ Unresponsiveness

___________convert liquid medication into a mist, which is delivered over several minutes. Nebulizers are especially helpful when the person is unable to take deep breaths, for children younger than 5 years and for older adults. T

Small-Volume Nebulizers

What are sign and symptoms of sudden illness?

The signs and symptoms of sudden illness vary widely, depending on the cause of the illness. The person may have: ■ Trouble breathing. ■ Pain, such as chest pain, abdominal pain or a headache. ■ Changes in level of consciousness, such as being confused or unaware of one's surroundings, or becoming unresponsive. ■ Light-headedness or dizziness. ■ Nausea, vomiting, diarrhea or stomach cramps. ■ A fever. ■ Pale or very flushed skin, which may be excessively sweaty or dry, or excessively hot or cold. ■ Problems seeing or speaking (e.g., blurred vision or slurred speech). ■ Numbness, weakness or paralysis. ■ Seizures. *To gain a better understanding of the situation, interview the person (or bystanders, if necessary) using SAMPLE, and then check the person from head-to-toe. Signs and symptoms like trouble breathing, pain that is persistent or severe, problems seeing or speaking, problems feeling or moving, seizures or unresponsiveness require a call to 9-1-1 or the designated emergency number. If you are unsure about the severity of the illness, it is better to call for help early than to wait for the illness to progress.

What are signs and symptoms of seizures?

There are different types of seizures: ■One common type of seizure is called a grand mal seizure. A person having a grand mal seizure loses consciousness and has convulsions (uncontrolled body movements caused by contraction of the muscles). ■Another common type of seizure is called an absence seizure. The person experiences a brief, sudden lapse of consciousness, causing the person to momentarily become very quiet and have a blank stare. ■A person with epilepsy may experience an aura (an unusual sensation or feeling) before the onset of the seizure. If the person recognizes the aura, he or she may have time to tell someone what is happening and sit down before the seizure occurs.

How do you do a reaching assist?

To do a reaching assist, use any available object that will extend your reach and give the person something to grab onto (such as a pole, an oar or paddle, a branch or a towel). Extend the object to the person, tell him or her to hold on, and pull the person to safety. If no equipment is available and you are close enough, you may be able to perform a reaching assist by extending your arm to the person. You can also perform a reaching assist from a position within the water by extending an arm or a leg to the person, if you are already in the water and you have something secure to hold onto

How do you provide first aid care for respiratory distress?

When a person is experiencing a breathing emergency, it is important to act at once. In some breathing emergencies, the oxygen supply to the body is greatly reduced, whereas in others the oxygen supply is cut off entirely. If breathing stops or is restricted long enough, the person will become unresponsive, the heart will stop beating and body systems will quickly fail. Recognizing that a person is having trouble breathing and providing appropriate first aid care can save the person's life. You usually can identify a breathing problem by watching and listening to the person's breathing and by asking the person how he or she feels. If a person is having trouble breathing, do not wait to see if the person's condition improves. Call 9-1-1 or the designated emergency number and provide appropriate first aid care until help arrives: ■ If you know the cause of the respiratory distress (for example, an asthma attack or anaphylaxis) and the person carries medication used for the emergency treatment of the condition, offer to help the person take his or her medication. ■ Encourage the person to sit down and lean forward. Many people find that this position helps to make breathing easier. Providing reassurance can reduce anxiety, which may also help to make breathing easier. ■ If the person is responsive, gather additional information by interviewing the person and performing a head-to-toe check. Remember that a person having breathing problems may find it difficult to talk. Try phrasing your questions as "yes" or "no" questions so the person can nod or shake his or her head in response instead of making the effort to speak. You may also be able to ask bystanders what they know about the person's condition. ■ Be prepared to give CPR and use an AED if the person becomes unresponsive and you are trained in these skills.

Describe first aid for shock

When a person who has been injured or is ill shows signs and symptoms of shock, call 9-1-1 or the designated emergency number immediately, if you have not already done so. Shock cannot be managed effectively by first aid alone, so it is important to get the person emergency medical care as soon as possible. While you are waiting for help to arrive: ■ Have the person lie flat on his or her back. ■ Control any external bleeding. ■ Cover the person with a blanket to prevent loss of body heat. ■ Do not give the person anything to eat or drink, even though he or she may complain of thirst. Eating or drinking increases the person's risk for vomiting and aspiration (inhalation of foreign matter into the lungs). Aspiration can cause serious complications, such as pneumonia. ■ Provide reassurance, and help the person rest comfortably. Anxiety and pain can intensify the body's stress and speed up the progression of shock. ■ Continue to monitor the person's condition and watch for changes in level of consciousness.

Is it safe to use an AED on a woman who is pregnant.?

Yes

Should you give care until EMS Personnel take over?

Yes. First aid care can be the difference between life and death. Often it makes the difference between complete recovery and permanent disability. In general, you should give the appropriate care to an injured or ill person until another trained responder or EMS personnel take over, you are too exhausted to continue.or the scene becomes unsafe.

What are Strategies for Gathering Information Effectively when the injured person is disabled?

■ A family member, caregiver or other person who knows the injured or ill person well can be a valuable source of information if the person is not able to speak for him- or herself. However, if the person is able to understand and answer your questions, speak directly to him or her, rather than addressing your questions to others who might be present. ■ A person with a disability may use a service animal. Be aware that service animals are trained to protect their owners, and both the service animal and the person may become anxious if they are separated. Allow the service animal to stay with the person if possible. ■ If the person wears an assistive device (e.g., a leg brace), do not remove the device when you are examining the person. ■ If the person has an intellectual disability: ❍ Address the person as you would any other person in his or her age group. If the person does not seem to understand you, rephrase your statement or question in simpler terms. ❍ Be aware that being injured or becoming suddenly ill may make the person very upset, anxious or fearful. Take time to explain who you are and what you intend to do, and reassure the person. ■ If the person has impaired hearing: ❍ Approach the person from the front. ❍ Hearing-impaired people who know how to read lips rely on watching your mouth move. Position yourself so that the person can see your mouth and facial expressions. Pronounce your words slowly and clearly, and speak in short sentences. ❍ If the person does not seem to understand what you are saying, change your words, not the volume of your voice, unless you spoke too softly. Shouting sometimes causes the person more distress and he or she still may not understand what you are trying to say. ❍ Use gestures or written messages as necessary to make your meaning clear. ■ If the person has impaired vision: ❍ Speak in a normal voice. It is not necessary to shout. ❍ As you provide care, describe what you are doing.

What are the signs and symptoms of choking?

■ A person who is choking typically has a panicked, confused or surprised facial expression. ■ Some people may place one or both hands on their throat. The person may cough (either forcefully or weakly), or he or she may not be able to cough at all. You may hear high-pitched squeaking noises as the person tries to breathe, or nothing at all. If the airway is totally blocked, the person will not be able to speak, cry or cough. The person's skin may initially appear flushed (red), but will become pale or bluish in color as the body is deprived of oxygen.

How do you provide first aid for an asthma attack?

■ An asthma attack can become life threatening because it affects the person's ability to breathe. If the person has an asthma action plan (a written plan that the person develops with his or her healthcare provider that details daily management of the condition as well as how to handle an asthma attack), help the person to follow that plan. ■ Encourage the person to use his or her prescribed quick-relief (rescue) medication, assisting if needed and if state or local regulations allow. ■ If you have not already done so, call 9-1-1 or the designated emergency number if the person's breathing does not improve after taking the quick-relief (rescue) medication or if the person becomes unresponsive. Stay with the person and monitor his or her condition until the person is able to breathe normally or help arrives.

Explain CPR and the purpose.

■ CPR, or cardiopulmonary resuscitation, is a skill that is used when a person is in cardiac arrest to keep oxygenated blood moving to the brain and other vital organs until advanced medical help arrives ■ CPR involves giving sets of 30 chest compressions followed by sets of 2 rescue breaths. ■ When you give compressions, you press down on the person's chest. This squeezes (compresses) the heart between the breastbone (sternum) and spine, moving blood out of the heart and to the brain and other vital organs. After each compression, you must let the chest return to its normal position. This allows blood to flow back into the heart. The rescue breaths you give after each set of 30 compressions deliver a fresh supply of oxygen into the person's lungs. When you give CPR, you help to keep oxygenated blood moving throughout the body, which can buy the person some time until advanced medical help arrives ■Although full CPR (compressions and rescue breaths) is preferred, if you are unable or unwilling for any reason to give full CPR, you can give compression-only CPR instead. In compression-only CPR, you give continuous chest compressions, with no rescue breaths. After checking the scene and the person and calling 9-1-1 or the designated emergency number, give chest compressions without stopping until another trained responder or EMS personnel take over or you notice an obvious sign of life.

If you experience an exposure event, such as another person's blood or other potentially infectious material comes into contact with your eyes, the mucous membranes of your mouth or nose, or an opening or break in your skin, or if you experience a needlestick injury, what should you do?

■ Decontaminate the exposed area. If your skin was exposed, wash the contaminated area with soap and water. For splashes into your mouth or nose, flush the area with water. For splashes into the eyes, irrigate the eyes with water, saline or a sterile irrigant for 15 to 20 minutes. ■ Report the exposure incident to EMS personnel or your healthcare provider. ■ If the exposure incident occurred in a workplace setting, notify your supervisor and follow your company's exposure control plan for reporting the incident and receiving post-exposure follow-up care

What are Strategies for Gathering Information Effectively when the injured person is a child?

■ If the child's parent or guardian is present, remember to get the parent's or guardian's consent to give care. ■ Be aware that children often take emotional cues from the adults around them. If the child sees that adults are upset, the child's anxiety and panic may increase. Stay calm, and encourage the child's parent or guardian to do the same. ■ The child's parent or guardian can be a valuable source of information if the child is not able to speak for him- or herself. However, if the child is old enough to understand and answer your questions, speak directly to the child using age-appropriate language, rather than addressing your questions to the parent or guardian. ■ If the care you need to provide will cause discomfort or pain, describe what the child can expect to feel in terms the child can understand. Never make promises or statements that you cannot support (e.g., do not say that something will not hurt if it will). ■ Take into consideration the child's developmental stage

What are Strategies for Gathering Information Effectively when the injured person is an older adult?

■ Pay attention to how the person introduces him- or herself. If the person gives a last name, consider addressing the person more formally (e.g., "Mr. Johnson" rather than "Bill") as a sign of respect . ■ A family member, caregiver or other person who knows the older adult well can be a valuable source of information if the older adult is not able to speak for him- or herself. However, if the older adult is able to understand and answer your questions, speak directly to him or her, rather than addressing your questions to others who might be present. ■ Speak clearly and loudly enough for the person to hear you, but do not shout. If the person does not seem to understand what you are saying, change your words, not the volume of your voice, unless you spoke too softly . ■ When interviewing the person, avoid rushing. Allow the person enough time to process your questions and respond. ■ Be aware that in older people, the signs and symptoms of a medical emergency may be very general and nonspecific, and they may not even be noticeable to someone who does not know the person well. General signs and symptoms that could indicate a medical emergency in an older adult. include headache, a change in the person's usual level of activity, a change in mental status (such as agitation, the new onset of confusion, or increased confusion in a person who is already confused), lethargy (extreme drowsiness or sleepiness) and difficulty sleeping. ■ Many older adults have impaired hearing, vision or both. If the person seems confused, make sure the "confusion" is not just the result of being unable to hear you or see you clearly. If the person normally wears a hearing aid, make sure it is in place and turned on. If the person usually wears glasses, make sure he or she has them on.

How do you give CPR to an infant?

■ Place the pads of two fingers on the center of the infant's chest, just below the nipple line. If you feel the notch at the end of the infant's breastbone, move your fingers slightly toward the infant's head. Place your other hand on the infant's forehead. Give compressions by using the pads of your fingers to compress the chest about 1½ inches. ■ When you give rescue breaths, open the airway by tilting the head to a neutral position (see Table 3-1). Instead of pinching the nose shut and covering the mouth with your mouth, cover the infant's nose and mouth with your mouth to form a seal.

What are Strategies for Gathering Information Effectively when the injured person speaks a different language?

■ Speak in a normal voice. It is not necessary to shout. ■ Find out if any bystanders speak the person's language and can assist by translating . ■ Do your best to communicate nonverbally, using gestures and facial expressions. ■ When you call 9-1-1 or the designated emergency number, explain that you are having difficulty communicating with the person, and tell the dispatcher which language you believe the person speaks. The dispatcher may have someone available who can help with communication.

If you decide it is necessary to summon EMS personnel, make the call quickly and return to the person. If possible, ask someone else to make the call so that you can begin giving care. The person making the call should be prepared to give the dispatcher what information?

■ The location of the emergency (the address, or nearby intersections or landmarks if the address is not known) ■ The nature of the emergency (e.g., whether police, fire or medical assistance is needed) ■ The telephone number of the phone being used ■ A description of what happened ■ The number of injured or ill people ■ What help, if any, has been given so far, and by whom *The caller should stay on the phone until the dispatcher tells him or her it is all right to hang up. The dispatcher may need more information. Many dispatchers also are trained to give first aid and CPR instructions over the phone, which can be helpful if you are unsure of what to do or need to be reminded of the proper care steps *If you are alone and there is no one to send to call 9-1-1 or the designated emergency number, you may need to decide whether to call first or give care first (Box 1-8). Call First situations are likely to be cardiac arrest. In cardiac arrest, the priority is getting help on the scene as soon as possible because early access to EMS personnel and an AED increases the person's chances for survival. Care First situations include breathing emergencies and severe life-threatening bleeding. In these situations, there are immediate actions that you can take at the scene that may prevent the person's condition from worsening. After you take these actions, call 9-1-1 or the designated emergency number to get advanced medical help on the way.

Describe first aid care for fainting

■The person may faint before you even know what is happening, but sometimes it is possible to prevent a fainting spell by having the person sit down with his or her head near his or her knees, or lie down flat on his or her back. ■If the person does faint, check the person for responsiveness and normal breathing. If the person responds and is breathing normally, check the person from head to toe for injuries that might have happened as a result of the fall. If there are no injuries, place the person in the recovery position and loosen any tight clothing. ■Call 9-1-1 or the designated emergency number if you find any injuries or have any concerns about the person's condition. Although the cause of fainting is not usually serious, the person should still follow up with his or her healthcare provider. ■If the person does not respond and is not breathing or is only gasping, begin CPR immediately and use an AED as soon as possible, if you are trained in these skills.

How do you use an AED?

■ To use an AED, first turn the device on. Remove or cut away clothing and undergarments to expose the person's chest. If the person's chest is wet, dry it using a towel or gauze pad. Dry skin helps the AED pads to stick properly. Do not use an alcohol wipe to dry the skin because alcohol is flammable. Next, apply the AED pads. Peel the backing off the pads as directed, one at a time, to expose the adhesive. Place one pad on the upper right side of the person's chest and the other pad on the lower left side of the person's chest below the armpit, pressing firmly to adhere ■ Plug the connector cable into the AED (if necessary) and follow the device's directions. Most AEDs will begin to analyze the heart rhythm automatically, but some may require you to push an "analyze" button to start this process. No one should touch the person while the AED is analyzing the heart rhythm because this could result in a faulty reading. ■ Next, the AED will tell you to push the "shock" button if a shock is advised. Again, avoid touching the person, because anyone who is touching the person while the device is delivering a shock is at risk for receiving a shock as well. ■ After a shock is delivered (or if the AED determines that no shock is necessary), immediately resume CPR, starting with compressions. The AED will continue to check the heart rhythm every 2 minutes. Listen for prompts from the AED and continue giving CPR and using the AED until you notice an obvious sign of life or EMS personnel arrive. If you notice an obvious sign of life, stop CPR but leave the AED turned on and the pads in place on the person's chest, and continue to follow the AED's prompts.

What are signs and symptoms of cardiac arrest?

■ When a person experiences cardiac arrest, you may see the person suddenly collapse. When you check the person, you will find that the person is not responsive and not breathing, or only gasping. (In an unresponsive person, isolated or infrequent gasping in the absence of normal breathing may be agonal breaths, which can occur even after the heart has stopped beating. Agonal breaths are not breathing and are a sign of cardiac arrest.) The person has no heartbeat. ■ Cardiac arrest can happen suddenly and without any warning signs. When this occurs, the person is said to have experienced sudden cardiac arrest. People who have a history of cardiovascular disease or a congenital heart disorder are at higher risk for sudden cardiac arrest. However, sudden cardiac arrest can happen in people who appear healthy and have no known heart disease or other risk factors for the condition. A person who experiences sudden cardiac arrest is at very high risk for dying and needs immediate care.

What are signs and symptoms of diabetic emergencies?

■A person who is having a diabetic emergency will seem generally ill. He or she may feel dizzy or shaky, have a headache, or have cool, clammy skin. ■The person's behavior may change (for example, he or she may become irritable, aggressive or argumentative). ■A person who is experiencing a diabetic emergency may appear to be under the influence of alcohol. For example, the person may slur his or her words or have difficulty walking. Interviewing the person (or bystanders) using SAMPLE and conducting a head-to-toe check may help you identify the true cause of the person's signs and symptoms ■ If the person is experiencing hyperglycemia, his or her breath may have a fruity or sweet odor. Severe hypoglycemia or hyperglycemia can result in confusion, seizures or loss of consciousness and may be life threatening.

Describe first aid care for seizures

■Although a seizure can be frightening to see, it is easy to care for a person who is having a seizure. Most seizures only last a few minutes, and the person usually recovers fully without any complications. If the person is known to have occasional seizures, it may not be necessary to call 9-1-1 or the designated emergency number. However, under some circumstances, you should call 9-1-1 or the designated emergency number when a person is having a seizure. ■Call for help if: - The seizure lasts more than 5 minutes, or the person has multiple seizures in a row. - The person was injured as a result of the seizure. - The person is unresponsive and not breathing or only gasping after the seizure. -The person is pregnant or has diabetes. -The person is a young child or infant and the seizure was brought on by a high fever. - The person is elderly. - This is the person's first seizure, or the cause of the seizure is unknown. -The seizure took place in the water. ■When a person is having a seizure, do not try to hold the person down or stop the seizure from happening. Just let the seizure run its course and take steps to protect the person from injury. Move furniture or other objects that could cause injury out of the way. The person may be drowsy and disoriented for as long as 20 minutes after the seizure is over. Check the person for responsiveness and normal breathing. If the person is responsive and breathing normally but not yet fully awake, check the person from head to toe for injuries and then place the person in the recovery position. Stay with the person until he or she is fully recovered and aware of his or her surroundings, or until emergency responders arrive. If the person is not responsive and not breathing or only gasping after the seizure, begin CPR immediately and use an AED as soon as possible, if you are trained in these skills.

Give cases when you should wear latex gloves

■When providing care, especially whenever there is a possibility that you will come in contact with a person's blood or other potentially infectious materials. ■ When there is a break in the skin on your own hands (cover any cuts, scrapes or sores before putting on the gloves). ■ When you must handle items or surfaces soiled with blood or other potentially infectious materials.

Describe First Aid Care for Diabetic Emergencies

■Call 9-1-1 or the designated emergency number if the person is unresponsive, not fully awake or having a seizure. While you wait for help to arrive, provide appropriate care. For example, if the person is not fully awake, interview bystanders and conduct a head-to-toe check, then put the person in the recovery position. Make sure the person's airway is clear of vomit and monitor the person's breathing until help arrives. If the person is having a seizure, take steps to keep the person safe while you let the seizure run its course ■If the person is known to have diabetes and thinks he or she is having a diabetic emergency, you may be able to help the person by giving him or her some form of sugar. Only offer the person sugar by mouth if the person is responsive, able to answer your questions and able to swallow. Some people may be responsive but not fully awake and therefore not able to safely swallow; in this case, do not attempt to give the person sugar by mouth. Instead, call 9-1-1 or the designated emergency number. You should also call 9-1-1 or the designated emergency number if you are not able to immediately obtain an acceptable form of sugar. Acceptable forms of sugar include: -Glucose tablets. - Candies that can be chewed. -Fruit juice. -Fruit strips. -Regular (non-diet) soda. - Milk. -A spoonful of sugar mixed into a glass of water. ■If it is safe for the person to have sugar by mouth, give 15 to 20 grams of sugar. . Even if the person is experiencing hyperglycemia (too much glucose in the bloodstream), giving the person 15 to 20 grams of sugar will not cause additional harm. If possible, have the person check his or her blood glucose level. If the person is not feeling better in about 10 to 15 minutes, call 9-1-1 or the designated emergency number. ■Some people with diabetes may have a prescribed glucagon kit that they carry with them to use in case of a severe hypoglycemic emergency. Glucagon is a hormone that stimulates the liver to release glucose into the bloodstream. The glucagon kit is only used when the person is unresponsive or has lost the ability to swallow.

What should you do if you think someone is having a heart attack?

■Call 9-1-1 or the designated emergency number immediately. Never try to drive a person who is experiencing signs and symptoms of a heart attack to the hospital yourself. EMS personnel can transport the person to the hospital safely while initiating care. ■ Have the person stop what he or she is doing and rest in a comfortable position to reduce the heart's need for oxygen. Many people experiencing a heart attack find it easier to breathe while sitting. ■ Loosen any tight or uncomfortable clothing. ■ Reassure the person. Anxiety increases the person's discomfort. ■ If the person has a history of heart disease and takes a prescribed medication to relieve chest pain (e.g., nitroglycerin), offer to locate the medication and help the person to take it. ■ If the person is responsive, able to chew and swallow, and allowed to have aspirin, you may offer two low-dose (81-mg) aspirin tablets or one 5-grain (325-mg) regular-strength aspirin tablet (Box 3-1). ■ Closely monitor the person's condition until EMS personnel arrive and take over. Notice any changes in the person's appearance or behavior. ■ If you are trained in giving CPR and using an automated external defibrillator (AED), be prepared to give CPR and use an AED if the person becomes unresponsive

Describe First Aid Care for Allergic Reactions and Anaphylaxis?

■If you know that the person has had a severe allergic reaction before, and the person is having trouble breathing or is showing signs and symptoms of anaphylaxis, have someone call 9-1-1 or the designated emergency number immediately. If the person carries medication (e.g., epinephrine) used for the emergency treatment of anaphylaxis, offer to help the person use the medication. If you are alone, help the person administer the medication and then call 9-1-1 or the designated emergency number. While you wait for help to arrive, make sure the person is sitting in a comfortable position, or have the person lie down if he or she is showing signs of shock. ■It is important to act fast when a person is having an anaphylactic reaction because difficulty breathing and shock are both life-threatening conditions. If the person is unable to self-administer the medication, you may need to help. You may assist a person with using an epinephrine auto injector when the person has a previous diagnosis of anaphylaxis and has been prescribed an epinephrine auto injector; the person is having signs and symptoms of anaphylaxis; the person requests your help using an auto injector; and your state laws permit giving assistance.

Describe First Aid Care for A Stroke

■If you think that a person is having (or has had) a stroke, call 9-1-1 or the designated emergency number immediately. Note when the signs and symptoms first started (or, if you do not know when the signs and symptoms started, note the last time the person was known to be well). This is important information to give to EMS personnel because some of the medications used to treat stroke are only effective within a certain time frame after the onset of signs and symptoms. ■Stay with the person and provide reassurance until help arrives. If the person is responsive but not fully awake, or if the person is drooling or having trouble swallowing, put the person in the recovery position and monitor the person's condition until EMS personnel arrive.

Explain what shock is and its causes

■Shock is a progressive, life-threatening condition in which the circulatory system fails to deliver enough oxygen-rich blood to the body's tissues and organs. As a result, organs and body systems begin to fail. ■Common causes of shock include severe bleeding and severe allergic reactions (anaphylaxis), but shock can develop quickly after any serious injury or illness. ■A person who is showing signs and symptoms of shock needs immediate medical attention.

How do you gain consent?

■State your name. ■ State the type and level of training that you have (such as training in first aid or CPR). ■ Explain what you think is wrong. ■ Explain what you plan to do. ■ Ask if you may help. *With this information, an ill or injured person can grant his or her consent for care. Someone who is unresponsive, confused or mentally impaired may not be able to grant consent. In these cases, the law assumes the person would give consent if he or she were able to do so. This is called implied consent. Implied consent also applies when a minor needs emergency medical assistance and the minor's parent or guardian is not present *An injured or ill person may refuse care, even if he or she desperately needs it. A parent or guardian also may refuse care for a minor in his or her care. You must honor the person's wishes. Explain to the person why you believe care is necessary, but do not touch or give care to the person if care was refused. If you believe the person's condition is life threatening, call EMS personnel to evaluate the situation. If the person gives consent initially but then withdraws it, stop giving care and call for EMS personnel if you have not already done so. *If you do not speak the same language as the injured or ill person, obtaining consent may be challenging. Find out if someone else at the scene can serve as a translator. If a translator is not available, do your best to communicate with the person by using gestures and facial expressions. When you call 9-1-1 or the designated emergency number, explain that you are having difficulty communicating with the person, and tell the dispatcher which language you believe the person speaks. The dispatcher may have someone available who can help with communication.

Explain the purpose of an AED

■While CPR can help to prevent brain damage and death by keeping oxygenated blood moving throughout the body, an AED can correct the underlying problem for some people who go into sudden cardiac arrest. Two abnormal heart rhythms in particular, ventricular fibrillation (V-fib) and ventricular tachycardia (V-tach), can lead to sudden cardiac arrest. In V-fib, the heart muscle simply quivers (fibrillates) weakly instead of contracting strongly. In V-tach, the heart muscle contracts too fast (tachy- means "fast"). Both abnormal rhythms impair the heart's ability to pump and circulate blood throughout the body and are life threatening. ■However, in many cases, V-fib and V-tach can be corrected by an electrical shock delivered by an AED. This shock disrupts the heart's electrical activity long enough to allow the heart to spontaneously develop an effective rhythm on its own. Starting CPR immediately and using an AED as soon as possible gives the person the best chance for surviving cardiac arrest