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By R. Youngson
Harper Collins PublishersCopyright © 2003 R. Youngson All right reserved. ISBN: 006053446X
The Signs of Life and Emergency Techniques
The Signs of Life
The signs of life are breathing and the pulse. In emergency situations, the following concerns take priority: 1 that the victim's airway is clear and that they are able to breathe; and 2 that the blood is circulating properly.
A Clear Airway
The Importance of Air Supply
The most urgent and immediate responsibility for any person giving first aid is to ensure that the injured person can either breathe freely or is provided artificially with an adequate supply of air. Nothing else is as important as this. Above all, the brain needs oxygen. At normal temperatures, serious brain damage or even death will occur in a matter of minutes if a person ceases to have an adequate intake of air. This may happen because the person has stopped breathing or because the passage along which the air enters the lungs (the airway) has become obstructed.
The first requirement is to check for breathing.
Checking For Breathing
Use more than one sense: 1 look for movements of the chest or abdomen - confirm that these are smooth and regular; 2 listen close to the mouth or nose for sounds of breathing; 3 you should be able to feel the victim's breath on yourface.
If the casualty is breathing freely you can safely turn your attention to checking for injuries. If the casualty is unconscious and the injuries permit, use the recovery position (see pp. 15-18) to ensure that safe breathing continues.
If There is No Breathing
This means that respiration has ceased and you must supply the air. If the chest and abdomen are moving, but there is no movement of air in and out of the mouth or nose, the airway is obstructed and you must clear it. Action is urgently needed to restore the air supply. Shout for help and ensure an ambulance has been called.
Opening the Airway
1 The airway may be blocked by the position of the head (a). 2 To remedy this, press down on the forehead with one hand and with the other lift the chin with two fingertips (b). This action stops the tongue from blocking the top of the airway.
- If there is still no breathing, there may be ax obstruction in the airway.
Clearing An Obstruction From the Airway
1 Turn the head to one side, keeping the chin forward and the top of the head back. 2 Sweep around the inside of the mouth above the tongue with two hooked fingers and remove any foreign material. Do this quickly. Do not waste time. 3 Check for breathing (see p. 2). 4 Check the pulse (opposite).
- If there is still no breathing, start artificial tilation at once (see pp. 6-9).
- If there is no breathing and no pulse, start artificial ventilation and external chest compression (see pp. 9-12) immediately.
The pulse indicates the state of the circulation is the repeated, brief pressure wave that passes along the arteries each time the lower chambers of heart tighten (contract) and squeeze out blood. rate and quality of the pulse may vary considerably, from slow, full and thrusting to rapid, weak fluttering. A rapid, weak pulse, characteristic shock (see pp. 104-108), may be difficult to especially in a panic situation where the first aider's own heart may be beating rapidly and his or her pulse may be much stronger than that of the victim. For this reason, feeling the pulse at the usual site, on the thumb side of the wrist, 1.5 cm above the wrist crease and 1.5 cm in from the edge (a), may not be reliable. So you should always feel for the carotid pulse in the neck. The carotids are large arteries that run up on either side of the back of the Adam's apple (larynx) (b).
Checking the Pulse
1 Breathe deeply to calm yourself, if necessary. 2 Use only the tips of two fingers. Place them on the side of the Adam's apple without pressing on it. 3 Slide your fingertips firmly backwards along the side of the Adam's apple so that they pass into the vertical groove between it and the muscle to the side of it (c). 4 If you do not immediately feel the pulse, move the fingertips a little nearer to and further from the Adam's apple until the pulse is felt.
The object of this is to provide the victim immediately with an air supply. The air you breathe out stiff has adequate amounts of oxygen for someone else to use. Many lives have been saved with "secondhand-oxygen. There must be no delay in starting artificial resuscitation and you must be sure that the air is getting to the right place - deep into the lungs of the victim.
It is essential that you succeed in inflating the lungs. If you do not see the chest rising when you blow and falling when you stop, you are not succeeding; you may have to follow the procedure for choking (see pp. 66-73).
Care must be taken when performing this technique. Deaths have occurred where obstructions in the airway have been blown deeper into the lungs.
Excerpted from First Aid by R. Youngson
Copyright © 2003 by R. Youngson
Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.