BLS: CPR and First Aid

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Scene Safety Assessment

Initial Assessment

Assess responsiveness and normal breathing

o Tap the individual's collar bone and loudly ask "Are you OK?"
o State your name and desire to help
If the individual responds, have him remain in the position found
If unresponsive but breathing normally, place in recovery position
If not breathing normally, begin CPR
o Use log roll to turn individual onto his back if not already supine
o Shout for help or send a specific person to call EMS
o Begin CPR

CPR
Do not delay CPR to wait on an AED or other equipment.
Use nipple line to find landmark at center of the chest for compressions
Deliver 30 compressions.
o Compress at a rate of at least 100 per minute.
o Compress to a depth of at least 2 inches (5 cm).
Place oronasal resuscitation mask on the person's face
Open airway using head tilt-chin lift
Deliver two normal breaths
o Each breath should last about 1 second
o Watch for chest to rise and fall
Continue CPR cycles of 30:2

Using an AED

Turn the unit on, and follow prompts provided by the unit.
Bare and dry the person's chest.
o It may be necessary to cut away clothing or shave off chest hair.
Apply pads firmly to the patient's chest.
o Follow illustrations on pads for placement.
If the AED indicates 'shock advised',
o Clear the scene both verbally and visually.
o State: "I'm clear, you're clear, all clear."
Deliver shock when indicated.
Immediately following the shock, begin chest compressions.
Deliver 2 minutes of CPR.
Follow prompts of the AED unit.

If signs of breathing return, place the patient in the recovery position.

Continue to monitor the patient
Be prepared to resume CPR if needed.

Emergency Hotline (+1-919-684-9111)

~DAN

BLS: CPR and First Aid

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Turn over to EMS

While waiting for EMS, continue to monitor the patient.

Leave the AED in place and turned on.

Provide a brief report to EMS indicating:
o Nature of incident
o Initial condition
o Care delivered including CPR and AED shocks
o Current condition
o Length of time patient was not breathing and without circulation
o Estimated time CPR was initiated

Foreign Body Airway Obstruction

Locate navel and place balled fist, thumb in, against stomach above navel.

Place other hand over fist.

Pull sharply inward and upward until obstruction is released.
If patient becomes unconscious, begin CPR, starting with compressions.

First Aid

Bleeding
o Apply direct pressure to the wound until the bleeding
- Apply dressing; use additional absorbent material
o Bandage the dressing in place, wrapping toward the
- Verify circulation in finger tips and toes
o Do not remove impaled objects; instead secure them
to avoid further injury.

is controlled.
if needed.
heart.
in place

Shock
o Maintain normal body temperature (provide warmth/cooling
o If no spinal injury is suspected, elevate legs slightly.
o Do not provide food or drink.

as needed).

Splinting
o Apply splint to injured limb (splint in the position found).
o Pad injured area to support and protect.
o Use sling for arm splints.

Secondary Assessment

Use eyes and hands to check for abnormalities, bleeding or other body fluids.
Inspect individual from head to foot palpating gently and visually checking:
o Scalp, face, nose and ears
o Neck and collarbones
o Ribs and abdomen
o Hips and legs
o Arms and grip strength
Have patient wiggle fingers and toes.

Emergency Hotline (+ 1-919-684-9111 )

-._

Scene Safety Assessment

Stop.

Initial Assessment

Assess responsiveness and normal breathing

- Tap the individual's collar bone and loudly ask "Are you OK?"
- State your name and desire to help.

If
If
If
-

the individual responds, have him remain in the position found.

unresponsive but breathing normally, place in recovery position
not breathing normally, begin CPR.
Use log roll to turn individual onto his back if not already supine.
Shout for help or send a specific person to call EMS.

Steps to Initiate Oxygen Delivery

Turn the unit on with one full turn.

Check the pressure gauge on the tank to assure cylinder is full.
Ask the injured diver for permission to assist:
- "This is oxygen. It may help you feel better. May I help you?"
- If the diver is unresponsive, permission is assumed.

Breathing Diver - Demand Valve

Constant flow setting should be in the OFF position.

Place an oronasal mask on the demand valve.

Take a breath from the oronasal mask and exhale away from the mask.
Place the mask over the injured diver's mouth and nose.
Instruct the injured diver to breathe normally from the mask.
Instruct the injured diver to hold the mask to help maintain a seal.
- Assist with elastic strap for good seal.

Breathing Diver - Non-Rebreather Mask

Stretch oxygen tubing to remove kinks.

Attach tubing to constant flow outlet.
Set constant flow control at 10-15 Ipm.

Prime mask reservoir bag.

Place mask over injured diver's mouth and nose.
Adjust nose clip and elastic strap to ensure a (snug) seal.
Adjust flow up or down to meet the needs of the injured diver.
- If reservoir bag deflates completely, increase flow.
- If flow has been increased to maximum Ipm and bag still deflates,
switch to demand valve.

Emergency Hotline +1-919-684-9111

~DAN

Non-Breathing Diver Bag Valve Mask (BVM)

First rescuer begins CPR.
Second rescuer prepares oxygen equipment then maintains
airway and seal.

Stretch tubing to remove kinks.

Connect tubing to constant flow outlet.
Set constant flow to 15 Ipm; allow reservoir bag to fill.
Position mask over injured diver's mouth and nose.
Open airway using head tilt-chin lift, lifting jaw into mask and creating seal.
First rescuer ventilates injured diver by gently squeezing the bag about
one-third of volume causing chest to rise.
- Each ventilation should last 1 second.
- Watch for chest to rise then fall between ventilations.

Continue CPR cycles of 30:2.

If oxygen supply runs out, continue to ventilate using room air.

Non-Breathing Diver Manually Triggered Ventilator (MTV)

First rescuer begins CPR.
Second rescuer prepares oxygen equipment then maintains
airway and seal.

If

Check MTV safety valve to ensure proper function.

- Press resuscitation button, block outlet - flow should stop.
- Do not use if it does not function properly.
Connect oronasal resuscitation mask to MTV.
Open airway using head tilt-chin lift, lifting jaw into mask and creating seal.
First rescuer ventilates injured diver by pressing resuscitation button.
- Deliver 2 breaths for 1 second each.
- Watch for chest to rise then fall between ventilations.
Continue CPR cycles of 30:2.
oxygen supply runs out, switch to another ventilation method.

General Guidelines

Monitor oxygen supply.

Monitor injured diver for signs of circulation.
Never leave injured diver alone.

Emergency Hotline +1-919-684-9111

~DAN

History
Date

Time

First Name

MI

Last Name

Conduct F A S T (check areas of abnormal findings)

o Facial Symmetry 0 Arms 0 Speech/Sudden Headache 0 Time
Complete SAM

PLE

(activate EMS)

(note responses in spaces provided)

Signs and Symptoms

Allergies

Medications

Pre-existing

conditions

Last oral intake (what and time)

Events leading up to incident

For Divers:
Dives during previous 24 hours:
Last dive Depth __
Surface interval
_

Bottom Time __

Breathing Gas

Previous dive - Depth __

Surface interval
_

Bottom Time __

Breathing Gas

Previous dive - Depth __

Surface interval
_

Bottom Time __

Breathing Gas

Previous dive - Depth __

Surface interval
_

Bottom Time __

Breathing Gas

Previous dive - Depth __

Bottom Time __

Breathing Gas

Unusual features of any dive

Did the diver use (check as applicable): 0 Computer

II

_
0 Dive Tables

Location of any pain

Does movement change level of pain? (circle one)
NOTE: attach dive buddy and/or witness comments:

Emergency Hotline (+1-919-684-9111)

0 Other
_

Yes

No

Vital Signs

Pulse

Respiration rate

Mental Function
Consciousness

(check one):

Orientation (check erroneous answers):

o Alert
o Verbal
o Pain
o Unresponsive

o What is your name?

o Where are you?
o What is the day and
o Why are you here?

time?

Ability to follow commands (check one)

"Stick out your tongue and close your eyes."

o Yes

0 No

Name 3 objects (able to complete - check one)

o Yes

0 No

Abstract reasoning (able to explain relationship):

0 Yes
Ex.: Father/Son
Student/Teacher
Pencil/Paper

0 No

Calculations
93
86

- count backwards from 100 by 7s (circle misses):

79
72
65 58
51
44
37
30
23

16

Memory - recall of 3 items identified earlier (check one): 0 Yes

0 No

Cranial Nerves
Eyes (circle any direction unable to look):

Left

Right

Facial Symmetry "Close your eyes and Smile"

Hearing Symmetrical

from about 1 foot (circle one):

Up

o Yes
o Yes

Down
0 No
0 No

Motor Function
Scale (note in blank next to area): Normal (N) Weak (W) Paralysis (P)
Upper Body Shoulders

II

L__

R__

Lower Body Hip-Flexors

L__

R_

Biceps

L_R_

Quadriceps

L__

R__

Triceps

L_R_

Hamstrings

L__

R__

Finger spread L__

R__

Foot - up

L__

R__

Grip Strength

R__

Foot - down L__

R__

L__

Coordination and Balance

Able to complete: Finger - Nose - Finger (check one)
Walk (check one)
Romberg

0 Normal

0 Yes

0 Wobbly

(check one)

o Yes

0 No
0 Unable
0 No

Exam Repeated
Time

Comments

Time

Comments

Emergency Hotline (+1-919-684-9111)

_
_

Traumatic Injuries

(control of external bleeding)

Signs and Symptoms

Bites (teeth in wound)

Severe scrapes

First Aid
1. Wash with soap and water.
2. Control bleeding with direct pressure.
3. Apply dressing and bandage.

4. Seek medical evaluation.

5. Monitor for signs of infection.

Life-Threatening Complications
Signs and Symptoms
Anaphylactic shock (swelling, itching, airway narrowing, respiratory distress)
Cardiogenic shock (pale, clammy skin; severe shortness of breath; weak pulse)
Hypovolemic shock (pale, clammy skin; confusion; weakness; rapid breathing)

First Aid
All are MEDICAL EMERGENCIES. Alert local emergency medical
services immediately.
1. Anaphylaxis: Assist with any prescribed allergy medications.
2. Cardiogenic: Have victim lay on back or in a position of comfort; monitor
responsiveness.
3. Hypovolemic: Control any bleeding; lay victim on back or in position of comfort;
monitor responsiveness.

Seafood POisoning

nx

Symptoms may progress rapidly with

poisoning. Activate emergency
medical services immediately if neurological symptoms appear.

Signs and Symptoms

Abdominal pain, gastroenteritis

Nausea, vomiting
Diarrhea
Numbness, tingling

Itching
Lack of muscle coordination
Paralysis
Reversal of hot and cold perception

First Aid
1. Monitor responsiveness.
2. Contact the local poison control center. Save fish or vomitus for
analysis if available.
3. Seek evaluation from a medical professional when seafood
poisoning is suspected .

Emergency Hotline +1-919-684-9111

~DAN

Emergency Hotline +1-919-684-9111