Emergency health assessment on the spot. Assessment in medical emergency situation. Analysis of complaints, incidents, issues, and problems. What should be your first question in case a patient is referred to you? How do you manage individual medical emergency problems while on duty? Questions that must be answered. Where is the patient now? How old is the patient? What is the gender of the patient? Who is reporting this emergency? What seems to be the complaint? What seems to be the problem? Coma scale analysis. First, analyze Glasgow Coma scale, then analyze vital signs including consciousness. When was the patient normal? Can the patient open both eyes spontaneously? No Can the patient talk or make noise relevant to age? No Can the patient walk or move extremities relevant to age? No Put your hand on the radial pulse. Is there a pulse? Yes. Put your hand on the chest. Is there respiratory movement? Yes. What is the diagnosis? What is the treatment? What is the diagnosis? Coma How do you proceed if a person is in a coma? Find the cause of the coma. Treat the underlying cause. Identify the causes of the coma and fix the underlying causes. Here are further guidelines. http://www.qureshiuniversity.com/coma.html When do you start cardiopulmonary resuscitation? Cardiopulmonary resuscitation for adults. 1. Assessment Here are further guidelines. Have you answered 10 questions relevant to this situation? 1. Where is the patient now? 2. Is the person on the ground? 3. Ask: How are you? No reply. 4. Are you okay? No reply. 5. Was the patient able to see, talk, and move a few minutes earlier? Yes. 6. Can the patient open both eyes spontaneously? No. 7. Can the patient talk or make noises relevant to age? No. 8. Can the patient walk or move their extremities relevant to age? No. 9. Put your hand on the radial pulse. Is there a pulse? No. 10. Put your hand on the chest. Is there respiratory movement? No. The patient was able to see, talk, and move a few minutes earlier. The patient cannot open both eyes spontaneously, talk or make noise relevant to age, and/or walk or move extremities relevant to age. There is no pulse, no breath movement, and/or no heart sounds at this point. Start cardiopulmonary resuscitation. These guidelines are for a person or victim who is more than 18 years old. If there is no pulse and no breathing for 10 seconds, begin chest compressions. Give 30 chest compressions before giving two rescue breaths. Hands-only cardiopulmonary resuscitation. Traditional cardiopulmonary resuscitation with breaths. See the 10 steps of cardiopulmonary resuscitation. 1. Ensure Scene safety 2. Call 911 3. Check Breathing 4. Position the person on their back on a flat, firm surface 5. Perform 30 Chest Compression 6. Open the Airway 7. Give 2 Rescue Breathes 8. Repeat CPR Cycles 9. Use AED 10. Put the Victim in the Recovery Position Child & Baby CPR Before Giving Child or Baby CPR 1 Check the scene for safety, form an initial impression, obtain consent from the parent or guardian, and use personal protective equipment (PPE) 2 If the child or baby appears unresponsive, check the child or baby for responsiveness (shout-tap-shout) For a child, shout to get the child’s attention, using the child’s name if you know it. If the child does not respond, tap the child’s shoulder and shout again while checking for breathing, life-threatening bleeding or another obvious life-threatening condition For a baby, shout to get the baby’s attention, using the baby’s name if you know it. If the baby does not respond, tap the bottom of the baby’s foot and shout again while checking for breathing, life-threatening bleeding or another obvious life-threatening condition Check for no more than 10 seconds 3 If the child or baby does not respond and is not breathing or only gasping, CALL 9-1-1 and get equipment, or tell someone to do so Performing Child & Baby CPR 1 Place the child or baby on their back on a firm, flat surface For a child, kneel beside the child For a baby, stand or kneel to the side of the baby, with your hips at a slight angle 2 Give 30 compressions For a child, place the heel of one hand in the center of the child’s chest, with your other hand on top and your fingers interlaced and off the child’s chest Position your shoulders directly over your hands and lock your elbows Keep your arms straight Push down hard and fast about 2 inches at a rate of 100 to 120 per minute Allow the chest to return to normal position after each compression For a small child, use a one-handed CPR technique Place the heel of one hand in the center of the child’s chest Push down hard and fast about 2 inches at a rate of 100 to 120 per minute For a baby, place both thumbs (side-by-side) on the center of the baby’s chest, just below the nipple line Use the other fingers to encircle the baby’s chest toward the back, providing support Using both thumbs at the same time, push hard down and fast about 1 ½ inches at a rate of 100 to 120 per minute Allow the chest to return to its normal position after each compression For a baby, if you can’t reach the depth of 1 ½ inches, consider using the one-hand technique 3 Give 2 breaths For a child, open the airway to a slightly past-neutral position using the head-tilt/chin-lift technique For a baby, open the airway to a neutral position using the head-tilt/chin-lift technique Blow into the child or baby’s mouth for about 1 second Ensure each breath makes the chest rise Allow the air to exit before giving the next breath If the first breath does not cause the chest to rise, retilt the head and ensure a proper seal before giving the second breath. If the second breath does not make the chest rise, an object may be blocking the airway 4 Continue giving sets of 30 chest compressions and 2 breaths until: You notice an obvious sign of life An AED is ready to use Another trained responder is available to take over compressions EMS personnel arrive and begin their care You are alone and too tired to continue The scene becomes unsafe You have performed approximately 2 minutes of CPR (5 sets of 30:2), you are alone and caring for baby, and you need to call 9-1-1