How to perform first aid Gloster, Annabella Satu; Johnson, Phillip John
Nursing standard,
2016-Jan-13, 2016-01-13, 20160113, Letnik:
30, Številka:
20
Journal Article
Recenzirano
RATIONALE AND KEY POINTS: This article aims to help nurses to perform first aid in a safe, effective and patient-centred manner. First aid comprises a series of simple, potentially life-saving steps ...that an individual can perform with minimal equipment. Although it is not a legal requirement to respond to an emergency situation outside of work, nurses have a professional duty to respond and provide care within the limits of their competency. First aid is the provision of immediate medical assistance to an ill or injured person until definitive medical treatment can be accessed. First aid can save lives and it is essential that nurses understand the basic principles. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. Your skill in performing first aid and any areas where you may need to extend your knowledge. 2. How reading this article will change your practice. Subscribers can upload their reflective accounts at: rcni.com/portfolio .
Aim
To investigate if recovery position and verbal interaction with the patient post sedation influences the recovery time for patients receiving intravenous conscious sedation following oral ...surgical procedures.
Material and methods
A randomised, prospective, single‐centre clinical trial was carried out in Dublin Dental University Hospital in the sedation day unit during the time period of March 2005–February 2006. Seventy‐three patients meeting the following criteria were recruited: requiring an oral surgery procedure under intravenous sedation, American Society of Anaesthetists classification I or II, no history of kidney/liver disease, 18–65 years of age, and neither pregnant nor breastfeeding. Patients were randomly assigned a position of recovery, which was either sitting, semi‐prone or lying with or without gentle verbal interaction, and recovery time to discharge from professional care was recorded. Two recovery times were recorded as the times to discharge from professional care. One from the last increment of drug (midazolam) given, known as ‘post‐midazolam recovery time’, and the second time from the end of the operative procedure, known as ‘post‐operative recovery time’.
Results
Position was significantly associated with outcome for both post‐midazolam recovery time (P = 0.046) and post‐operative recovery time (P = 0.010), with patients in the sitting position recovering more quickly than those in the supine position.
Conclusion
Variability in recovery times is significantly related to recovery position. Patients if haemodynamically stable should be recovered in a sitting position.
To identify what 10-11-year-old children do and do not learn during a 10 min session teaching the recovery position, with a view to suggesting possible improvements in training.
Participants were 148 ...boys and 144 girls. Before intervention, safety knowledge was assessed in a pencil and paper test. 198 children were taught the recovery position at a safety education centre. Three months later, their attempts to leave a casualty in a safe position were observed, and compared with the attempts of 94 children who had not received training.
19% of the control group and 31% of trained children successfully placed a casualty in the recovery position. Only two of the seven standard routine moves were used by more than 50% of trained children, namely raise the casualty's leg to a flexed position, roll the casualty on to his/her side. Even when performed, these and other individual moves were often not integrated into an effective routine.
The implication is that in a short session it is over-ambitious to attempt to teach a complex routine. It is more realistic to focus on a few moves which are easily learnt. The present results suggest that these should be flexing the leg and rolling the casualty on to his/her side. In this study, simply improving the participants' performance of these two moves could increase the number of learners who are successful from less than a third to nearly 50%.
Seizures are sudden electrical disturbances induced in the brain which cause behavioral changes, changes in the level of consciousness, and body movements. Generalized Tonic-Clonic Seizures (GTCS) ...are the most common type of seizure among people where the person loses consciousness and experiences convulsions. This paper seeks to empower and enhance the independence of those with GTCS, especially those experiencing a higher frequency of seizures. Seizure detection is achieved using multi-modal sensor fusion and machine learning methods. A fall protection system using airbags and a mechanism to shift an unconscious person to a recovery position using recovery airbags during sessions of seizure and informing caretakers during emergencies are also discussed in detail in further sections of this paper.
Awareness of the risk of spinal-cord damage in moving an unconscious person with a suspected neck injury into the "lateral recovery position," coupled with the even greater risk of inadequate airway ...management if the person is not moved, has resulted in a suggested modification to the lateral recovery position for use in this circumstance.
It is proposed that the modification to the lateral recovery position reduces movement of the neck. In this modification, one of the patient's arms is raised above the head (in full abduction) to support the head and neck. The position is called the "HAINES modified recovery position." HAINES is an acronym for High Arm IN Endangered Spine.
Neck movements in two healthy volunteers were measured by the use of video-image analysis and radiographic studies when the volunteers were rolled from the supine position to both the lateral recovery position and the HAINES modified recovery position.
For both subjects, the total degree of lateral flexion of the cervical spine in the HAINES modified recovery position was less than half of that measured during use of the lateral recovery position (while an open airway was maintained in each).
An unconscious person with a suspected neck injury should be positioned in the HAINES modified recovery position. There is less neck movement (and less degree of lateral angulation) than when the lateral recovery position is used, and, therefore, HAINES use carries less risk of spinal-cord damage.
Adult basic life support Sarin, H.; Kapoor, D.
Indian journal of critical care medicine,
04/2006, Letnik:
10, Številka:
2
Journal Article
Odprti dostop
Prompt and skilful resuscitation during cardiac arrest can make a significant difference between life and death. There have been important advances in the science of resuscitation and various ...international resuscitation committees have formulated evidence-based recommendations for the performance of basic life support. The revised guidelines published in the year 2005 have been designed to simplify cardiopulmonary resuscitation. In this article, we have summarized basic life support guidelines for adult victims.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
In April 1997 the ILCOR Basic Life Support advisory statements were announced in conjunction with changes to the recovery position for use in the UK. This study compared the new and old positions by ...using a questionnaire to assess how well each position satisfied the ILCOR statements. The study was carried out over six different hospital trusts by eight resuscitation training officers. Each tutor alternately taught the 1992 or 1997 recommended positions. After the practical session each student completed a questionnaire on ease of learning and use of the position, as well as other factors such as spinal stability. They were also asked to score the position when they were placed in recovery by other students. Their competency was assessed using the ALS criteria. Over the duration of the study 687 forms were suitable for analysis. For every question there was a significant trend in favour of the 92 position, with students finding the technique easier to learn and use, simpler for positioning for CPR and with less spinal movement during rolling. Possible sources of bias such as previous training, tutor or staff grade made no statistical difference to the results. When performed competently the 1997 position appears to cause less brachial compression, but other problems with learning or use of the 97 position outweigh this advantage. The 1992 position currently provides the best compromise between ease of use, spinal stability and other factors, and better satisfies the ILCOR advisory statements.
Background: Basic life support guidelines of the European Resuscitation Council (ERC) suggest a modified type of recovery position compared to that recommended by the American Heart Association ...(AHA). However, anecdotal reports and the results of a small study by Fulstow and Smith (Resuscitation 1993; 26: 89–91) gave evidence that the new ERC position may cause an impairment of perfusion of the lower forearm. The aim of our study was to evaluate the effects of different recovery positions on arterial perfusion and venous drainage of the forearm. Methods: We placed 20 young healthy volunteers randomly in either ERC or AHA position for 15 min first, and in the other position thereafter. Before and between volunteers were positioned supine. In a second series 10 volunteers were positioned according to the same protocol in semiprone positions as described by Morrison, Mirakhur and Craig (MMC), and Rautek's position, respectively. Forearm perfusion indices of the dependent arm were continuously assessed by photoplethysmographic pulsatility change, photoplethysmographic volume change, invasive peripheral venous pressure and non-invasive blood pressure amplitude. Subjective discomfort was assessed non-qualitatively. Results: All indices of arterial perfusion demonstrated an impairment of arterial inflow in ERC, MMC and Rautek's position as well as venous congestion in these three positions. On the contrary, AHA position was associated with no significant changes of arterial flow and only moderate, insignificant signs of venous congestion. Conclusion: The results of this study suggest that AHA position causes less circulatory disturbances than the ERC, MMC and Rautek's positions.
Both the 1992 and the 1997 recovery positions were demonstrated to 100 employees attending for Basic Life Support resuscitation training at a district general hospital (Chesterfield and North ...Derbyshire Royal Hospital NHS Trust). They used both positions, experiencing being the first-aider and the casualty and then completed a closed questionnaire. The results were evaluated from this 100% response. In every aspect the 1992 or ‘How’ position was preferred both in terms of ease of use and comfort during the procedure by the majority of each sample group. In every comparison the 1992 position was preferred highly significantly, (
P<0.001) using chi-square statistical analysis.
In November 1992 the European Resuscitation Council issued new guidelines which included the description of a modified recovery position. Anecdotal reports have suggested that this 'new' position may ...result in obstructed venous return in the dependent arm. The findings of a small study to evaluate the 'new' recovery position are reported here. In a group of six healthy adult volunteers measurements of digital temperature, plethysmographic wave form and transcutaneous oxygen saturation were made in the previously favoured semi-prone recovery and repeated in the 'new' position. In the 'new' position 67% of the study group developed signs of venous or venous and arterial obstruction; no such complication was encountered when the same individuals were placed in the semi-prone recovery position. The need to position unconscious persons in some form of recovery position is emphasised, however, the suggestion that the semi-prone position be re-adopted is offered for discussion. Alternatively, adequate monitoring of perfusion and venous drainage in the dependent limb must be undertaken if the 'new' recovery position is chosen.
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