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CPR AND SPORTS MEDICINE SERVICES, LLC
8161 Andover Court, Suite B
West Palm Beach, FL 33406
Main Phone: 1-888-388-9250
Local Phone: 561-512-6466
Website: www.cprflorida.net
e-mail:
info@cprflorida.net
Printer Friendly Review Sheet in English Here
Printer Friendly Spanish / Espanol Review
sheet here
Sign up for CPR classes here at www.cprflorida.net/signup.html
(All classes, unless scheduled at your own location, are at our Military Trail
office in West Palm Beach)
We teach American Heart Association (AHA), American Red Cross (ARC) and American Safety and Health Institute (ASHI) classes such as Healthcare Provider BLS, cpr and first aid, aed, bloodborne pathogens, hiv, oxygen administration, professional rescuer, acls and pals.
Visit our AED Defibrillator Store. Buy Philips, Medtronic, Defibtech, Zoll, Samaritan or Powerheart aeds. We are a distrubutor of aed cabinets, trainers and signs and provide web based aed management software, medical direction and oversight and free shipping.
ADULT CPR IN THREE SIMPLE STEPS
1. CALL
Check the victim for unresponsiveness. If there is no response, Call 911 and
return to the victim. In most locations the emergency dispatcher can assist you
with CPR instructions.
2. BLOW
Tilt the head back and listen for breathing. If not breathing normally, pinch
nose and cover the mouth with yours and blow until you see the chest rise. Give
2 breaths. Each breath should take 1 second.
3. PUMP
If the victim is still not breathing normally, coughing
or moving, begin chest compressions. Push down on the chest 11/2 to 2 inches 30
times right between the nipples. Pump at the rate of 100/minute, faster than
once per second. *Continue or Repeat
CONTINUE WITH 2 BREATHS AND 30 PUMPS UNTIL HELP ARRIVES
Learn CPR in Spanish / Espanol Here
Frequently asked question: "Can you hurt the person doing cpr?" NO!
Click here to
see what the cpr man tell you what he thinks
CPR VIDEOS:
VIEW A VIDEO OF REAL CPR AND AED BY LIFEGUARDS HERE. EXCELLENT ACTUAL CPR ON REAL PERSON!
VIEW A VIDEO of Adult CPR here here
View a video
of 2 person cpr with and AED (Defibrillator) Here
**CPR Changes: Checking The Pulse
The pulse check is no longer taught or expected of laypersons. Instead, if
there is no response after two mouth-to-mouth breaths, begin to pump on the
chest. Please note that the pulse check is still expected of health care providers.
Remember, CPR is for those
who have NO pulse and are NOT breathing. When you give cpr, you are
giving them breaths and compressions. You give breaths to help give oxygen to
the victim and you give chest compressions to act like their heart and help
circulate the blood to the body.
RESCUE BREATHING:
If the victim
DOES have a pulse, but they are not breathing, you do rescue breathing. Rescue
breathing is giving breaths only. This is for healthcare professionals only.
For adults, give one breath every 5 seconds. For children and infants, give one
breath every 3 seconds.
CHILD RESCUE BREATHING AND CPR
Check your child's breathing and pulse
Gently place her on her back on a firm surface. Make
sure her airway is open by lifting her chin gently, then tipping her head back
slowly. For 5-10 seconds, look, listen, and feel for signs of breathing. �If they are not breathing, give two breaths
and then do 30 compressions.� (Healthcare
professionals: To check for a pulse, gently place your first two fingers on
your child's neck and feel for the carotid artery that's next to her throat.
Feel for a pulse for 5-10 seconds. If there is a pulse, give one breath or use a bag-valve mask BVM every 3 seconds.)
If your child is not breathing and has no pulse, begin CPR.
With your toddler still lying on her back, put the heel of your hand on the
lower third of her breastbone. (*Use only 1 hand or use 2 hands, but do not
press as hard or as deep as adult cpr)
Depress her chest between 1 and 1 1/2 inches. Repeat 30 times within about 20
seconds. (Count "one and two and three.")
With your child's head still tilted, pinch her nose shut, put your mouth over
hers, and give two slow, gentle breaths. Repeat the cycle of 30 compressions
and 2 breaths.
CPR for Infants (Age <1)
Shout and
Tap
Shout and
gently tap the child on the shoulder. If there is no response, position the
infant on his or her back.
Open The Airway
Open the
airway slightly using a head tilt lifting of chin.
Give 2
gentle breaths making sure your mouth covers their nose and mouth
Use 2-3
fingers to give 30 chest compressions
If the baby is
NOT breathing give 2 small gentle breaths. Cover the baby's mouth and nose with
your mouth. Each breath should be about 1 second long. You should see the
baby's chest rise with each breath. Continue 2 puffs (breaths) and 30 compressions until EMS (911) arrives.
Healthcare Professionals: Check for a pulse in the inside
of their arm (brachial pulse). If no pulse, do cycles of 30 Compressions (using
2-3 fingers in the center of their chest between the nipples) and 2 breaths.
Press down about 2 inch (or 1/3 the depth of the chest). Continue cpr until ems arrives. If there is a pulse, give one breath every 3 seconds.
See a Video of Child CPR Here
See a Video of Infant CPR Here
CHOKING Infant:
If your baby can't clear her airway on her own and you believe something is
trapped there, carefully position her face down on your forearm, with your hand
supporting her head and neck, and rest the arm holding the baby on your thigh.
Support her so that her head is lower than the rest of her body. Then give her
five back blows between her shoulder blades with the heel of your hand to try
to dislodge the object. Next, place your free hand (the one that had been
delivering the back blows) on the back of her head and along her spine and carefully
turn her over supporting the head and neck. Support her face-up, with your
forearm resting on your thigh, keeping her head lower than the rest of her
body. Place two or four fingers in the center of your baby's breastbone and
give five chest thrusts, each about 1 inch deep. Continue the series of back
blows and chest thrusts until the object is forced out, she begins to breathe
on her own, she becomes unconscious, or advanced medical help arrives and takes
over.
View Video of Infant Choking Here
Infant 2 person cpr
One person does bag valve mask and the other does the two hands encircling the chest technique to give 15 compressions and then 2 breaths. Remember, one person cpr for an infant is 2 breaths and 30 compressions. When two people are doing cpr, it is 2 breaths and 15 compressions.
VIEW VIDEO HOW TO DO ADULT AND CHILD HEIMLICH MANEUVER (CHOKING) HERE
|
First Aid for a Choking Conscious Adult and children How to help clear an obstructed airway in a conscious
adult or child. |
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Determine if the person can speak or cough. |
|
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Continue these
steps repeatedly until the foreign body is expelled. |
|
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A chest thrust may be used for markedly obese persons
or in late stages of pregnancy. |
|
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If the adult or child becomes unresponsive perform CPR- if you see an object in the throat or mouth, remove
it by doing a finger sweep. |
DO CPR with finger
sweep. |
If a child is choking, bend over and do the Heimlich. You can also go on both of your knees and perform the maneuver.
AED Defibrillator Training
What
is an automated external defibrillator (AED)?
An AED is a device about the size of a laptop computer that analyzes the
heart's rhythm for any abnormalities and, if necessary, directs the rescuer to
deliver an electrical shock to the victim. This shock, called defibrillation,
may help the heart to reestablish an effective rhythm of its own.
How does an
AED work?
An AED is easy to operate. It uses voice prompts to instruct the rescuer. Once
the machine is turned on, the rescuer will be prompted to apply two electrodes
provided with the AED to the victim's chest. Once applied, the AED will begin
to monitor the victim's heart rhythm. If a "shockable"
rhythm is detected, the machine will charge itself and instruct the rescuer to
stand clear of the victim and to press the shock button.
The time to
the first defibrillation shock is the most critical factor in determining
survival rates for sudden cardiac arrest (SCA). With every minute that goes by,
survival rates decrease by about 10%. That leaves a window of ten minutes in
which to potentially save your life or the life of someone you know, after
which survival rates average less than 2%.
The best results for defibrillation occur in the first three minutes, measured
from the moment the victim collapses to when the defibrillation shock is
delivered.
How to work
and AED machine: Put one pad on upper right of the chest and one on the
lower left side of the body (side of body near stomach). When you place pads
and then connect the cord, it will check for a shockable
pulse. If there is a shockable pulse, it will say
Shock Advised!. If so, tell everyone to Clear! and
then press shock. If no pulse, you press shock again. After 1 shock with no
pulse, you MUST do cpr for 2 minutes
and then let it reanalyze for a heart rhythm. Continue until ems arrives.
SEE A VIDEO DEMONSTRATION HERE OF HOW AN AED WORKS AND
SOUNDS
Manual defibrillator show above (different than an AED)
ADVANCED VIDEO: ONLY FOR ACLS, PARAMEDICS, EMT: SEE A VIDEO DEMONSTRATION HERE OF STEPS OF MEGACODE TESTING, MANUAL DEFIB, INTUBATION, DRUGS, more
FIRST AID:
Always start first aid with: Check, Call, Care.
Check the scene and see if anyone can help, to see if
there is other dangers and safe for you to help them. Call 911 right away. Then
give Care to the victim.
Assess ABC's. Check their Airway, Breathing and
Circulation.
Shock in adults
and older children
Shock is a life-threatening condition. Immediate medical
care can make the difference between life and death.
Early signs of shock (most of which will be present)
include:
* Lightheadedness or a
feeling that you are about to pass out.
*
Restlessness,
confusion, or signs of fear.
*
Shallow, rapid
breathing.
*
Moist, cool skin or
possibly profuse sweating.
*
Weakness.
*
Thirst, nausea, or
vomiting.
Also, a person in shock usually has an abnormal increase
in heart rate and an abnormal decrease in blood pressure.
Late signs of shock include:
*
Changes in the
person's level of consciousness, such as sudden unresponsiveness, faintness,
loss of consciousness, or behavior changes.
*
A pale face or blue
lips or earlobes.
Shock may occur in response to a sudden illness or
injury. When the body loses too much blood or fluids, the circulatory system cannot
get enough blood to the vital organs, and shock results. Shock is often associated with heavy external or internal bleeding from a serious injury. Spinal injuries can also cause shock.
*To help them, raise their feet 12 inches in the air and keep them calm and
comfortable.
Food or bite allergies and anaphylactic shock:
| 
Many people have food allergies or are allergic to bites and stings. They may need an Epi Pen as soon as possible. An epi-pen has medicine inside a tube that has a needle. You place your hand around the pen (do not touch the bottom or top when using it), take off the top gray cap (round) and point the narrower end with the needle inside towards the person's leg. They can do it themself, or you can do it for them. Jab the pen through their clothes or on the bare skin. Hold in place for 10 seconds then rub for 10 seconds and throw away in a sharps container. The person will feel relief, but still make sure you called 911.
VIEW A VIDEO of How to Use an EPI Pen Here
Diabetes:
What
it is: Diabetes
mellitus is a chronic and currently incurable condition in which the body is
unable to regulate the glucose (sugar) levels in the blood. It occurs when the
pancreas doesn't make enough or any of the hormone insulin, or when the insulin
produced doesn't work effectively. In diabetes, this causes the level of glucose
in the blood to be too high. It is managed by a healthy lifestyle and balanced
diet, sometimes requiring tablets or insulin.
Two conditions:
- Hyperglycemia (high blood sugar)
- Hypoglycemia (low blood sugar)
How to recognize it:
- A history of diabetes – casualty may recognize onset of ‘hypo’ attack
- Hunger (A missed or late meal can cause the onset of a ‘hypo’ attack for a diabetic.)
- Shallow breathing
- Weakness, faintness or hunger
- Palpitations and muscle tremors
- Strange behavior – may seem confused or belligerent
- Sweating and cold clammy skin
- Pulse may be rapid and strong
- Deteriorating level of response
Diabetic’s warning card, glucose gel, tablets, or insulin syringe in casualty’s possession.
Dangerously low blood sugar (Severe hypoglycemia)
Low blood sugar, known as hypoglycemia, can occur in diabetics when they use too much insulin, exercise too hard or too long, or have not eaten enough food. Hypoglycemia can develop quickly in people with diabetes.
Symptoms of low blood sugar typically appear when the sugar level falls below 70. Watch for:
- Weakness
- Shaking
- Sweating
- Headache
- Nervousness
- Hunger
If these symptoms occur and you have a blood sugar test kit available, do a blood sugar check. If the level is low, the person with diabetes should eat something with sugar: fruit juice, several teaspoons of sugar, a cup of skim milk, or regular soda. If you don't have a test kit handy, sugar should be eaten anyway — it can't hurt. Symptoms should subside within 15 minutes. If the symptoms don't subside, more sugar should be eaten and the sugar level tested again.
AFTER the symptoms subside, more substantial food can be eaten. Eat simple sugar FIRST to get the situation under control. Even if you or your child is hungry, "real" food should not be eaten until the sugar level comes up — real food won't produce enough sugar and takes too long to digest.
If casualty improves, give him/her more to eat and drink.
Watch for complications:
- If condition does not improve look for other possible causes.
- If consciousness is impaired, do not give anything to eat or drink
If
unconscious, carry out ABCD’s, remembering to call for an ambulance.
Heart Attack
| 
Heart Attack Warning Signs
Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:
· Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
· Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
· Shortness of breath. May occur with or without chest discomfort.
· Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1... Get to a hospital right away.
Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive -- up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.
VIEW A VIDEO of Heart Attack Warning Signs Here
Sudden Cardiac Arrest or SCA
What Is Sudden Cardiac Arrest?
Sudden cardiac arrest (SCA), also known as sudden cardiac death, is when the heart suddenly and unexpectedly stops beating. When this occurs, blood stops flowing to the brain and other vital organs. SCA usually causes death if not treated in minutes.
The heart has an internal electrical system that controls the rhythm of the heartbeat. Problems with the electrical system can cause abnormal heart rhythms, called arrhythmias (ah-RITH-me-ahs). There are many types of arrhythmia. During an arrhythmia, the heart can beat too fast, too slow, or it can stop beating. SCA occurs when the heart develops an arrhythmia that causes it to stop beating.
SCA is not the same thing as a heart attack. A heart attack is a problem with blocked blood flow to a part of the heart muscle. In a heart attack, the heart usually does not suddenly stop beating. SCA, however, may happen during recovery from a heart attack.
People with heart disease have a higher chance of having SCA. But most SCAs happen in people who appear healthy and have no known heart disease or other risk factors for SCA.
Stroke:
Stroke Warning Signs
The American Stroke Association says these are the warning signs of stroke:
· Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
· Sudden confusion, trouble speaking or understanding
· Sudden trouble seeing in one or both eyes
· Sudden trouble walking, dizziness, loss of balance or coordination
· Sudden, severe headache with no known cause
If you or someone with you has one or more of these signs, don't delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.
Cardiac arrest strikes immediately and without warning.
Here are the signs:
· Sudden loss of responsiveness (no response to tapping on shoulders).
· No normal breathing (the victim does not take a normal breath when you tilt the head up and check for at least five seconds).
If these signs of cardiac arrest are present, tell someone to call 9-1-1 and get an AED (if one is available) and you begin CPR immediately. If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is available) before you begin CPR. Use an AED as soon as it arrives.
VIEW A VIDEO of Stroke Warnings Here
HEAT ILLNESSES:
Heat stroke:
is the most dangerous of the heat-related illnesses. If not treated
immediately, it can be fatal. The exact cause of heat stroke isn't clear, and
unlike heat exhaustion, it strikes suddenly and with little warning. When the
body cooling systems fails, the core temperature rises quickly. Signs of heat
stroke include a core body temperature above 40.5C / 104F, hot, dry skin, lack
of sweating, and a very fast pulse, and mental status changes.
Heat Exhaustion:
Heat exhaustion may be difficult to differentiate from heat stroke, but it
typically occurs when one is exposed to heat for a prolonged period of time.
The body may become overwhelmed by heat when its mechanism (sweating) for
keeping cool breaks down. Symptoms of heat exhaustion include nausea,
dizziness, weakness, headache, pale and moist skin, weak pulse, and
disorientation. The key difference between heat stroke and heat exhaustion is
that there are no mental status changes (other than mild confusion) in those
suffering from heat exhaustion. Stopping activity, and
cooling the body are the key treatments for heat exhaustion.
Preventing Heat Illness
*
Always acclimatize
for up to a week when exercising in hot weather conditions. This allows your
body to gradually adapt to the heat.
*
Hydrate well before
thirst kicks in. Once you are thirsty you are already dehydrated.
*
Do not exercise
vigorously during the hottest time of day. Try to train closer to sunrise or
sunset.
*
Wear light, loose
clothing, such as cotton, so sweat can evaporate. Better yet, invest in some
clothes that wick, like Cool-Max.
Frostbite:
frostbite on fingers (skin is dead).
Occurs when skin is damaged from extreme cold. You want to re-warm the hands by
a fire or with warm water.
Do not use hot water or rub them together (do not massage it).
This will damage the skin more. If it becomes worse where the ends of the
fingers or toes are becoming black, you need to go to the hospital or call 911
right away.
Splinting or Immobilizing breaks and sprains:
See a 9 minute video here of how to do ace wraps, splints and immobilizing different injuries
arm splint using wood and bandages
arm splint using bandage
finger splint with tape
Splint and ace bandage on ankle
arm sling
Dial
If the break
is in the forearm, loosely wrap a magazine or a thick newspaper around the
break and use a sling fashioned from gauze, ace bandage or a strip of cloth to keep the elbow
immobilized.
A
break in the lower part of the leg requires two splints, one on each side of
the leg (or at least the chin). If suitable material is not available, you
can use the victim's healthy leg as a makeshift splint. If you have to splint
it, remember to splint it ABOVE AND BELOW the injury.
As much as
possible, keep the victim from moving and until an ambulance arrives,
remember ICE:
- "I" is for ice - if
possible apply an ice pack or ice cubes to the injured area. This will
keep down the swelling and reduce pain.
- "C" is for compression -
if the wound is bleeding, apply direct pressure with a clean cloth to
reduce blood flow.
- "E" is for elevation -
try to keep the injured area as high above heart level as possible.
BURNS:
picture of a 3rd degree burn
A
burn victim will require different type of care depending on the type and
extent of his injury. Burns vary greatly from a common,
fairly harmless sunburn to a potentially life-threatening 3rd degree burn
caused by open flames or electrocution.
Here's how to distinguish the three different types of burn injuries and
how to care for each:
- 1st degree burns
are usually accompanied by redness and some swelling of the skin.
Treat a minor burn by first cooling the affected area. If possible, keep the injury under cool running water for at least 10 minutes. If running water is not available place the burn in a container of cold water such as a bucket, tub or even a deep dish. Using a cool, wet compress made of clean cloth will also work if nothing else is available. Keeping the burn cool will reduce pain and minimize the swelling. If the injury is on the part of a body where jewelry or snug clothing is present, carefully remove them before it begins to swell. Apply a moisturizing lotion or Aloe Vera extract and dress the burnt area with loosely wrapped sterile gauze. - 2nd degree burns
will result in deeper, more intense redness of the skin as well as
swelling and blistering.
This type of burn should be treated just as a 1st degree burn but because the damage to the skin is more extensive, extra care should be taken to avoid infection and excessive scarring. Replace the dressing daily and keep the wound clean. If a blister breaks use mild soap and warm water to rinse the area. Apply antibiotic cream such as Neosporin to prevent infection before redressing in sterile gauze. - 3rd degree burns
may appear and feel deceptively harmless as the victim may not feel
much pain due to complete destruction of all layers of skin and tissue
as well as nerve endings. The damaged area may appear charred or
ash-color and will instantly start to blister or "peel".
If the victim's clothing is on fire, douse him with non-flammable liquid. Dial
Choking:
Is
usually caused by a piece of foreign matter such as food becoming lodged in
a person's windpipe. Because a choking victim is fully aware that he cannot
breathe normally, a sense of panic may overcome them, making assessing the
situation and rescue efforts difficult. It is important to try and keep the
victim calm in order to determine whether your assistance is truly
necessary or if the victim's own coughing reflex is sufficient.
Start by asking the person if he is choking. This simple step can be deceptively effective - the victim may be coughing violently or even gasping for air, but if he is able to answer then he is probably not choking. A choking victim will not be able to speak since oxygen cannot reach his lungs. But if after asking the person if he's choking all he can do is gesture or point to his throat and you notice his face starting to turn blue, then he is most likely choking and you will need to perform the Heimlich Maneuver immediately. (see illustrations above).
Cuts or Lacerations:
cut on baby's head (laceration)
The
first and most important step when treating minor cuts and
scrapes is to thoroughly clean the wound with mild anti-bacterial soap
and water. You can use sterilized tweezers to remove any debris that
remains embedded in the wound after rinsing. This will reduce the risk of
an infection and possible complications. If the debris is abundant or
can't be removed for some other reason, a trip to the emergency room will
be necessary.
Water
may induce bleeding by thinning the blood. If while rinsing the wound you
notice increased blood flow, use gauze or a clean cloth to apply gentle,
continuous pressure until the blood clots.
Although hydrogen peroxide is commonly used as a
disinfectant for minor cuts and scrapes, it is actually not very
effective and may even delay the healing process by irritating a person's
living cells. You can use hydrogen peroxide but apply it around the
open wound, not directly to it. An antibiotic ointment such as Neosporin
is a better alternative - it will keep the wound from getting infected
and speed up the healing process.
Dress the wound with a bandage or sterile gauze to keep dirt and bacteria out. Change the dressing frequently and rinse the wound as often as necessary to keep it free of dirt. Continue to monitor the wound for several days. If the injured area turns red or puffy, or if excessive pain persists, then it may've become infected and will require a physician's attention. Do not simply dismiss cuts as minor injuries as some may be quite serious if not tended to by a professional. If the wound is very deep or the bleeding is profuse, it may require stitches in order to heal properly.
Nosebleed:
A human nose is rich with small fragile blood vessels which are susceptible
to damage. A nosebleed may be caused by a fall, a strike to the nose, or
even from breathing excessively dry air. If the nosebleed is not a symptom
of a more serious injury, it is rarely dangerous and can usually be stopped
by applying continuous pressure.
- Do NOT tilt the
victim's head backward.
- Pinch the nostrils
shut and press the tip of the nose against the bones of the face.
- Maintain pressure
for 5 to 10 minutes.
- Once the bleeding
has stopped, the victim should avoid blowing his nose or otherwise
straining himself for at least an hour.
Bleeding:
Always wear gloves and dispose of everything in a bio hazard
bag (red).
To stop
bleeding, first use gauze. If it keeps bleeding, add more gauze on top and
raise the injured area if it is not broken.
Remember
these steps:
Apply
pressure
If this does not work, add more gauze or elevate the arm or leg.
If this still does not work, use the brachial pressure point (between bicep and tricep near the armpit) or femoral artery (inside of groin in the leg).
Bloodborne Pathogens:
There are
several diseases that are caused by blood borne pathogens (BBP's).
While many BBP's are fairly exotic and you may never
encounter them, a few BBP's are fairly common and
present a risk to you if you come in direct contact with potentially infectious
materials such as human blood and certain body fluids.
Occupational
Safety and Health Administration (OSHA) has recognized that health care workers
and others, who may in contact with human blood or blood associated materials
(Other Potentially Infectious Materials or OPIM for short) has recognized this
occupational hazard and created the "Blood borne Pathogen
Standard".
This standard
has served as the basis for implementing policies and practices to minimize
your risk of exposure to BBP's, specifically to
Hepatitis B virus (HBV), Hepatitis C virus and Human Immunodeficiency Virus
(HIV). These policies and practices, if followed, are an effective means to
reducing your risk of exposure to other pathogens as well.
How to take off gloves:
Take off
first glove starting at the top near the wrist.
Make the
glove inside out and place it inside the other gloved hand.
Remove the
other glove by slipping your bare fingers inside the glove at the top of the
wrist and pull it off so that it is inside out. The gloves should be inside of
each other. Any lightly soiled bandages or band aids should be inside the
gloves. Put in biohazard bag.
Blood and
Other Potentially Infectious Materials (OPIMs)
HIV and HBV
may be found not only in human blood, but also in other potentially infectious
materials including the following body fluids:
�
blood products (such as plasma or serum)
�
semen
�
vaginal secretions
�
cerebrospinal fluid
�
pleural fluid (or lung fluid)
�
synovial fluid (or
fluid from your joints)
�
amniotic fluid (or uterine fluid)
�
peritoneal fluid (or fluid that fills your body cavity)
�
saliva in dental settings
�
any body fluid that is visibly contaminated with blood
�
any body fluid that you can't tell what it is
Other items
found in the clinical or laboratory setting are also considered to be other
potentially infectious materials (OPIM) and they include:
�
any unfixed tissue or organ, other than intact skin, from
a living or dead person
�
cell or tissue cultures that may contain blood borne
pathogens as outlined in LBNL's Exposure Control Plan
�
organ cultures and culture medium or other solutions that
may contain HIV or HBV blood from experimental animals infected with HIV,
�
HBV or other BBPs.
It is a
required practice to use Universal Precautions when handling these body fluids
and materials.
The following
body fluids are not expected to be infectious sources of blood borne pathogens
unless they are visibly contaminated with blood:
�
urine
�
feces
�
vomit
�
tears
�
sweat
�
sputum
�
nasal secretions
Although these
body fluids do not currently require universal precautions, good personal
hygiene practices are highly recommended when handling these materials.
Transmission of
Blood borne Pathogens
Blood borne
pathogens can be transmitted when infectious blood or OPIM is introduced into
the bloodstream of a person. Transmission of blood borne pathogens in the
workplace can occur through the following routes of transmission:
�
Parenteral exposure -
this means that the infected blood or OPIM is introduced directly into your
body through a break in the skin. Examples include: a needle-stick injury or a
cut with a piece of contaminated glass.
�
Mucous membrane exposure - this means that the infected
blood or OPIM enters your body through contact with a mucous membrane found in
your eye, nose or mouth.
Blood borne
pathogens may also be transmitted through:
�
Sexual contact
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Infected women may expose their newborn children to BBP's through amniotic fluid, through blood during the
birthing process, and (less likely) through breast milk.
Human
Immunodeficiency Virus (HIV)
HIV is the
virus that gradually weakens the immune system of the infected person, leaving
that person unable to fight off other infections. This leads to acquired
immunodeficiency syndrome (AIDS) and will ultimately cause death.
HIV-infected
persons may have no symptoms or may experience symptoms such as swollen lymph
nodes, fatigue, weight loss, diarrhea, persistent dry cough and fever.
HIV & AIDS
Trends
According to
CDC statistics, HIV-related illness was the leading cause of death among young
adults between the ages of 25 and 44 years old in 1995. It is still the second
leading cause of death for this age group today.
Hepatitis B
Virus (HBV)
HBV Hepatitis
B virus (HBV) is a virus that causes an infection of the liver potentially
leading to liver disease, liver cancer and possibly death.
Symptoms of
HBV infection may range from no symptoms, to brief flu-like symptoms, to
jaundice and serious illness. If symptoms do occur, they may not be evident
until 2 to 6 months after the person is infected. However, studies have shown
that an infected person can be infectious to others several weeks before the
onset of symptoms.
HBV Infection
Trends
CDC estimates
that between 140,000 and 320,000 people become infected every year in the
Approximately
one-half of all people who become infected do not have any symptoms of
infection.
Approximately
10% of all people who become infected may become "carriers" of HBV.
This means that they may suffer from infection at a later time (chronic
infection). They can also be infectious to others for the rest of their lives
while not necessarily demonstrating any symptoms of HBV infection themselves.
Occupational
Exposure
Individuals
whose jobs involve handling blood and OPIM are at a much greater risk of
becoming infected with HBV than HIV.
Why you may
ask?
It is because
there are many more HBV-infected people than HIV-infected people in the
community. Thus the chance of exposure to HBV is greater. Also
Hepatitis B
virus is much more infectious than HIV.
This
difference in infection risk is best illustrated by the following statistics:
If you had a
needle stick accident and were exposed to infected blood, your chance of
acquiring an infection would be:
HIV ~0.3% or 3 in 1000
HBV ~30.0% or 300 in 1000
According to
CDC, your risk for acquiring an HBV infection is 100 times greater than for
HIV.
When
considering the risk of occupational exposure to HBV, keep in mind that a safe
and effective vaccine is available to you.
Reducing the
Risk through Vaccination
A 3-shot vaccination series is available for hepatitis B
virus. The vaccination is highly effective and safe.
As
an employee encountering blood and potentially infectious materials in the
course of your job, you are entitled to the vaccination at no cost.
Hepatitis C
Virus (HCV)
Hepatitis C
virus (HCV), also formerly known as "non A-non B",
is another pathogen that you need to be aware of if you have occupational
exposure to human blood or other potentially infectious materials.
Hepatitis C
virus has been found in all parts of the world. The virus appears to be
transmitted most efficiently through parenteral
exposure to blood from an infected individual. Common examples of transmission
events are: receiving a blood transfusion from an infected source or sharing
intravenous drug needles with an infected individual.
Comparing HBV
and HCV
Like HBV,
symptoms of HCV can range from no symptoms or flu-like symptoms to jaundice and
even death in rare instances. Also similar to HBV, HCV has a carrier state
which can lead to chronic infection and liver disease.
Unlike HBV,
there is currently no vaccine for HCV available and immune globulin
administered after exposure does not appear to be very effective in preventing
HCV infection.
Transmission
Risk
Although the
risk of HCV transmission is still being defined, the risk of transmission by
the following routes appears to be low:
�
regular household contact situations
�
sexual contact
�
passing the infection from mother to unborn child
Cases of
transmission of HCV to health care workers have occurred through accidental
needle sticks, cuts with sharp instruments, and splashes to the eye with human
source material.
Questions I hear all the time: How long does HIV or Hepatitis b or c last on surfaces or in the air? HIV does not last long at all in the air or on surfaces. It must be contained in the blood to infect someone. Hepatitis A, hepatitis B and hepatitis C are all forms of viral hepatitis—an inflammation of the liver caused by a virus. However, there are a number of characteristics that differentiate these diseases. Hepatitis A - is spread by a fecal-oral route or by eating and drinking contaminated food or water. In younger patients the infection often goes unnoticed. Most patients recover fully after a short illness. As a result of their infection, they develop lifelong immunity. Hepatitis B - is transmitted through infected blood and body fluids. It can be passed, for example, from mother to child during delivery. It can also be transmitted sexually, and is therefore a sexually transmitted disease. Hepatitis B is often spread through injection drug use. The majority of adults infected with the hepatitis B virus recover completely, and as a result of their infection, develop lifelong immunity to the virus. However, approximately 10% of adults and 90% of infants who become infected with hepatitis B cannot get rid of the virus and are considered to have chronic hepatitis B. These people become long-term carriers, and although they may be symptom free for many years, they may develop cirrhosis or liver cancer later in life. Is there a cure for hepatitis C? Current treatment includes a combination of anti-viral drugs (interferon and ribavirin) and approximately 40% of people receiving this treatment are able to completely eliminate the Hepatitis C virus from their bodies. Success ranges from 20-80% and depends on many factors: the amount of scarring in the liver, the amount of virus in the body and the specific genotype of hepatitis C. Most people with hepatitis C can live a healthy life for many years. Only about 20% of hepatitis C patients develop cirrhosis or liver cancer. The key to successful treatment and management of the disease is early diagnosis and treatment. Is there a vaccine for hepatitis C? There is no vaccine for hepatitis C at the present time. Once in the body, HCV can literally change its coat (or outer capsule) in a process called mutation. It is this outer coating that helps the body or vaccine identify a virus and attack it. Thus, developing a vaccine for hepatitis C has become a moving target. You would need a different vaccine for each mutation of the virus. Researchers are currently tackling this challenge but a vaccine is not expected in the near future. How long can HCV live outside the body and transmit infection? Recent studies suggest that HCV may survive on environmental surfaces at room temperature at least 16 hours, but no longer than 4 days. What do you use to remove HCV from environmental surfaces? You should clean up any blood spills - including dried blood, which can still be infectious - using 1:10 dilution of one part household bleach to 10 parts of water for disinfecting the area. Use gloves when cleaning up any blood spills.
Go here to view more info on Hepatitis : View more info here
Head, neck and spine injuries
View how to do cpr and spine board the patient is in a pool if you are a lifeguard or EMT. View steps here
Professional Rescuer / Healthcare Provider
BLS CPR:
You must know adult, child and infant cpr. You must know advanced first aid.
You must also know 2 person cpr, bag/valve
mask, cpr one way valve mask, and AED.
You must also know about advanced airways and intubation.
Additional components are: oxygen administration, oral and nasal adjuncts and
suction devices. I have provided pictures of these objects below.
*Pictures of advanced professional rescuer and healthcare
provider cpr materials.
Oral-Pharyngeal Airways adjuncts (OPAs)
These curved pieces of rigid plastic are inserted into the mouth of a patient
who has lost their gag-reflex (often because they are unconscious) to protect
them from occluding their own airway as the muscles of the tongue and to relax.
Nasal-Pharyngeal Airway adjuncts (NPAs)
These soft flexible rubber tubes are lubricated and inserted in through a
patient's
nostril with the same purpose as the OPAs above. They
are designed to provide a
protected airway through which the patient may breathe, naturally or with the
help of emergency rescuers. The advantage to using an NPA is that a patient
with an
intact gag-reflex who will reject an OPA may still be provided with an airway.
Suction Devices: The Res-Q-Vac
If a patient develops fluid in their mouth or throat,
it is often necessary to remove the
fluid in order to prevent aspiration into the lungs. This is accomplished using
a suction
device. Most ambulances will carry an electric suction device, but for reasons
of
portability our organization uses a hand-pump device which accomplishes the
same task.
Administration of Oxygen
Oxygen is most commonly given by nasal cannula, which is a plastic tubing
that reaches to the nostrils. It is also given by a mask, which covers the
mouth and nose. In both cases, the nasal cannula or mask are attached to plastic tubing which
attaches to a source of oxygen: oxygen tanks of various sorts or oxygen
concentrators.
Oxygen is given at a certain speed or rate which is
measured in liters per minute. A 2 liter per minute rate is quite common in
adults, although when there is severe shortness of breath, the rate is
increased to 3, 4 or 5 liters/minute in some cases. It is very important to
follow the physician's orders about how much oxygen to given per minute.
Bag-Valve Mask (BVM)
Like the Pocket Mask, the BVM includes a face mask with a one-way valve.
The key difference is that the air for respirations comes from the bag and
reservoir,
which can be attached to an oxygen tank for high concentration oxygen, rather
than
from the rescuers own lungs. (it also does not have to have oxygen....either
way, it is better for the patient.) This method of delivery is often much more
effective, contains more oxygen and is more beneficial
especially if there are multiple rescuers on scene.
How to hold a one way valve mask with one rescuer:
and www.cprflorida.net and learncpr.org