CPR Booklet.

Anatomy 2
Introduction 4
BASIC LIFE SUPPORT
Infection Control 5
Emergency response 5
Primary Survey 6
Contacting the Emergency
Services 6
DRSABC 7
Secondary Survey 8
Casualty Communication 9
Unconscious Casualty 10
SCA 11
Chain of Survival 11
CPR 13
Asfandeyar Niazi
Choking 16
Recovery Position 20

Copyright © 2013 by Asfandeyar Niazi
Cover by Asfandeyar Niazi
Written by Asfandeyar Niazi
ALL RIGHTS RESERVED
No part of this book may be reprinted or reproduced, or utilized in any form or by any
electronic, mechanical or other means, now known or here after invented, including
photocopying, or in any information storage and retrieval system, without permission
in writing from the copyright owner.
WAIVER OF LIABILITY
This manual is intended as a training aid and reference text, it is not intended to
substitute formal classroom based training. Because we have no control over the
level of training you will receive or the amount of experience and knowledge you may
gain, the author and organization are not responsible for the reader’s use of this
manual and the information contained herein.
First printing: September, 2013.
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This will appear
throughout this book
to assist you in being a
competent first-aider.
1

Anatomy 101
To be able to give first aid described in this book, it is not necessary to know how the body
works, but if you read the information, you will understand the reasons for the first aid
which should be given.
The basic functions of the human body can be simply described. It processes food, water
and oxygen to produce the energy necessary for living and disposes of the waste that arises.
We should think of the body as a series of separate systems for doing these things.
Exampled of these systems are the digestive system, the breathing system, the circulatory
system and the nervous system. If any of these are badly damaged, it will affect the others.
The principal parts of these systems are the lungs, the heart and the brain. These organs are
supported and protected by the skeleton. The body also has an envelope of kin to act as a
barrier against infection.
If the skeleton is damaged, as it is when a bone is broken, then the part of the body that is
being protected and supported may also become damaged by the broken ends of the bone.
If the skin is pierced, or cut infection may be admitted and this can be more dangerous than
the actual injury.
In this brief explanation we will consider only three of the body systems – Breathing,
Circulation and the Nervous system. In emergency aid you are mainly concerned with these
when a life is in Danger.
BREATING SYSTEM (Respiratory System)
Its purpose is to extract oxygen from the air, the oxygen is then absorbed by the blood. The
lungs act as bellows, drawing air in, extracting some of the oxygen and then pushing out air
which contains the waste product – a gas called carbon dioxide.
CIRCULATORY SYSTEM
Comprises of the heart, blood and blood vessels. It works with the breathing system to
provide oxygen to those parts of the body which needs it. The blood absorbs oxygen from
the lungs and circulates it around the body.
The heart expands and receives blood, then contracts and forces it out. In fact, one side of
the heart circulates blood through the lungs, where it absorbs oxygen, and the other side
supplies the oxygenated blood to the rest of the body.
The average body contains about 10 pints of blood. (1 litre of blood per 13kg of body
weight). The heart pumps out the oxygenated blood though the arteries and the used blood
is returned to the heart through the veins. If too much of these 10 pints is lost, or if the
2

lungs are not providing enough oxygen, or if the heart is not pumping properly, the blood
cannot do its work efficiently and the body may eventually cease to function.
If the skin is broken, blood will escape, and infection may enter the body. However as soon
as a blood vessel is cut, the blood coming from the cut will start to clot. This is the body’s
mechanism for sealing off a wound and preventing further blood loss.
NERVOUS SYSTEM
Part of which controls functions such as the heartbeat. Another, very important part of the
nervous system affects body movements and sensations under control of the brain. Nerves
run down the spinal column in the spinal cord, rather like wires in an insulated sheath. If the
spinal cord is damaged the nerves may also be damaged and paralysis may result.
A person becomes “unconscious” as a result of the brain not working properly. In accident
cases this is usually due to damage to the brain or excessive bleeding.
As the various parts of the body work, they make unwanted chemicals which must be
carried away in the blood. One example of this is urea, a substance like ammonia, which is
extracted from the blood by the kidneys and is eventually passed out of the body as urine.
3

DEFINITION
Basic Life Support (CPR Module)
The immediate assistance given in the case of injury
or sudden illness.
AIMS
To Act quickly, calmly and correctly to:
• Preserve life
• Prevent the condition from worsening
• Promote recovery
FIRST AID PRIORITIES
• Assess a situation quickly and calmly
• Protect yourself and any casualties from danger. – Never put yourself at risk.
• Prevent cross infection between yourself and the casualty as far as possible. (Wear
gloves and use resuscitation aids).
• Comfort and reassure casualties at all times
• Assess the casualty; identify, as far as you can, the injury or nature of illness affecting
the casualty
• Give early treatment, and treat the casualties with the most serious (life threatening)
conditions first
• Arrange for appropriate help; call 1122/15 for emergency help if you suspect serious
injury or illness; ask for AED if heart problem; take or send the casualty to hospital;
transfer him into the care of a healthcare professional or to his home. Stay with a
casualty until care is available.
KEY STEPS
• Be calm in your approach
• Be aware of risks (to yourself and others) Remove the danger from the casualty (only
if in further danger)
• Build and maintain trust (from the casualty and bystanders)
• Give early treatment, treating the most serious (life threatening) conditions first
• Call appropriate help
• Remember your own needs
4

Infection prevention and hygiene
It is important that as a first aider you do not transmit infections to your casualty or indeed
contract infections from your casualty. To assist in minimising the risk of infection and crosscontamination
there are various precautions that can be taken such as:
Having good personal hygiene
Ensuring that barrier devices are used
Covering any open cuts or sores
Minimising contact with blood or bodily fluids
Changing gloves between casualties
Washing hands thoroughly after removing gloves
Resuscitation barrier devices
Resuscitation barrier devices are essential equipment and help to eradicate the spreading of
infection and cross-contamination. Barrier devices as their name suggests, place a barrier
between the first aider and the casualty. Battier devices include:
Nitrile power-powder free gloves
Face shields
Pocket masks
Emergency Response
At any incident involving casualties, it is essential you appear and remain calm and let your
common sense, allied with your training and skills take over.
Upon arrival at an incident a scene survey must be conducted to ensure
the safety of the casualty, any bystanders and the first aider. The scene
survey should be conducted by remembering the acronym CLAP.
C
L
A
P
Control the situation: Stop, take a deep breath and take charge of people and vehicular
traffic.
Look for potential hazards: Look for anything that could cause further harm to the casualty,
bystanders or more importantly yourself within the immediate area.
Assess the situation: Gather as much information about what has occurred from the
casualty and from bystanders, and try to make a diagnosis (history, signs and symptoms).
Protect and Priorities: Ensure protection is worn (gloves), and that casualties are prioritised
(breathing, bleeding, bones/burns and other conditions). Try to gain assistance from a
bystander and contact the emergency services.
5

Primary survey
Having conducted a scene survey and established that the immediate area is safe from any
dangers, you can now approach the casualty. When the approaching the casualty an initial
casualty assessment should be conducted – this initial assessment is called a primary survey.
The Primary survey is a systematic process of approaching, identifying and delaying with
immediate and or life-threatening conditions.
The primary survey can be remembered by the
acronym DRSABCD (or the easy way to
remember, Doctors ABCD).
Contacting the emergency services
First aiders will either contact the emergency
services themselves or instruct a bystander to
do so. Contacting the emergency services at
the earliest opportunity is paramount. When
contacting the emergency services on either
1122 or 15, it is important that the information
given is clear, concise and sufficient. This can
be achieved by remembering the acronym
LINE.
L
I
N
E
Location
Incident
Number of casualties
Extent of their injuries
Remember: If you have not contacted the emergency services
then they will not arrive!
6

Doctors ABCD
D R S A B C D
DANGER
R
DANGER:
Prior to
approaching
the casualty,
ensure the
scene is safe to
do so.
RESPONSE SHOUT AIRWAYS BREATHING CPR/
RESPONSE:
If possible,
approach the
casualty from
the feet as this
prevents
hyperextensio
n of the neck
from a
responsive
casualty.
When checking
for a response,
use the AVPU
scale.
SHOUT FOR
HELP:
If you are on
your own do
not leave the
casualty at this
stage.
AIRWAYS:
With an
unresponsive
casualty open
the airways
using the
head-tilt-chinlift
method.
BREATHING:
After opening
the airway
look, listen and
feel for normal
breathing no
more than 10
seconds.
If the casualty
is not
breathing dial
1122/15
Agonal Gasps
CIRCULATION
CPR/
CIRCULATION
Casualty not
breathing
commence
CPR (30
compressions
2 breaths).
Casualty
breathingcarry
out
secondary
survey
DEFIBRILLATION
DEFIBRILLATION
If available an
AED (Automated
External
Defibrillator)
should be used
alongside CPR.
A
V
P
U
ALERT: Is the casualty moving? NO. Proceed to V
VOICE: Does the casualty respond to speech? NO.
Proceed to P.
PLACE: Place your hand on the casualty’s shoulders
and gently shake them. Ask loudly, ‘Are you all right?’,
If NO response then proceed to U.
UNRESPONSIVE: Assume the casualty is unresponsive.
Present in 40%
of cardiac
arrest victims.
After a cardiac
arrest a
casualty may
be barely
breathing or
taking NOISY
infrequent
gasping
breaths. This is
not to be
confused with
normal
breathing.
Compression
-only CPR
If you are
unable, not
trained, or are
unwilling to
give rescue
breaths, give
chest
compressions
only. These
should be
continuous at
a rate of 100-
120 per
minute to a
depth of 5-
6cm.
The ‘P’ in the acronym AVPU is sometimes also referred to
as ‘Pain’ depending on the scale used. Examples of this
would include pinching ear lobes or fingertips.
7

Secondary survey
Head –to-toe survey
If the casualty is breathing a secondary survey should be carried out. Inform the casualty
what you are doing at all stages. If the casualty is responsive ask them to tell you if they feel
any pain during the head-to-toe survey.
Head and Face
Look at the casualty’s head and face for any obvious signs of injury or trauma. Remove
spectacles if the casualty is wearing them. Gently feel around the head, face and scalp for
any bleeding, swelling depressions. Look at the casualty’s ears for signs of bleeding or the
presence of cerebrospinal fluid (CSF)
Neck
Loosen any restrictive clothing such as ties or collars. Gently feel around the
cervical spine area and back of the neck to check for any bleeding, swellings or
deformity. Also check for medical necklaces.
Chest and Shoulders
Gently feel around the shoulders to check for signs of deformity and
bleeding. Check the chest for normal breathing movement (rise and fall) and
check for any bleeding.
Arms and Hands
Check along the arms, feel for signs of deformity, swelling and bleeding.
Check the wrists for medical bracelets.
Spine
Try to check as much of the spine as possible without moving the casualty; feel for
tenderness and deformity as well as signs of bleeding.
Pelvis
Check the hips for deformity, unnatural positioning or bleeding.
Abdomen
Gently check the abdomen for signs of bleeding, swelling or unnatural softness.
Legs and Feet
Check the legs and feet for bleeding, unnatural positioning, swelling and deformity.
Check the pockets of skirts or trousers for objects that may cause discomfort or
pain should the casualty be moved.
8

Casualty communication
It is vital that clear and effective communication is used at all times when dealing with a
casualty or casualties. A casualty may be in a distressed and confused state; the first aider
should remain calm and authoritative. Talk to the casualty constantly and explain what you
are going to do prior to doing it, irrespective of whether the casualty is responsive or not.
Other considerations with regards to the casualty communication.
Try to use the
casualty’s
preferred name:
“Are you alright
Faisal?”
Gather as much
information as possible
about what has
occurred “Did anyone
see what happened?”
Let the casualty, if
possible explain where
the injury is. “Can you
tell me where it hurts
Faisal?”
Only speak about
the facts, not what
your opinion is “OK,
Faisal, I’m going to
call for help.”
Narrate exactly what
is happening before it
happens. “I’m
sticking the pads
onto your chest.”
Directly face the casualty
and speak clearly and
slowly without shouting.
“Can you hear me Faisal?”
Allow the casualty
time to think and
respond. “Can you
tell me your name?”
Ask the casualty to assist
wherever possible (a
distraction) “What were
you doing before you
fell?”
9

Unconscious Casualty
Severe bleeding, shock, broken bones and other injuries.
Reassure the casualty at all times.
Monitor casualty (Record if possible)
Keep reassessing the situation – (Safety, weather, crowds, traffic, hazards)
When help arrives (information and evacuation)
Try not to leave the casualty (Depends on circumstances)
Reassure everyone
Possible causes of unconsciousness
F. Fainting
I. Infection
S. Shock
H. Heart Attack
S. Stroke
H. Head injuries
A. Airway Hypoxia
P. Poisoning
E. Epilepsy emergencies
D. Diabetes emergencies
Learn the aid memoir FISHSHAPED to ensure
in an unconscious casualty situation that you
may be able to diagnose the underlying
condition by assessing the possible options.
10

Sudden Cardiac Arrest
Sudden cardiac arrest (SCA) is one of the leading causes of premature death. Sudden
cardiac arrest occurs when the electrical rhythm that controls the heart becomes a chaotic
and disorganized electrical rhythm called ventricular fibrillation (VF). For a casualty to have
any chance of survival, immediate cardiopulmonary resuscitation (CPR) combined with
automated external defibrillation must be administered as soon as physically possible.
What is an AED?
An automated external defibrillator (AED) is a compact portable electronic
device that when attached to a casualty automatically diagnoses the life
threatening abnormal heart rhythm (cardiac arrhythmia) of ventricular
fibrillation (VF).
An abnormal heart rhythm (cardiac arrhythmia) is a
condition treated through a controlled electrical
shock (defibrillation), which allows the heart to reestablish
an effective rhythm. Due to its simplistic
nature and design, an AED can be used safely and
effectively by anyone, even if they have had no
previous training, although formal training is highly
recommended to provide greater knowledge and
skills.
The chain of survival
The chain of survival is a series of actions, or links, that when put quickly in motion increase the odds
of survival. If the chain is broken, or has a link missing, then the odds of survival will be greatly
reduced.
CPR AED
Early access to care
Early CPR
Early defibrillation
Early advanced care
Dial 1122
immediately!
Provide CPR to help
maintain blood flow
to the brain until
the next step
Defibrillation is the
only way to restart
a heart in cardiac
arrest
After defibrillation an
emergency team
provides advanced
cardiac care on scene
such as intravenous
medications.
11

Chest compressions
Chest compressions should be administered to a casualty who is not breathing normally. The depth
of the chest compression is 5-6 centimetres (the height of a credit card) and the rate of compression
should be 100-120 compressions per minute. 30 chest compressions should be administered prior to
moving on to rescue breaths (expired air ventilation).
Airway maintenance
It is important that the casualty’s airway is opened and
remains open (maintained).
Rescue breathing (expired air ventilation)
After completing 30 chest compressions the emergency
first aider should administer 2 effective rescue breaths.
12

Each breath should take one second to complete and the
casualty’s chest should rise as in normal breathing; this is
known as an effective rescue breath. Administering the 2
breaths should not take more than 5 seconds to complete in
total.
Once the first breath is administered remove your mouth from
the casualty’s mouth, turn your head and watch the chest rise
and fall, then administer the second breath.
Cardiopulmonary resuscitation (CPR)
CPR is a method of combining chest compressions with effective rescue
breaths in order to artificially circulate blood and to put air into the lungs.
CARDIO = ‘heart’
PULMONARY = ‘lungs’ RESUSCITATION = ‘revive’
To administer CPR
Kneel by the side of the casualty. Place the heel of one hand in the
centre of the casualty’s chest.
Place the hell of your other hand on top of the first hand. Interlock
the fingers of your hands.
Position yourself vertically above the casualty’s chest and with your
arms straight, press down on the sternum 5-6 cm.
After each compression, release all of the pressure on the chest
without losing contact between your hands and the sternum.
Repeat at a rate of 100-120 compressions per minutes 30 times.
Administer to effective rescue breaths.
Agonal gasps are present in up to 50% of cardiac arrest victims. This is not
normal breathing and sounds like a strained gasp, if agonal breathing is
present you should start CPR immediately!
13

Complete 30 compressions and 2 rescue breaths until:
1. Qualified medical assistance takes over
2. The casualty shows signs of regaining consciousness such as coughing, opening their
eyes, speaking or moving and starts to breathe normally.
3. You become physically exhausted and cannot continue.
4. If there is assistance available when administering CPR you should change over ever
1-2 minutes.
Adult basic life support
Check for DANGER
Check for RESPONSE AVPU
If responsive, treat injuries. Call the
emergency services if needed.
Shout for HELP
Open AIRWAY
Head tilt and chin lift
Check for normal breathing for no
more than 10 seconds.
NO
YES
If breathing normally, check for
injuries. Place in the recovery
position. Call the emergency services
and monitor ABC
If help is available send aid to call the
emergency services and to see if an
AED is available.
If no help is available then you must
call the emergency services yourself
and see if an AED is available.
Start with 30 chest compressions
Give 2 effective rescue breaths
Continue with CPR 30:2 until the
Compression-only emergency services CPR take over, you
become exhausted or your casualty
recovers.
FOR DROWNING CASUALTIES
Give 5 initial breaths and
resuscitate for 1 minute before
calling 1122/15. Upon your return
continue with CPR, i.e 30:2
14

If you are not trained, the casualty has extensive facial injuries or you are unwilling to give
rescue breaths then chest compressions only may be administered. If chest compressions
only are given, these should be continuous at a rate of 100-120 compressions per minute.
Infant and child CPR
The age definition of an infant can best be defined as from birth to 1 year old. The age of a
child can best be defined as from 1 year old to the onset of puberty.
Ad
Check for DANGERS
Check for RESPONSE AVPU
If responsive, treat injuries. Call the
emergency services if needed.
Shout for HELP
Open AIRWAY
Minimum head tilt and lift the chin carefully
Check for normal breathing for no
more than 10 seconds.
NO
YES
If breathing normally, check for
injuries. Place in the recovery
position. Call the emergency services
and monitor breathing.
If help is available send aid to call the
emergency services and to see if an
AED is available.
Remove any visible obstruction and
give 5 initial rescue breaths.
If no help is available then
you must remove any visible airway
obstructions and give 5 initial
breaths followed by 1 minute of
CPR before you call them yourself
and attempt to locate an AED*
Give 30 chest compressions followed
by 2 breaths.
Continue with CPR (30:2) until your
casualty recovers, the emergency
services take over or you become
exhausted.
*The use of an AED is not recommended for infants aged less than 1 year.
15

Obstructed airway
An obstructed airway is the partial or complete blockage of the upper
airway (larynx and trachea) which leads to the lungs. The obstruction of the
airway can be due to different causes including foreign bodies (foods),
allergic, reactions, asthma, blood, vomit and infections. An obstruction can
cause minor or major breathing difficulties and in severe circumstances
may cause the casualty to become unconscious and unresponsive.
A choking adult or child (airway obstruction)
Someone who is choking will have either a partial or complete obstruction
of the airway. The severity of the blockage will determine the difficulty in breathing.
Recognising a choking casualty
Grasping at the throat area
Difficulty in breathing and speaking
Redness of the face
Eyes enlarged and watering
Displaying distress
With a complete obstruction the casualty may show the above signs but also the skin colour
may develop a blue/grey tinge; the casualty will get progressively weaker and eventually will
become unconscious.
Treating a choking adult or child
Encourage the casualty to cough. If the coughing clears the obstruction,
monitor the casualty. If after coughing the obstruction still remains and
the casualty is still choking, then administer up to a maximum of 5 back
blows.
X5
16

BACK BLOWS
Lean the casualty forward (supporting the upper chest
with one hand).
Administer a maximum of 5 sharp back blows with the
other hand.
If, after 5 sharp back blows the obstruction still
remains, then administer abdominal thrusts.
X5
ABDOMINAL THRUSTS
Stand behind the casualty, lean them forward and
place your hands around their stomach.
Make a clenched fist with one hand and place the
thumb of the clenched fist above the navel.
Cup the clenched fist with the other hand and pull
inwards and upwards in one motion.
Repeat this procedure up to a maximum of 5 times.
If the obstruction still remains, complete the process of
5 back blows and 5 abdominal thrusts up to a
maximum of a further two cycles.
If, after this process, the casualty is still choking, then
contact the emergency services (1122, 15).
Continue the process.
If the obstruction clears at any point, monitor and
advise the casualty to seek qualified medical
assistance.
If the casualty becomes unresponsive commence CPR.
Casualties should seek medical assistance if they:
Have received abdominal thrusts
Have difficulty swallowing or still feel as though they have an object stuck in their throat
17

Action for a choking child
START
Encourage the child to cough
If there is no improvement after 3 cycles
of back blows and abdominal thrusts you
must summon an ambulance.
Give up to 5 back blows
Is this successful?
YES
NO
Reassure and seek
medical help
Give up to 5 abdominal thrusts
Is this successful?
YES
NO
If at any time the child becomes
unresponsive you should start CPR but
check in the mouth before each rescue
breath.
18

Action for a choking infant
START
Look in the mouth and remove any
visible, easily removed object
Give up to 5 back blows.
Is this successful?
YES
NO
Reassure and seek medical help
NO
Give up to 5 chest thrusts
(using 2 fingers)
Is this successful?
YES
If there is no improvement
after 3 cycles of back blows
and chest thrusts you must
summon an ambulance
If at any time the infant
becomes unresponsive you
must start CPR but check in
the mouth before each rescue
breath.
For an infant, abdominal thrusts are not
recommended and should be replaced
with chest thrusts instead.
19

Recovery Position
Four simple steps:
More casualty lives are saved by opening the airway and this
basic simple action than any other First Aid task or treatment.
You normally always place an unconscious casualty into the
recovery position to ensure the airway is kept open and clear. The
casualty’s tongue, if body and head are correctly positioned,
will fall forward.
There is a high chance of
a casualty vomiting
(regurgitation) on
recovery and whilst
unconscious.
instead.
Casualty position is now also stable, and blood, secretions and
vomit will drain. Due to some “medical” conditions preventing
movement such as in fractures, it may not be in the casualty’s
interest to move them. Monitor the airway in these cases at
all times.
Remove glasses and turn any sharp pointed rings on their
hands. Empty pockets of keys and bulky items. Remove tools
When placing a pregnant woman into
the recovery position she should be
placed on her left-hand side, as this
prevents compression of the inferior
vena cava (the large vein which carries
deoxygenated blood from the lower
half of the body into the right atrium
(chamber) of the heart).
if applicable. Monitor the airway whilst placing in the recovery position, ensuring you check
the airway is open and clear. Pillows etc., may be used for extra support. Do not necessarily
turn the casualty over if the casualty is laying face down, but modify, the position to ensure
that the airway is kept open and clear.
20

NOTES:
21