Marine First Aid Level 4 (VTQ)
Course Content
- Course Introduction
- Human anatomy and physiology for immediate emergency care
- Safety and Calling for Help
- What3Words - location app
- Marine band radios
- Marine VHF Radios
- Common Coastal Water Dangers
- Common Fresh Water Marine Dangers
- Emergency Flares
- LED Flares
- The Coastguard
- The Air Ambulance
- Personal Location Beacons
- Accident Prevention
- Boat Safety
- Calling for help
- Water safety tubes
- Types of Blankets
- Emergency response for hybrid and electric boats
- First Aid and Safety Equipment\
- Initial Assessment and Care
- Basic airway management in emergency care
- CPR
- AED
- Administration of oxygen therapy
- Drowning
- Choking
- Shock
- Bleeding
- Catastrophic Injury
- Injuries
- Hypothermia
- Illness
- FIrst Responder - Management of injuries
- Prioritising first aid
- Pelvic Injuries
- Spinal Injuries
- Rapid Extrication
- SAM Pelvic Sling
- Box Splints
- Spinal Injury
- Stabilising the spine
- Spinal Recovery Position
- Introduction to Spinal Boards
- The spinal board
- Using the Spinal Board
- The Scoop Stretcher
- Using the scoop stretcher
- Cervical collars
- Vertical C-Spine Immobilisation
- Joint examination
- Adult fractures
- Types of fracture
- First Responder - Management of trauma
- Elevated Slings
- Lower limb immobilisation
- Elevation Techniques
- Helmet Removal
- Different Types of Helmets
- The Carry Chair
- Applying Plasters
- Strains and Sprains and the RICE procedure
- Eye Injuries
- Electrical Injuries
- Foreign objects in the eye, ears or nose
- Nose bleeds
- Bites and stings
- Chest Injuries
- Foxseal chest seals
- Abdominal Injuries
- Treating Snake Bites
- Types of head injury and consciousness
- Dislocated Shoulders and Joints
- Other Types of Injury
- Dental Injuries
- First Responder - Management of medical conditions
- Asthma
- Asthma Spacers
- When an Asthma inhaler is not available
- Accuhaler®
- Heart Attack
- Warning signs of cardiac arrest and heart attack
- Heart Attack Position
- Aspirin and the Aspod
- Stable angina
- Hypertension
- Pulse Oximetry
- Epilepsy
- Epilepsy treatment
- Meningitis
- Diabetes
- Blood Sugar Testing
- Poisons and Food Poisoning
- Shock
- Near and secondary drowning
- Cold water shock
- Allergic Reactions and Anaphylaxis
- Course Summary
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Now, we are going to look at adult CPR. So, remember CPR, cardiopulmonary resuscitation. So, it is a quite straightforward cycle we need to go through in order to help this person. Now, remember, this person is not breathing. So, they are unconscious and not breathing. And we need to get the CPR process started as quickly as possible. So, the way the cycle would work, first off, what we need to do is as we are approaching the person; stop, think and act, introduce yourself, just to say, "Hi, my name is Keith. I am a first aider. May I help you?" Give them a little tap on the collarbones just to see if you can get any response at all from them. Then we need to do the breathing check. So, in order to do the breathing check, take one hand on the forehead, the other one under the chin, tilt it right back. Because we need to open the airway. And pull the tongue away from the back of the throat. Once we do that, we need to put our ear down onto the mouth and nose here and we need to look down the body. Because we have been able to look and see. We will be able to feel and we will be able to hear whether they are breathing. Now, it is important we hear normal breathing. Someone in cardiac arrest would make what is called agonal breathing. These like gasping noises. They are fairly obviously not normal breathing. So, literally, put your head down, go down here, heads close on and then count to 10. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. At that point, you know they are not breathing, so if you are alone or there is no one else around here to make the call to Emergency Services, you must, must, go and do it. Because we must make sure the Emergency Services are on their way. So, if I was on my own here or no one immediately around who can grab my mobile phone and call, rather than stick my phone up here, what I can do is dial 999, put it onto speakerphone and then I can do chest compressions while talking to the Emergency Services. So, they actually can help me along with the process. So, we know they are not breathing. We know we need to do CPR. So, the next phase is the chest compressions. So, chest compressions, we are pushing down on the chest to force blood out of the heart. Then we release to allow blood to be sucked back in. So, it is really important that you push down enough to squeeze the heart and you fully release. We do not want to go down and there is just this sort of action. We want to have a nice good, depth and release. Now, we need to do 30 compressions. We are doing those at depth of about 5-6 centimeters and we are doing it at speed of about 100-120 per minute, which is roughly 2 per second. We need to push down on the centre of the chest. And to do that, we need to just interlock our fingers and we are ideally pushing down on this part of the hand. If you cannot do that and you have to put your hands this way, you can do that. But try and do that because it then concentrates the pressure down on the breastbone. So, we then pop your fingers up here and the hand down. We need to bring the body right over the patient, so we are pushing down. We want to lock our arms in to give as much pressure down as possible. And then we are going to do 30 compressions. 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 22, 23, 24, 25, 26, 27, 28, 29, 30. Once we have done those 30 compressions, we then need to move to the breaths. To do that, we need to open the airway, draw the head back so that the tongue comes away from the back of the throat, squeeze the nose and we blind the mouth. Now, depends on who the person is here, then you may well put a pocket mask on or a face shield or something like that for barriers. But we are just assuming in this case, we have not got anything like that available and we know the person, so we are quite happy to do mouth-to-mouth resuscitation. The reason we squeeze the nose is to stop it... The fact that you could blow in the mouth here and just come straight out the nose. So tilt the head back, far back as it will go. Hand here, head tilt, chin lift, squeeze the nose, seal your mouth around theirs and put two breaths in. Putting the breaths in, we really want to get them in quickly. So, breath, let out, breath, out. We want to try and get that done reasonably quickly. We do not want to take too much time because what we do not want to do is interrupt these compressions much at all. So, the time between the last compression and the first compression, ideally, should be less than 10 seconds. So, once we have done the two compressions redo over here and then start back on your hand your compressions again. So, we are literally just going through this cycle of 30 compressions, 2 breaths, 30 compressions, 2 breaths, and we keep going on that until the Emergency Services arrive or we can hand over to somebody else. Because doing this is tiring. It is hard work. So, you are looking at really maybe after two minutes, you will find that you are going to be too tired just to carry on. Now, you will be able to do it with adrenaline in your body, but if there is somebody else there to help you, that is a really good thing. So, having someone else there to hand over. If they are not trained, then you can just tell them what to do and they will be able to do it and help you out. If they do not want to do the breaths, then they can do just chest compressions. And then when you are recovered, after another couple of minutes, you get back onto it. So, you can try and keep this cycle going of continual chest compressions and breaths and try to get as much air and compression down the lungs to sustain life as long as possible before you can get relieved. Now, if you have got an automatic external defibrillator, then obviously you would put that on as quick as possible. If there is one locally or the Emergency Services would arrive, they will bring one. That is what is going to revive this person. What we are doing here is just maintaining life until the defibrillator does arrive. So, depending on where you are, what sort of boat it is, maybe you have one with you. But if not, then you are waiting for the Emergency Services or the Coast Guard to come and help you. If the patient does show signs of recovery, so maybe you have delivered a shock and then they are showing signs of recovery and they are breathing normally. So, again, head tilt, chin lift or they are physically showing signs, as in, they are waking up, then you can put them into the recovery position and maintain them going forward. If you did find yourself doing CPR and then the person showed signs of recovery and maybe it was that their heart had not stopped and you brought them round or maybe they are drowning and they have come round, then again, stop. So, if you were are at cycle number seven on the compressions, do not finish the 30. Just stop there. But just be cautious to make sure that they are definitely breathing and definitely okay and it is not just agonal breathing.
Adult CPR Procedure: Step-by-Step Guide
Introduction to CPR
CPR, or cardiopulmonary resuscitation, is essential for unconscious individuals not breathing.
Assessing the Situation
- Approach and Introduce Yourself: Stop, introduce yourself as a first aider, and check for responsiveness.
- Breathing Check: Tilt the head back, lift the chin, and check for normal breathing sounds or signs of agonal breathing (gasping).
Calling Emergency Services
If alone, call Emergency Services immediately (dial 999 in the UK) before starting CPR.
Performing Chest Compressions
- Positioning: Interlock fingers and place hands on the centre of the chest.
- Compression Technique: Push down 5-6 centimeters at a rate of 100-120 compressions per minute.
- Depth and Speed: Ensure full release between compressions to allow blood to flow back into the heart.
Administering Rescue Breaths
- Opening Airway: Tilt head back, lift chin, and pinch nose shut.
- Delivering Breaths: Provide two quick breaths, ensuring chest rises.
Continuing CPR Cycle
- After breaths, resume compressions immediately with minimal interruption (less than 10 seconds).
- Continue cycles of 30 compressions and 2 breaths until help arrives or the patient shows signs of recovery.
Using an AED (Automatic External Defibrillator)
If available, use an AED as soon as possible. Follow its prompts and continue CPR until advised otherwise.
Assessing Signs of Recovery
If the patient shows signs of recovery (normal breathing or waking up), place them in the recovery position and monitor.
Stopping CPR
If signs of recovery occur during CPR, assess the situation carefully before stopping compressions to ensure sustained improvement.