Emergency first aid

Checking vital functions.

As the most vital organs we consider th brain, the heart and the lungs. The respective vital functions are consciousness, circulation and breathing. A problem with any of these functions must be considered as lifethreatening.

Checking these vital functions always happens according to a set protocol:
* check for consciousness by addressing the victim and gently shaking the shouders
* if a victim responds, try to find out what happened
* if a victim does not respond, immediately call 1-1-2 or have someone else do this, and have someone fetch an AED if possible
* subsequently check the breathing of the victim
* if the victim is not breathing normally, alert the operator and immediately start CPR

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Checking the consciousness.

Approach the victim on the side their face is pointing towards, and try to make contact.

Gently shake the victim by the shoulders and ask in a loud and clear voice "are you allright?"

Alert 1-1-2

When you call 1-1-2 on your mobile phone, first you will get the operator of the 'korps landelijke politiediensten'. He or she will ask what you need; ambulance, fire department or police and in which city. Then you will be connected to the regional emergy service. The operator there will ask for your name, telephone number and the address you are at.

After exchanging the necessary information and answering a few questions, you will proceed with checking the victim's breathing.

Checking the breathing.

* place one hand on the forehead of the victim and tilt the head slightly backwards
* use two fingers of the other hand to lift the chin a little bit to open the airway
* place your cheek over mouth and nose of the victim and listen and feel if there is any airflow
* at the same time look across the chest and abdomen of the victim to see if any movement is visible
* check for a maximum of 10 seconds
* if you do not observe any breathing, alert the operator and start CPR immediately

Attention!

The victim may show socalled agonal respiration. This is not normal breathing and is always a sign of a loss of cirrculation!

The victim makes abnormal breathing sounds, seems to be moaning or makes gurgling sounds.

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Performing CPR

Performing chestcompressions

* place the heel of one hand on the middle of the sternum
* place the other hand on top of the first and lift the fingers of the first hand so they do not touch the chest
* depress the sternum 5 to 6 centimeters
* fully release the sternum, without losing contact with the chest
* perform 30 compressions at a rate of 100 to 120 per minute

Breathing

* place one hand on the forehead of the victim and tilt the head slightly backwards
* use two fingers of the other hand to lift the chin a little bit to open the airway
* using thumb and indexfinger of the hand which is on the forehead, close the nostrils of the victim
* place your mouth over the victim's and make sure you enclose it entirely
* breathe out during 1 secondinto the victim's mouth, and do this twice within 10 seconds
* at the same time watch from the corner of your eye, whether the victim's chest is rising
* turn your head away from the victim's face between the two breaths, so you can inhale fresh air

Connecting the AED

As soon as the AED arrives, it has to be connected as soon as possible. While doing this, interrupt the compressions as little as possible!
If you are alone and there is an AED nearby, then fetch and connect it first, then start CPR
With two EROs: work together as much as possible, so you have to interrupt CPR as little as possible
* depending on the type of AED, turn it on by pressing the button or opening the lid
* follow the instructions given by the AED accurately
* Every 2 munites the AED will analyse the victim's heartrate. This is an opportune moment to releave each other.
This way it is easier to continue CPR, especially when it takes a bit longer for professional assistance to arrive.

Arterial bleeding

Arterial bleeding requires immediate action, because of the life threatening nature of the situation.
Arterial bleeding can be recognised by the pulsating bloodflow from the wound.

How to act

In case of arterial bleeding we have to apply pressure to the wound as quickly as possible, in order to stop the bleeding.
Call 1-1-2 or have someone else do this. If possible, apply a pressure bandage and stay with the victim until the ambulance arrives.

Shock

Shock is always life threatening! Beginning with the skin, all organs will gradually be shut down, from the outside inward.
In this way the body tries to supply the vital organs with oxygenated blood for as long as possible.
These organs are the brain, the heart and the lungs.

Causes of shock

* severe loss of bodily fluids, i.e. by internal or external bleeding
* blisters caused by (2nd degree) burns on more than 10% of the skin surface
* a disturbance in the function of the heart/circulation

Due to a shortage of flowing, oxygen rich blood, the body reacts with accelerated heartrythm and rapid, shallow breathing.
More blood has to flow to the vital organs and more oxygen has to be absorbed.

Symptoms of shock

* rapid heartrate and shallow breathing
* pale, clammy and cold skin
* muscle weakness
* dry mouth and lips, due to dry mucous membranes, thirst
* victim feels nauseous because the digestive system is not working properly
* victim is restless, often anxious and confused
* victim is cold

How to act in case of shock

* call 1-1-2 when a victim shows signs of shock
* have the victim lie down
* stem severe external bleeding
* stay with victim
* set the victim at rest
* prevent cooling by means of a thermal blanket
* do not try to warm the victim; this counteracts the natural reaction to shock
* do NOT give the victim anything to drink; it may cause them to vomit
* place an unconscious victim in the recovery position to maintain an open airway

Brain haemorrhage,cerebral infarction and TIA

This category of afflictions is also known as stroke. However there are different causes and effects.
The medical term is cerebrovascular accident (CVA).

Brain haemorrhage

This is a bleeding in the brain due to the rupture or tear of a weak spot in a bloodvessel.

Cerebral infarction

In about 80% of all cases this is the cause of a stroke. A bloodvessel in the brain is blocked by a clot, which leads to oxygen deprivation in that part of the brain. When blood thinners are administered within 4 hours, a complete recovery is possible. The clot will be dissolved and bloodflow restored.

TIA

A TIA, or Transient Ischemic Attack, is a mild form of a stroke with symptoms of a passing nature. These symptoms usually disappear after 24 hours.
It is very important that the cause is determined, so treatment can start promptly.

Symptoms of a stroke

* halfsided failure phenomena: arms, leg and/or sight
* crooked, hanging mouth
* slurred speach
* sudden, heavy headache, often accompanied by nausea and vomiting
* blurred or double vision, blindness of one or two eyes
* disturbance in coordination and/or balance, dizzyness
* loss of strength
* confused behaviour
* disturbance in thinking, emotions

How to act in case of a stroke

Above mentioned symptoms can occur in different combinations, but also separately. When observing one of the first four symptoms, always call 1-1-2, even when in doubt.
Stay with the victim until professional assistance arrives and takes over. Keep the victim in a upright position as not to increase pressure on the brain when lying down.

Diabetes mellitus

With diabetes mellitus the body is incapable of processing glucose or sugers from food in a correct manner.
The body produces too little or no insulin, whitch is needed for this processing.
Patients who are not treated, continuously have high bloodsugar levels. This is called hyperglycemie.
When a patient injects too much insulin, or eats too little after injecting, a low bloodsugar level occurs. This is called hypoglycemie.
Popularly this is called a hypo.

Symptoms of hyperglycemie

* thirst and a dry mouth
* having to pee a lot and often
* tired, sleepy
* tingling or stinging sensations
* numb feeling

How to act

Call a physician or huisartsenpost:

* if the victim becomes weak or dazed
* if the victim has laboured ( very fast and/or very deep) breathing
* in case of vomiting

Call 1-1-2:

* if the victim is not responsive
Place the victim in the recovery position!
Immediately start CPR if the victim no longer has normal breathing.

Symptoms of hypoglycemie

* sweating
* paleness
* heart palpitations
* headache
* shivering, unsteady or weak feeling
* slurred speach
* hungry feeling
* yawning
* tingling around the mouth
* blurred vision
* shaking
* moodswings (stubborn, irritable, agitated)
* cold
* trouble with concentration
* lightheadedness
* unconsciousness (don't give anything to drink)

How to act

Give a victim with a hypo, fast acting carbohydrates such as suger or glucose. Liquid carbohydrates are absorbed more quickly.
If the victim is dazed or unconscious, rub some honey or syrup on the inside of the cheek. Rub the cheek from the outside to promote absorbtion.

Epilepsy

Epileptic seizures usally occur totally unexpected, and have many different appearances. The most commonly known is the one where the
vicitm falls down on the floor while moving and convulsing uncontrollably.
There are also variants with less severe, or even hardly detectable symptoms.

Symptoms of an epileptic seizure

* muscle spasms
* convulsions
* uncontrolled, jerky movements
* unconsciousness
* (short) absence
* repeating certain acts or movements as in a trance
Usually a seizure only lasts a few minutes. In case a (severe) seizure should last for more than five minutes, it is advisable to call a doctor.
After a severe seizure the victim is often very tired and sometimes even falls asleep. The victim may show a deep, gurgling breath.

How to act

In case of a severe seizure you make sure the victim cannot hurt themselves. If necessary protect the head, or put something soft underneath it.
Steer moving victims away from danger, such as traffic or water. Keep track of the time, if the seizure lasts too long, call a doctor or the
huisartsenpost.
Put an unconscious victim in the recovery position a monitor their breathing.
If necessary loosen tight clothing and give the victim some time to recover. Keep bystanders at a distance.

Brain injury

Brain injury often occurs after a significant blow to the head, i.e. as in an accident. A visible wound or damage to the skull
does not always mean there is also damage to the brain.

Symptoms of a brain injury

* dizzyness
* headache
* memory loss
* temporarily unresponsive, not reacting to stimuli
* deminished or absent sense of time
* confused
* nausea, vomiting

How to act

Call 1-1-2 when following symptoms occur:
* severe headache
* unconsciousness
* severe stuffyness
* if the injury is caused by a serious accident
In all other cases call the huisartsenpost.
Let the victim rest, cool potential bump or swelling on the head with coldpacks, ice of wet towels.

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