and list whom to call for help. For example, a person with diabetes may have some form of medical ID tag, bracelet or necklace identifying this condition. If a child or an infant becomes extremely upset, conduct a toe-to-head check of the child or infant. This will be less emotionally threatening. Parents or guardians who are present may be able to calm a frightened child. In fact, it often is helpful to check a young child while he or she is seated in his or her parent’s or guardian’s lap. Parents also can tell you if a child has a medical condition. When you have finished checking, determine if the person can move his or her body without any pain. If the person can move without pain and there are no other signals of injury, have him or her attempt to rest in a sitting position or other comfortable position (Fig. 1-16). When the person feels ready, help him or her to stand up. Determine what additional care is needed and whether to call 9-1-1 or the local emergency number.
SHOCK When the body is healthy, three conditions are needed to keep the right amount of blood flowing: ■ ■ ■
The heart must be working well. An adequate amount of oxygen-rich blood must be circulating in the body. The blood vessels must be intact and able to adjust blood flow.
Shock is a condition in which the circulatory system fails to deliver enough oxygen-rich blood to the body’s tissues and vital organs. The body’s organs, such as the brain, heart and lungs, do not function properly without this blood supply. This triggers a series of responses that produce specific signals known as shock. These responses are the body’s attempt to maintain adequate blood flow.
When someone is injured or becomes suddenly ill, these normal body functions may be interrupted. In cases of minor injury or illness, this interruption is brief because the body is able to compensate quickly. With more severe injuries or illnesses, however, the body may be unable to adjust. When the body is unable to meet its demand for oxygen because blood fails to circulate adequately, shock occurs.
What to Look For The signals that indicate a person may be going into shock include: ■
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Restlessness or irritability. Altered level of consciousness. Nausea or vomiting. Pale, ashen or grayish, cool, moist skin. Rapid breathing and pulse.
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Excessive thirst.
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Be aware that the early signals of shock may not be present in young children and infants. However, because children are smaller than adults, they have less blood volume and are more susceptible to shock.
When to Call 9-1-1 In cases where the person is going into shock, call 9-1-1 or the local emergency number immediately. Shock cannot be managed effectively by first aid alone. A person suffering from shock requires emergency medical care as soon as possible.
What to Do Until Help Arrives Caring for shock involves the following simple steps: ■
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FIGURE 1-16 If there are no signals of obvious injuries, help the person into a comfortable position.
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Participant’s Manual
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Have the person lie down. This often is the most comfortable position. Helping the person rest in a more comfortable position may lessen any pain. Helping the person to rest comfortably is important because pain can intensify the body’s stress and speed up the progression of shock. Control any external bleeding. { Since you may not be sure of the person’s condition, leave him or her lying flat. { Help the person maintain normal body temperature (Fig. 1-17). If the person is cool, try to cover him or her to avoid chilling. { Do not give the person anything to eat or drink, even though he or she is likely to be thirsty. The person’s condition may be severe enough to require surgery, in which case it is better if the stomach is empty. Reassure the person.
FIGURE 1-17 Help the person going into shock to lie down and keep him or her from getting chilled or overheated.
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FIGURE 1-18 If you are not sure whether an infant is unconscious, check by tapping the infant’s shoulder or flicking the bottom of the infant’s foot.
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Continue to monitor the person’s breathing and for any changes in the person’s condition. Do not wait for signals of shock to develop before caring for the underlying injury or illness.
CHECKING AN UNCONSCIOUS PERSON If you think someone is unconscious, tap him or her on the shoulder and ask if he or she is OK. Use the person’s name if you know it. Speak loudly. If you are not sure whether an infant is unconscious, check by tapping the infant’s shoulder and shouting or by flicking the bottom of the infant’s foot to see if the infant responds (Fig. 1-18).
When someone is unconscious and lying on his or her back, the tongue may fall to the back of the throat and block the airway. To open an unconscious person’s airway, push down on his or her forehead while pulling up on the bony part of the chin with two or three fingers of your other hand (Fig. 1-19). This procedure, known as the head-tilt/chin-lift technique, moves the tongue away from the back of the throat, allowing air to enter the lungs. { For a child: Place one hand on the forehead and tilt the head slightly past a neutral position
If the person does not respond, call 9-1-1 or the local emergency number and check for other life-threatening conditions. Always check to see if an unconscious person: ■ ■
Has an open airway and is breathing normally. Is bleeding severely.
Consciousness, effective (normal) breathing and circulation and skin characteristics sometimes are referred to as signs of life.
Airway Once you or someone else has called 9-1-1 or the local emergency number, check to see if the person has an open airway and is breathing. An open airway allows air to enter the lungs for the person to breathe. If the airway is blocked, the person cannot breathe. A blocked airway is a life-threatening condition.
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FIGURE 1-19 Open an unconscious person’s airway using the head-tilt/chin-lift technique.
Before Giving Care and Checking an Injured or Ill Person
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