First Responder EMS Curriculum for Training Centers in Eurasia

Veins are the vessels that carry blood from the tissues of the body back to the heart.These vessels are less muscular than the arteries and under much less pressure. Venouspulsations, in general, are not palpated.Blood is the fluid of the circulatory system. As mentioned above, it carries oxygen andnutrients to the tissues and carbon dioxide and waste products away from the tissues.Highly oxygenated blood appears bright red. Blood with a low oxygen content appearsblue.b. PhysiologyWhen assessing a patient’s circulation, it is important to know the anatomy and functionof the circulatory system. Without the effective pumping of the heart and thedistribution of blood and its nutrients through the blood vessels to the rest of the body,the vital organs (such as the brain) are subject to injury and death. Recognizingcirculatory impairment is the first step. Understanding the techniques of restoringcirculation through CPR is the first step in becoming an effective First Responder.The heart is a four-chambered muscular pump that contracts to send blood to the rest ofthe body. The left ventricle is the largest portion of the muscle. When the left ventriclecontracts, it sends a wave of blood through the arteries. This wave of pressurized bloodproduces a palpable pulse when the artery passes near the skin surface and over bone.Medical personnel typically use four major arteries to evaluate the effectiveness ofcirculation: the carotid, femoral, radial, and brachial arteries. A strong, regular pulseindicates that the heart is effectively pumping blood throughout the body. A weak pulseindicates ineffective circulation. A patient with no palpable pulse is in cardiac arrest andrequires emergency intervention to restore circulation.Remember that organ damage begins quickly after the blood flow has stopped. In fact,brain damage begins 4 to 6 minutes after a patient suffers a cardiac arrest. Irreversiblebrain damage results in 8 to 10 minutes. Therefore, it is vital to begin CPR as soon asyou identify that a patient is in cardiac arrest. The heart may stop beating for severalreasons. Sudden death because of heart disease and respiratory arrest, especially inchildren, are common causes. Medical emergencies, such as stroke, epilepsy, diabetes,allergic reactions, electrical shock, and poisonings are also considerations. Drowning,suffocation, congenital abnormalities, trauma, and bleeding are also causes of cardiacarrest. Regardless of the reason, the First Responder will treat cardiac arrest using thetechniques of CPR.External chest compressions are used to circulate blood any time the heart is notbeating. External chest compressions are combined with artificial ventilation tooxygenate the blood. The combination of artificial ventilation and external chestcompressions is called cardiopulmonary resuscitation.. Remember that the FirstResponder is not required to identify the reason why a patient is in cardiac arrest. Theability to assess a patient’s airway, breathing, and circulation and perform effectiveCPR, however, makes the First Responder a vital first link in the chain of survival forthe patient.4. Cardiopulmonary ResuscitationCPR is a combination of artificial ventilation and external chest compressions to oxygenateand circulate blood when the patient is in cardiac arrest. By depressing the sternum toFirst Responder EMS Curriculum/AIHA, July 2002 105