First Responder EMS Curriculum for Training Centers in Eurasia

change the pressure in the chest, external chest compressions cause enough blood to flowto sustain life for a short time. CPR has limitations, but it is the best first response to apatient in cardiac arrest. Even the most effective chest compression may only produceapproximately 25% of the heart’s normal functional blood flow. However, it is essential tosustain life in this manner until more advanced cardiac care can be given. CPR is onlyeffective for a short time and must be started as soon as possible. The earlier you are ableto treat a person suffering from cardiac arrest, the likelier the survival. In many cases,patients may require defibrillation to survive. CPR increases the amount of time thatdefibrillation will be effective. Early CPR and defibrillation, if available, are the keys topatient survival from cardiac arrest.For a patient who has suffered a cardiac arrest, there exists a chain of survival within thecommunity. The links in this chain of survival include early access, early CPR, earlydefibrillation, and early advanced cardiac life support (ACLS). Early access includespublic awareness and education, rapid recognition of a cardiac emergency, and rapidnotification of the EMS system and more advanced emergency care providers. Early CPRcan only begin if First Responders, as well as the lay public including family andbystanders, are trained to perform CPR. Early defibrillation is now recognized as a vitallink in the chain of survival. First Responders can effectively learn the use of automatedexternal defibrillation and save lives in the community. It is the ultimate goal to sustain lifelong enough so that more advanced cardiac care can be given. Early ACLS is the final linkin the chain of survival. Through the use of more advanced airway management,defibrillation techniques, and cardiac stimulating and supporting medications, ACLSproviders in the field and in the hospital are better able to increase the likelihood ofsurvival. It is important to remember that all links in the chain of survival are vital. Anyweak links in the chain lower survival rates.a. Steps of One-Rescuer Adult CPRIf you are the first person to encounter a patient, be sure that the scene is safe and thatyou follow body substance isolation precautions while performing CPR. Remember, asa First Responder, you are the initial link in the chain of survival for the patient.Step 1: Determine unresponsiveness – As you approach a patient, gently shake thepatient and ask, “Are you OK?” If the patient does not respond, activate theEMS system and call for more advanced help. If there are two rescuers, oneperson should call for help while the other rescuer continues the assessment.If the patient is responsive, monitor the airway and conduct a history andphysical exam.Step 2:Step 3:Step 4:Activate EMSAirway – Position the patient on his/her back on a firm surface. Takeprecautions to stabilize the cervical spine if trauma is suspected. Open andmaintain the airway using the head –tilt-chin lift maneuver in non-traumapatients, or the jaw thrust without head tilt maneuver if trauma is suspected.Breathing – Look, listen, and feel. After opening the patient’s airway, lookto see if the chest is rising and falling, listen for breath sounds from thepatient’s mouth, and feel if any air is coming from the patient’s mouth.Assess breathing for 3 to 5 seconds.106 First Responder EMS Curriculum/AIHA, July 2002