Heart attacks and shock

Shock is a life-threatening condition that occurs when the vital organs, such as the brain and heart are deprived of oxygen due to a problem affecting the circulatory system. The most common cause of shock is blood loss but can be caused by other fluid loss such as vomiting or severe burns. Shock may also be caused when the heart has been damaged in some way, such as heart attack or angina and is unable to pump an adequate supply to the body.

The recognition features of shock include:

• Pale, cold, clammy skin (skin could become blue/grey in appearance in severe shock, lips especially may appear blue)
• Sweating
• Weakness and dizziness
• Feeling sick and possibly vomiting
• Thirst
• Rapid, shallow breathing.

If shock is not treated the casualty will:

• Become restless and aggressive
• Start yawning and gasping for air
• Lose consciousness.

Eventually the heart will stop.

1. Severe allergic reactions (Anaphylaxis)

Introduction

A severe allergic reaction will affect the whole body, in susceptible individuals it may develop within seconds or minutes of contact with the trigger factor and is potentially fatal.

Possible triggers can include skin or airborne contact with particular materials, the injection of a specific drug, the sting of a certain insect or the ingestion of a food such as peanuts.

Recognition features

• Impaired breathing: this may range from a tight chest to severe difficulty
• There may be a wheeze or gasping for air.
• Signs of shock.
• Widespread blotchy skin eruption.
• Swelling of the tongue and throat.
• Puffiness around the eyes.
• Anxiety.

Treatment

Your aim is to arrange immediate removal of the casualty to hospital.

• Dial 999 or 112 for an ambulance.
• Give any information you have on the cause of the casualty’s condition.
• Check whether the casualty is carrying any necessary medication. If they are, help them to use it.

If the casualty is conscious:

• Help them to sit up in a position that most relieves any breathing difficulty, this is usually sitting up and leaning forward slightly.

If the casualty becomes unconscious:

• Open the airway and check breathing.
• Be prepared to give rescue breaths and chest compressions.
• Place them into the recovery position if the casualty is unconscious but breathing normally.

2. Heart attacks

Introduction

A Heart attack is most commonly caused by a sudden blockage of the blood supply to the heart muscle itself, for example a blood clot. The main risk is that the heart will stop beating so your aims are to make the casualty as comfortable as possible and rest and arrange urgent removal to hospital.

Recognition

• Persistent central chest pain - often described as a heavy pressure crushing or vice like pain.
• The pain often spreads (radiates) to the jaw, neck and down one or both arms
• Breathlessness.
• Discomfort high in the abdomen similar to indigestion.
• There could be collapse without warning.
• Ashen skin and blueness at the lips.
• Rapid, weak pulse which may be irregular.
• Profuse sweating, skin cold to the touch.
• Gasping for air (air hunger).
• Nausea and/or vomiting.

Treatment

Your aim is to make the casualty as comfortable as possible and arrange urgent removal to hospital.

• Sit the casualty down in the ‘W’ position: Semi-recumbent (sitting up at about 75° to the ground) with knees bent.
• Dial 999 or 112 for the ambulance.

If the casualty is fully conscious:

• Give him or her a 300mg aspirin tablet to chew slowly provided there are no reasons not to give the aspirin and provided the patient is not under 16 years of age.
• If the casualty has any medication for angina, such as tablet or spray, then assist them to take it.
• Constantly monitor and record the vital signs, breathing and pulse rate etc, until help arrives.

If the casualty becomes unconscious:

• you need to open the airway and check breathing and be prepared to start CPR if necessary, please refer to the tips on CPR for adults.

3. Shock

Recognition

In the case of a serious accident (and once you have treated any obvious injuries and called an ambulance), watch for signs of shock;

• Pale face.
• Cold, clammy skin.
• Fast, shallow breathing.
• Rapid, weak pulse.
• Yawning.
• Sighing.
• In extreme cases, unconsciousness.

Treatment

• Lay the casualty down, raise and support their legs.
• Use a coat or blanket to keep them warm – but not smothered.
• Do not give them anything to eat or drink.
• Check breathing and pulse frequently. If breathing stops, follow the resuscitation sequence – DRABC .
• Give lots of comfort and reassurance

http://www.sja.org.uk/sja/first-aid-advice/life-saving-procedures.aspx

Note: Phone number Varies.. Contact local emergency number..

Life saving procedures

As a first aider the priorities when dealing with a casualty are always the same:

• Airway
• Breathing
• Circulation.

A primary survey of a casualty will establish your priorities. When dealing with an unconscious casualty you should open and maintain their airway as your first priority. If the airway should become obstructed, possibly by the tongue falling to the back of the throat, then the casualty will be unable to breathe and this will lead to death if untreated.

If the casualty is breathing, the simple procedure of placing the casualty in to the recovery position should ensure that the airway will remain clear of obstructions.

If the casualty has stopped breathing you can assist them by performing a combination of chest compressions and rescue breaths. You breathe out enough oxygen to potentially keep the casualty alive until the emergency services arrive, the oxygen you breathe into the casualty will need to then be pumped around the body using chest compressions.

It is important to remember that in any life threatening situation the emergency services should be called as soon as breathing or absence of breathing has been identified.

1. The primary survey

Danger

Are you or the casualty in any danger? If you have not already done so, make the situation safe and then assess the casualty.

Response

If the casualty appears unconscious check this by shouting

‘Can you hear me?’, ‘Open your eyes’
and gently shaking their shoulders.

If there is a response:

· If there is no further danger, leave the casualty in the position found and summon help if needed.

· Treat any condition found and monitor vital signs - level of response, pulse and breathing.

· Continue monitoring the casualty either until help arrives or he recovers.

If there is no response:

· Shout for help.

· If possible, leave the casualty in the position found and open the airway.

· If this is not possible, turn the casualty onto their back and open the airway.

Airway

Open the airway by placing one hand on the casualty’s forehead and gently tilting the head back, then lift the chin using 2 fingers only.

This will move the casualty's tongue away from the back of the mouth.

Breathing

· Look, listen and feel for no more than 10 seconds to see if the casualty is breathing normally.

· Look to see if the chest is rising and falling. Listen for breathing.

· Feel for

breath against your cheek.

If the casualty is breathing normally , place them in the recovery position.

· Check for other life-threatening conditions such as severe bleeding and treat as necessary.

If the casualty is not breathing normally or if you have any doubt whether breathing is normal begin CPR:

· CPR for adults

o

If you have someone with you, send them to Dial 999 (or 112) for an ambulance immediately.

o If you are alone Dial 999 (or 112) for an ambulance immediately and then return to help the casualty.

· CPR for children (1 year to puberty)

o If you have someone with you, send them to Dial 999 (or 112) for an ambulance immediately.

o If you are on your own carry out CPR for 1 min before dialling 999 (or 112) for an ambulance.

·

CPR for babies (birth to 1 year)

o If you have someone with you, send them to Dial 999 (or 112) for an ambulance immediately.

o If you are on your own carry out CPR for 1 min before dialling 999 (or 112) for an ambulance.

Agonal breathing

This is common in the first few minutes after a sudden cardiac arrest. It usually takes the form of sudden irregular gasps for breath. It should not be mistaken for normal breathing and if it is present chest compressions and rescue breaths (together called cardio-pulmonary resuscitation or CPR) should be started without hesitation.

Related topics

·

CPR

· Recovery position

Please note:

These hints are no substitute for thorough knowledge of first aid! St John Ambulance holds first aid courses throughout the country.

2. Card

io-Pulmonary Resuscitation (CPR)

Adult

• If you have someone with you, send them to dial 999 (or 112) for an ambulance immediately.
• If you are alone dial 999 (or 112) for an ambulance immediately and then return to help the casualty.

Give 30 chest compressions

• Place heel of your hand in the centre of the chest.
• Place other hand on top and interlock fingers.
• Keeping your arms straight and your fingers off the chest, press down by 4-5cms. then release the pressure, keeping your hands in place.
• Repeat the compressions 30 times, at a rate of 100 per minute.

Give 2 rescue breaths.

• Ensure the airway is open.
• Pinch nose firmly closed.
• Take a deep breath and seal your lips around the casualty’s mouth.
• Blow into the mouth until the chest rises.
• Remove your mouth and allow the chest to fall.
• Repeat once more.

Continue resuscitation, 30 compressions to 2 Rescue Breaths.

Do not stop unless:

• Emergency help arrives and takes over.
• The casualty breathes normally or
• You become so exhausted that you cannot carry on

3. Cardio-Pulmonary Resuscitation (CPR)

Children

A child is considered to be between one year to puberty for the purposes of these instructions. It is neither necessary nor appropriate to check if a child has reached puberty.

• If you have someone with you, send them to dial 999 (or 112) for an ambulance immediately.
• If you are on your own carry out CPR for 1 min before dialling 999 (or 112) for an ambulance.

Give 5 rescue breaths

• Ensure the airway is open.
• Seal your lips around the child’s mouth while pinching the nose.
• Blow gently into the lungs, looking along the chest as you breathe. Take shallow breaths and do not empty your lungs completely.
• As the chest rises, stop blowing and allow it to fall.
• Repeat four more times then check for circulation.

Give 30 chest compressions

• Place 1 or 2 hands in the centre of the chest (depending on the size of the child.
• Use the heel of that hand with arms straight and press down to a third of the depth of the chest.
• Press 30 times, at a rate of 100 compressions per minute.
• After 30 compressions, give 2 rescue breath.

Continue resuscitation (30 compressions to 2 rescue breaths) without stopping until help arrives.

4. Cardio-Pulmonary Resuscitation (CPR)

Infants

A baby is considered to be less than 1 year old for the purposes of these instructions.

• If you have someone with you, send them to dial 999 (or 112) for an ambulance immediately.
• If you are on your own carry out CPR for 1 min before dialling 999 (or 112) for an ambulance.

Give 5 rescue breaths:

• Ensure the airway is open.
• Seal your lips around the baby’s mouth and nose.
• Blow gently into the lungs, looking along the chest as you breathe. Fill your cheeks with air and use this amount each time.
• As the chest rises, stop blowing and allow it to fall.
• Repeat this 5 times.

Give 30 chest compressions:

• Place the baby on a firm surface.
• Locate a position in centre of the chest.
• Using 2 fingers, press down sharply to a third of the depth of the chest.
• Press 30 times, at a rate of 100 compressions per minute.
• After 30 compressions, give 2 Rescue Breath.
• Continue resuscitation (30 compressions to 2 rescue breath) without stopping until help arrives.

5. The recovery position

Baby

A baby is considered to be less than 1 year old for the purposes of these instructions.

For a baby less than a year old, a modified recovery position must be adopted.

Cradle the infant in your arms, with his head tilted downwards to prevent him from choking on his tongue or inhaling vomit.

Monitor and record vital signs - level of response, pulse and breathing until medical help arrives.

Child/adult

Anyone over the age of 1 year old for the purpose of these instructions.

An unconscious casualty who is breathing but has no other life- threatening conditions should be placed in the recovery position.

• Turn casualty onto their side.
• Lift chin forward in open airway position and adjust hand under the cheek as necessary.
• Check casualty cannot roll forwards or backwards.
• Monitor breathing and pulse continuously.
• If injuries allow, turn the casualty to the other side after 30 minutes.

6. Choking

A foreign object that is stuck at the back of the throat may block the throat or cause muscular spasm.

Young children especially are prone to choking. A child may choke on food, or may put small objects into their mouth and cause a blockage of the airway.

If the blockage of the area airway is mild, the casualty should be able to clear it; if it is severe they will be unable to speak, cough, or breathe, and will eventually lose consciousness.

Recognition

Mild obstruction

• Casualty able to speak, cry, cough or breathe.

Severe obstruction

• Casualty is unable to speak, cry, cough or breathe.
• Casualty will eventually become unconcious without assistance.

Treatment for adult or child

Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary.

If the obstruction is mild

• Encourage them to continue coughing.
• Remove any obvious obstruction from the mouth.

If the obstruction is severe

• Give up to 5 Back blows.
• Check the mouth and remove any obvious obstruction.

If the obstruction is still present:

• Give up to 5 abdominal thrusts.
• Check the mouth and remove any obvious obstruction.

If the obstruction does not clear after three cycles of back blows and abdominal thrusts:

• Dial 999 (or 112) for an ambulance.
• Continue until help arrives.

Treatment for infants

Your aims are to remove the obstruction and to arrange urgent removal to hospital if necessary.

If the infant is distressed, is unable to cry cough, or breathe:

• Lay them face down along your forearm, with their head low, and support the back and head.
• Give up to 5 back blows, with the heel of your hand.
• Check the infant's mouth; remove any obvious obstructions.
• Do not do a finger sweep of the mouth.

If the obstruction is still present:

• Turn the infant onto his back and give up to 5 chest thrusts.
• Use two fingers, push inwards and upwards (towards the head) against the infants breastbone, one finger's breadth below the nipple line.
• The aim is to relieve the obstruction with each chest thrust rather than necessarily doing all five.
• Check the mouth.

If the obstruction does not clear after three cycles of back blows and chest thrusts:

• Dial 999 (or 112) for an ambulance.
• Continue until help arrives.

BASIC FIRST AID.. Might help someone..

Read the LIFE SAVING PROCEDURE without fail..
Please note that the Emergency Number varies with location.. So contact your local emergency number..


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