Red Cross: First Aid/CPR

Seven Fundamental Principles

Humanity, Impartiality, Neutrality, Independence, Voluntary Service, Unity, Universality

Humanity

We serve people, but not systems.

Seven Fundamental Principles

Humanity, Impartiality, Neutrality, Independence, Voluntary Service, Unity, Universality

Humanity

We serve people, but not systems.

Impartiality

We care for the victims and the aggressors alike.

Neutrality

We take initiatives, but never take sides.

Independence

We bow to needs, but not rulers.

Voluntary Service

We work around the clock, but never for personal gain.

Unity

We have many talents, but a single idea.

Universality

We respect nations, but our work knows no bounds.

Official Symbols of the Red Cross

Red Cross, Red Crescent, Red Crystal

International Symbols of the Red Cross

Proprietary symbols that represent neutrality and aid, both military and humanitarian, and as such must always be used appropriately.

Mission of the Canadian Red Cross

To improve the lives of vulnerable people by mobilizing the power of humanity in Canada and around the world.

Vision of the Canadian Red Cross

The leading humanitarian organization through which people voluntarily demonstrate their caring for others in need.

Values of the Canadian Red Cross

Respect, dignity, and care for one another within and outside the Canadian Red Cross; integrity, accountability, effectiveness, and transparency.

Services and Programs

Disaster Management, International Operations, First Aid Programs, Swimming and Water Safety, Respect Education, and Community Health and Wellness

Disaster Management

Provides aid to individuals and families across Canada following emergencies such as house fires, flooding, ice storms, and even chemical spills.

International Operations

Works around the world to protect and promote the rights of all people affected by armed conflict, and also provides aid following emergencies such as natural disasters and disease outbreak.

First Aid Program

Offers first aid and CPR training for individuals, groups, workplaces, and first responders.

Swimming and Water Safety Program

Offers courses to help people of all ages and abilities learn about water safety and learn how to swim.

Respect Education

Offers programs to teach children, youth, and adults about healthy relationships, signs of abuse, dating violence, personal safety, and bullying prevention.

Community Health and Wellness

Offers nutrition-based programs, transportation services, and health equipment loans to help individuals continue to live independently in their homes despite illness, injury, or other circumstances.

Be prepared...

Have easy access to emergency items; keep first aid kit in home and vehicle; know the location of first aid kits and AED in workplace; download Red Cross app.

First Aid Kit Checklist

Adhesive tape, adhesive bandages in assorted sizes, a thermometer, barrier devices (pocket masks or face shield), scissors, tweezers, safety pins, Canadian Red Cross first aid manual, sterile gauze pads (small and large), emergency telephone numbers, a pencil and pad, cold packs, a flashlight with extra batteries, antiseptic wipes or soap, eye patches, an emergency blanket, disposable non-latex gloves, roller or triangular bandages (for slings).

Indicators of an Emergency

Unusual sights, sounds, odours, or behaviours.

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 colour.

Unusual Odours

A foul or unusually strong chemical odour; the smell of smoke; the smell of gas; an unrecognizable odour; an inappropriate odour (e.g., a sickly-sweet odour

on a person's breath).

Unusual Behaviours

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).

Four reasons someone may not get involved...

Bystander Effect, unpleasant injury or illness, catching a disease, doing something wrong/causing more harm.

Bystander Effect

"Someone else will look after them..." [Never assume that someone else has taken action, and even if it looks like they have there are still many important things to do--always offer to help in any way you can.]

Unpleasant Injury/Illness

"That makes me feel sick!" [Close your eyes or turn away and take a deep breath, then offer to help in any way you are able.]

Catching Disease

"I don't want to get sick!" [EMS deal with sick people all the time without incident--use gloves and protective barriers to minimize risk.]

Doing Something Wrong/Causing More Harm

"What if I make it worse?" [The most harmful thing to do is nothing at all. Use good judgment and only administer care you've been trained in. At the very least call EMS/911 and follow their instructions.]

Good Samaritan Law

Good Samaritan laws usually protect first-aiders who act in the same manner as a "reasonable and prudent person" would; if first-aider is grossly negligent or reckless, or abandons someone after starting care, then they may not be protected.

"Reasonable and Prudent" Actions

Only move a person who's life is in danger; ask responsive person or guardian for permission before giving care; check for life-threatening conditions before giving further care; call EMS/911 if necessary; continue to give care until more highly trained personnel take over.

Permission

Tell the ill or injured person who you are, that you are there to help, and ask if you can administer care; if the ill/injured person is a child, ask parent or guardian unless one is unavailable.

Reasons it may be difficult to get permission...

Language barriers, the person is unresponsive, confused or has a mental impairment, the person refuses care.

What to do if there is a language barrier...

See if someone at the scene can translate, use hand gestures and facial expressions, call EMS/911 and explain that there is a language barrier.

What to do if the person is unresponsive, confused, or unable to give consent...

The law assumes implied consent; also in the case of an unattended baby or child.

What to do if the person refuses care...

You must respect their wishes; explain why you believe care is necessary and stay close in case the situation changes, but do not force care or touch the ill or injured person without consent. If you believe the condition is life-threatening call EMS/911 and explain that the person is refusing care.

Chain of Survival Behaviours

Prevent and prepare, early recognition, first aid/access help, self-recovery/early medical care.

Prevent and Prepare

This step is done before an emergency occurs or before you or another person becomes ill. Depending on the type of emergency and who is involved you may not have control over this step. Keep a properly stocked first-aid kit available at all times, and reduce the risk of illness and injury.

Early Recognition

Probably the most important step, without it the remaining actions in the chain cannot take place. This step involves checking the scene and checking the person.

First-Aid/Access to Help

This step is based on the nature of the emergency. Not all emergencies require EMs/911 (e.g. a minor cut); sometimes basic first aid is all that is required. On the other hand, many emergencies require both first-aid and EMS/911 (e.g. cardiac arrest).

Self-Recovery/Early Medical Care

This step is two-fold. Depending on the nature of the emergency, a person may recover without further medical care, while others will require it in some shape or form.

First Aid

The immediate care given to an ill or injured person until more advanced care can be obtained.

Basic Steps of First Aid

Recognize the emergency, protect yourself, act according to your skills, knowledge, and comfort level... [One of the simplest and most important ways of providing first aid is calling EMS/911--this ensure the ill/injured person receives care from highly trained medical professionals.]

Emergency Medical Services System

EMS dispatchers take down information about the emergency and provide it to EMS personnel; many dispatchers are trained to provide first-aid and CPR instructions over the phone.

First Responders

These include police, firefighters, and job-specific personnel such as athletic trainers and workplace first-aid response teams. First responders have a legal obligation to act in an emergency when they are on duty.

Paramedics

Highly specialized emergency personnel whose skills include both basic and advanced life support. Once on the scene, these people take over care of the ill/injured person, including any necessary transportation to medical facilities.

Call EMS/911...

If there is danger to you or another person; the ill/injured person is not accessible, is unresponsive or has an altered mental state, is not breathing normally, has persistent pressure or chest pain, has life-threatening bleeding, has a seizure, has a head/neck/back injury, has an apparent mental health crisis; if you are unsure if the situation is an emergency.

Risks of First Aid Care

First aid care may put you or others in close contact with another person's bodily fluids (e.g. saliva, mucus, vomit, blood), which may contain harmful pathogens (microorganisms that can cause disease or infection).

Personal Precautions

Hand-washing, treating all blood and bodily fluids as infectious materials, covering your mouth and nose when coughing/sneezing, eating well, getting enough sleep and exercise.

Hand Washing

Remove jewellery and turn on water before applying soap, rub hands together for at least 30 seconds before rinsing (fingernails on palms, between fingers, backs of hands, and wrists), dry with towel, turn water off with towel (in public restroom); if hand washing is unavailable, use alcohol-based sanitizer.

Protective Equipment

Personal protective equipment (PPE) protects you from contact with germs; always use PPE when administering first aid; examples include gloves and breathing barriers.

Glove Removal

Grasp one gloved hand (with other gloved hand) near the wrist, pull glove off of hand, form into ball and hold it in the palm of your gloved hand, insert fingers into the cuff of gloved hand, and remove inside out and over the first glove; dispose in proper waste container and properly wash hands.

PPE Gloves

Throw out disposable gloves after one use, don't handle anything with soiled gloves that others might touch later, throw out gloves that are discoloured, punctured, or torn.

Other PPE

Check your clothing for contamination after giving care, follow workplace or provincial legislation regarding cleaning, clean all equipment or surfaces that have come in contact with bodily fluids (4 tbsp bleach to 4 l water), always wash hands after removing gloves.

Stress Symptoms

Crying fits or uncontrollable anger, troubles eating or sleeping, fatigue or unusual/unexplained pains, loss of interest in activities, avoiding family, friends or daily tasks, feeling guilty, helpless or hopeless.

Check, Call, Care

Check the scene and the person, call for help and/or call EMS/911, care for the person.

Check the Scence

Are there any hazards? What happened? How did it happen?

Check the Person (Primary Assessment)

Is the person responsive (do they respond when you talk to them or tap them on the shoulder)? If not responsive check the ABCs [airway, breathing, circulation].

A = Airway

Make sure the person has an open airway--if they are moaning or crying then it is open. If the person is unresponsive, perform a head-tilt/chin-lift by gently tipping the head back until the chin is pointing upward.

B = Breathing

Check normal breathing for 5-10 seconds. Normal breathing is air moving in and out of lungs and/or chest rising and falling in a normal pattern. Someone who can speak or cry is breathing normally.

Agonal Respiration

An abnormal breathing pattern characterized by irregular or sporadic breaths, ie. gasping for breath.

C = Circulation

Quickly look the person head to toe for signs of life-threatening breathing. Life-threatening bleeding must be controlled as soon as possible.

Signs of a Life-Threatening Emergency

Unresponsiveness, trouble breathing, and severe bleeding; must provide immediate care and call EMS/911; obtain first-aid kit and AED if these items are available.

Call First/Care First

In almost every circumstance you should call EMS/911 before administering care in a life-threatening circumstance; if injury or illness is life-threatening such as a person not breathing or bleeding uncontrollably, enlist the help of a bystander or putting your phone on speaker while you begin care.

Care First Situations

Choking, life-threatening external bleeding, anaphylaxis, non-breathing/unresponsive child or baby.

Continual Care

Have the person rest, help the person maintain a normal body temperature, monitor the person's condition and ABCs, move the person into the recovery position (if necessary), give comfort and reassurance.

Recovery Position

Support and protect the head while rolling the person, try to roll the whole person at the same time (head/neck/back/legs), roll the person into a position where the body will stay safely on their side, check the ABCs after you complete the roll.

Recovery Position

One arm above the head, the other arm across chest with hand cradling the face/neck and the corresponding knee raised, place one hand behind the shoulder and one behind the knee and gently roll the person towards yourself, adjust the knee and shoulder appropriately and check the ABCs.

Medication

Help a person take their medication only if it is safe to do so and they are responsive and/or have expressed the need for assistance. Life-saving medication such as an inhaler or epi-pen may be administered if the person is unable to do so themselves, but ingested medications should be limited to helping the person find their medication, dispensing and guiding, and only if explicitly asked.

Secondary Assessment

After identifying and caring for life-threatening injuries and/or completing your primary assessment, check the person for other injuries and conditions that need care, unless it is not safe to do so (e.g. if you are already administering life-saving care such as CPR).

SAMPLE Questions

Signs and symptoms, allergies, medication, past medical history, last oral intake (food or drink), events leading up to the emergency.

Check Vital Signs

Level of responsiveness [alert, sleepy, confused], breathing [fast, slow, deep, shallow, painful], skin [wet or dry, unusual colour/temperature].

Injury Check

Check carefully for injuries not identified in primary assessment [focused examination/hands-on check]; if you find a medical-identification product read carefully.

Focused Examination

Explain the purpose of the examination is to identify injuries, ask the person if anything hurts or feels uncomfortable, if the person indicates an area of pain, discomfort, or concern, look at the area for signs of injury, ask focused questions about how the person feels.

Hands-On Check

If the person is breathing, but unresponsive or unable to communicate, you may need to do a hands-on check. Begin by checking the head for injuries; then work downward, focusing on the chest, abdomen, and legs before checking the arms.

Shock

A life-threatening condition in which symptoms include: anxiety or confusion, cool/clammy/pale skin, weakness, excessive thirst, rapid breathing, drowsiness or loss of responsiveness, nausea or vomiting.

Choking

When the airway becomes partially or completely blocked by a mechanical obstruction, an anatomical obstruction, or by fluids.

Partial Choking

When a person's airway is only partially blocked; the person is still able to breathe, which means they can cough or speak; can become complete choking.

Complete Choking

When a person's airway is completely blocked; can't cough or speak but may make high-pitched squeaking noises; person can't breathe and is in a life-threatening emergency needing immediate care.

Partial Choking: Care

Call EMS/911 if the obstruction does not clear or gets worse; encourage person to cough forcefully, assist person in sitting upright, if possible.

Complete Choking: Care

Begin to help immediately, enlist the help of a bystander (if possible) to call EMS/911 and retrieve and AED device; try to dislodge the object by alternating between back blows, abdominal thrusts, and chest thrusts; if the person becomes unresponsive begin CPR, starting with chest compressions.

Back Blows

Stand or kneel behind the person and place your arm across their chest, bend the person forward and use the heel of your hand to deliver up to 5 firm blows between the person's shoulder blades.

Abdominal Thrusts

Stand or kneel behind the person, wrap your arms around the person's waist and place your fist just above their belly button, cover your fist with your other hand and give up to 5 quick, inward and upward thrusts.

Chest Thrusts

Stand or kneel behind the person and wrap both arms around their chest, place your fist in the middle of their chest, with your thumb facing inward, and place your other hand over your fist, give up to 5 chest thrusts by pulling straight back toward you.

Back Blows/Chest Compressions for Babies

Sit or kneel with the baby face-down along your forearm, holding the jaw in your hand [be careful not to cover the baby's mouth], deliver 5 firm blows between the shoulder blades. If the object does not come out, flip the baby face-up, ensuring you support the head, place two fingers in the middle of the chest and deliver 5 firm chest compressions. Repeat until the object comes out.

Self Choking

Call EMS/911 (from a land-line if possible) and leave the line open; try to move into the open or near people; attempt to dislodge object by performing abdominal thrusts against a safe object.

Three Types of Blood Vessels

Arteries, capillaries, and veins.

Arteries

Large, high-pressure vessels that carry blood away from the heart.

Capilleries

Small vessels that pass oxygen, nutrients, and waste to and from cells.

Veins

Large, low-pressure vessels that carry blood to the heart.

Heart Attack

When the heart muscle cannot get enough oxygen because of a blockage in a coronary artery.

Heart Attack: Signs & Symptoms

Pain, pressure, tightness, or heaviness in chest; radiating pain from chest to arm(s), shoulder(s), jaw and/or neck; dizziness, unresponsiveness, sweating, nausea, vomiting, diarrhea, shortness of breath, back or jaw pain.

Heart Attack: Care

Call EMS/911; have the person rest quietly; have the person chew either 1 adult-dose or 2 low-dose acetylsalicylic acid (ASA) tablets (e.g. Aspirin) [do not repeat].

Angina

The heart's oxygen needs are elevated because of narrowing in the arteries due to cardiovascular disease; painful squeezing, suffocating, or burning feeling in the chest, often brought on by physical activity or stress.

Stroke

Damage to the brain from interruption of its blood supply.

Hemorragic Stroke

Occurs when a brain aneurysm ruptures, causing bleeding on the brain.

Ischemic Stroke

When a clot becomes lodged in an artery of the brain and deprive brain cells of necessary oxygen.