S
T.O.T.A.P.S adalah satu kaedah membuat penilaian terhadap kecederaan mangsa
T = Talk (Bercakap)
Bercakap dengan mangsa yang mengalami kecederaan.Bolehkah mangsa itu
bercakap? Tanya mangsa ; Tujuannya mengetahui serba sedikit latar belakang
kemalangan dan keadaan mangsa seperti : Di mana bahagian yg sakit / tempat
tercedera? ..... peringkat kesakitan ! Bagaimana dengan penglihatan (kabur atau
Jelas)? ..... boleh dengar atau tidak !
O = Observe (Melihat Keadaan)
Lihat, perhatikan dan periksa tempat kecederaan dan keadaan mangsa seperti di
bahagian kepala dan kulit (lebam, bengkak atau pendarahan) , perubahan suhu badan
serta pernafasan dan denyutan nadi (nomal atau tidak). Perhatikan dan pastikankan
darjah kecederaan mangsa
T = Touch (Sentuh)
Sentuh bahagian yang cedera dengan perlahan dan berhati-hati. Periksa sebarang
bengkak atau defomiti yang dialami anggota badan yang terlibat . Beritahu dulu
mangsa sebelum memeriksa dan menyentuh bahagian tercedera, ini mengelakkan
mangsa terkejut dengan sentuhan tersebut.
A = Active Movement (Pergerakan Aktif)
Arahkan dan minta mangsa supaya menggerakkan anggota badan yg cedera seperti
tangan, kaki dan kepala; tujuannya mengesan tahap kecederaan. Mangsa akan
melakukan pergerakan sendiri secara aktif tanpa bantuan individu lain. Sekiranya
mangsa rasa sakit, rujuk kepada pakar perubatan dgn segera
P = Passive Movement (Pergerakan Pasif)
Bantu seandainya mangsa tersebut tidak dapat menggerakkan bahagian anggotanya
sendiri. Beritahu mangsa tersebut bahawa kita hendak membantunya untuk
menggerakkan anggotanya. Bantu mengerakkan bahagian yang cedera secara
perlahan-lahan ; tujuan untuk memeriksa/menentukan tahap kecederaan/kesakitan yg
diialami. Regangkan otot dan benarkan bermain semula jika pasti kecederaan tidak
serius
S = Skill (Kemahiran)
Arahkan mangsa melakukan pergerakan asas seperti berdiri, berjalan, berlari dan
melompat sambil melakukan kemahiran permainan yg mudah untuk memastikan tahap
kecederaan yg dialami. Jika berasa sakit, bawa mangsa ke hospital atau klinik untuk
mendapatkan rawatan doktor atau paramedik. Jika tiada tanda berlakunya kecederaan
yg khusus, benarkan mangsa meneruskan aktiviti.
RICE (medicine)
From Wikipedia, the free encyclopedia
1.1 Rest
1.2 Ice
1.3 Compression
1.4 Elevation
2 Variations
3 Alternatives
4 See also
5 References
6 External links
Rest is a key component of repairing the body. Without rest, continual strain is placed on the affected area,
leading to increased inflammation, pain, and possible further injury. Additionally, some soft tissue injuries will
take longer to heal without rest. There is also a risk of abnormal repair or chronic inflammation resulting from a
failure to rest. In general, the period of rest should be long enough that the patient is able to use the affected
limb with the majority of function restored and pain essentially gone.
Ice[edit]
Ice is excellent at reducing the inflammatory response and the pain from heat generated. [5] Proper usage of ice
can reduce the destruction over-response which can result from inflammation. [5] A good method is ice 20
minutes of each hour. Other recommendations are an alternation of ice and no-ice for 1520 minutes each, for
a 2448 hour period.[6] To prevent localised ischemia or frostbite to the skin, it is recommended that the ice be
placed within a towel before wrapping around the area.
Exceeding the recommended time for ice application may be detrimental, as it has been shown to delay
healing.
Compression[edit]
Compression aims to reduce the edematous swelling that results from the inflammatory process. Although
some swelling is inevitable, too much swelling results in significant loss of function, excessive pain and
eventual slowing of blood flow through vessel restriction.[citation needed]
An elastic bandage, rather than a firm plastic bandage (such as zinc-oxide tape) is required. Usage of a tight,
non-elastic bandage will result in reduction of adequate blood flow, potentially causing ischemia. The fit should
be snug so as to not move freely, but still allow expansion for when muscles contract and fill with blood.
Compression stockings are a viable option to manage swelling with graded compression. These garments are
especially effective post-operatively and are used in virtually all hospitals to manage acute or chronic swelling,
such as congestive heart failure.
Elevation[edit]
Elevation aims to reduce swelling by increasing venous return of blood to the systemic circulation. This will
result in less edema which reduces pain.
Variations[edit]
Variations of the acronym are sometimes used, to emphasize additional steps that should be taken. These
include:
"PRICE" - Pulse (Typically Radial or Distal), Rest, Ice, Compression, and Elevation
[12]
Alternatives[edit]
As RICE and its variations work[citation needed] by reducing blood flow to the injured area, some people argue that
for some types of injuries (such as ligaments and tendons) a protocol that increases blood flow, such as MEAT
(Movement, Exercise, Analgesics and Treatments) should be used instead.
Untrained. If you're not trained in CPR, then provide hands-only CPR. That means uninterrupted
chest compressions of about 100 a minute until paramedics arrive (described in more detail below). You
don't need to try rescue breathing.
Trained, and ready to go. If you're well trained and confident in your ability, begin with chest
compressions instead of first checking the airway and doing rescue breathing. Start CPR with 30 chest
compressions before checking the airway and giving rescue breaths.
Trained, but rusty. If you've previously received CPR training but you're not confident in your
abilities, then just do chest compressions at a rate of about 100 a minute. (Details described below.)
The above advice applies to adults, children and infants needing CPR, but not newborns.
CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical
treatment can restore a normal heart rhythm.
When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A
person may die within eight to 10 minutes.
To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an
automatic external defibrillator (AED).
Before you begin
Before starting CPR, check:
If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you
OK?"
If the person doesn't respond and two people are available, one should call 911 or the local
emergency number and one should begin CPR. If you are alone and have immediate access to a
telephone, call 911 before beginning CPR unless you think the person has become unresponsive
because of suffocation (such as from drowning). In this special case, begin CPR for one minute and then
call 911 or the local emergency number.
If an AED is immediately available, deliver one shock if instructed by the device, then begin CPR.
2.
3.
Place the heel of one hand over the center of the person's chest, between the nipples. Place your
other hand on top of the first hand. Keep your elbows straight and position your shoulders directly
above your hands.
4.
Use your upper body weight (not just your arms) as you push straight down on (compress) the
chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100
compressions a minute.
5.
If you haven't been trained in CPR, continue chest compressions until there are signs of
movement or until emergency medical personnel take over. If you have been trained in CPR, go on
to checking the airway and rescue breathing.
If you're trained in CPR and you've performed 30 chest compressions, open the person's airway
using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the
head back. Then with the other hand, gently lift the chin forward to open the airway.
2.
Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen
for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not
considered to be normal breathing. If the person isn't breathing normally and you are trained in
CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack
and you haven't been trained in emergency procedures, skip mouth-to-mouth rescue breathing and
continue chest compressions.
With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-tomouth breathing and cover the person's mouth with yours, making a seal.
2.
Prepare to give two rescue breaths. Give the first rescue breath lasting one second and
watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat
the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions
followed by two rescue breaths is considered one cycle.
3.
4.
5.
about two minutes before calling 911 or your local emergency number or using an AED.
Use the same compression-breath rate as is used for adults: 30 compressions followed by two
breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions
and breaths.
After five cycles (about two minutes) of CPR, if there is no response and an AED is available,
apply it and follow the prompts. Use pediatric pads if available. If pediatric pads aren't available, use adult
pads.
Continue until the child moves or help arrives.
baby.
Place the baby on his or her back on a firm, flat surface, such as a table. The floor or ground also
will do.
2.
Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just
below this line, in the center of the chest.
3.
4.
After 30 compressions, gently tip the head back by lifting the chin with one hand and pushing
down on the forehead with the other hand.
2.
In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look
for chest motion, listen for breath sounds, and feel for breath on your cheek and ear.
breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second
breath.
3.
4.
5.
6.
If the baby's chest still doesn't rise, examine the mouth to make sure no foreign material is inside.
If the object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a
choking baby.
Give two breaths after every 30 chest compressions.
Perform CPR for about two minutes before calling for help unless someone else can make the
call while you attend to the baby.
Continue CPR until you see signs of life or until medical personnel arrive.
Sukan Rekreasi
Dengan nama Allah yang Maha Pemurah lagi Maha Belas Kasihan.
Terdapat 4 aspek daripada kerja kursus Sukan Rekreasi yang mahu dikongsi bersama. Moga
bermanfaat. ^_^
-
1. Pendahuluan
Pendidikan Jasmani merupakan salah satu subjek yang tersenarai dalam jadual waktu
sekolah pelajar-pelajar sekolah rendah mahupun menengah. Subjek ini penting kerana
pelajar-pelajar dapat meningkatkan tahap kecergasan mental dan fizikal mereka sekaligus
menjana pelajar yang seimbang dari segi jasmani, emosi, rohani , intelek dan sosial.
Aspek JERIS ditekankan dalam Falsafah Pendidikan Negara kerana hasrat Negara
mahu melahirkan modal insan kelas pertama yang bukan sahaja bernas idea fikirannya
tetapi juga aktif dalam bidang kokurikulum dan pandai bergaul. Hal ini menunjukkan
Pendidikan Jasmani merupakan subjek yang penting .
Aspek jasmani penting bagi seorang pelajar kerana hakikatnya, seorang pelajar yang
sihat mampu menjadi pelajar yang aktif di dalam kelas lantaran dia mempunyai badan yang
sihat. Di dalam Pendidikan Jasmani, bukan aspek jasmani sahaja yang ditekankan kerana
pelajar juga belajar menguruskan stress, menajamkan fikiran, bergaul dengan rakan-rakan
dan masyarakat serta menerapkan elemen-elemen rohani mengikut kepercayaan masingmasing.
Sukan rekreasi merupakan salah satu elemen yang terdapat dalam Pendidikan
Jasmani. Menurut Mohd Salleh Aman (2004), rekreasi boleh didefinisikan sebagai aktiviti
masa lapang yang membina (positif) sama ada bentuk riadah (aktif) atau santai (pasif).
Rekreasi adalah aktiviti yang bertentangan dengan kerja. Ia biasanya dilakukan secara
berkumpulan. Aktiviti rekreasi boleh disusun atur dalam bentuk pertandingan atau
persembahan atau dalam bentuk tanpa dirancang.
2. Konsep rekreasi
Konsep rekreasi seringkali dikaitkan dengan personal fulfillment atau kepuasan
kendiri . Kepuasan kendiri ini mampu memberikan impak yang besar terhadap seseorang
individu memandangkan tingkah laku seseorang yang maju ataupun mundur akan
menentukan kualiti kerjanya. Kepuasan kendiri ini member kesan kepada individu itu sendiri,
tempat kerja, rakan-rakan, keluarga, masyarakat dan Negara.
Semakin ramai penduduk Malaysia sekarang yang sedar akan perihal rekreasi ini
dan kepentingannya malah terdapat pertubuhan yang menyokong aktiviti-aktiviti yang
mereka jalankan. Selain kepuasan kendiri , konsep rekreasi ialah apresiasi estetika.
Apresisasi estetika membawa maksud penghargaan tehadap alam semula jadi. Tidak
dinafikan, seorang pengembara hutan lebih menghargai flora dan fauna ciptaan Tuhan
berbanding orang awam yang tidak pernah mengembara. Mereka lebih mengutamakan
kebersihana dan tidak membuang sampah ke merata-rata tempat.
Rekreasi juga menekankan gaya hidup sihat. Sihat dari segi fizikal, mental, rohani
dan emosi. Seringkali perkara ini dipandang enteng oleh masyarakat kerana merasakan
mereka sudah mampu menjadi insane seimbang tanpa bersukan. Perkara ini salah sama
sekali kerana pembentukan personality seimbang bukan mudah sepeti yang diujarkan. Gaya
hidup sihat memerlukan seseorang yang mampu mengatur masa untuk bekerja, belajar,
bermain dan bersantai bersama keluarga dengan bijak. Amalan pemakanan sihat juga perlu
dipantau kerana kini, masyarakat semakin mengutamakan makanan segera yang mudah
didapati dan sedap. Hakikatnya, makanan segera tidak mempunyai zat yang mencukupi
untuk perkembangan pertumbuhan.
Nyata,jelaslah bahawa, Sukan dan Rekreasi mendokong konsep yang jelas dan
memberi manfaat kepada orang ramai.
1 3. Kepentingan rekreasi dalam kurikulum sekolah
Terdapat 5 komponen yang ditekankan dalam usaha melahirkan modal insan kelas pertama
dalam Falsafah Pendidikan Negara, iaitu, jasmani, emosi, intelek, rohani dan sosial.
Pendidikan jasmani penting kerana terdapat berbagai-bagai faedah dapat diperolehi dalam
subjek ini antaranya :
1. Pelajar cergas dan sihat
Pelajar yang terlibat aktif dalam sukan dapat menjadi lebih sihat berbanding rakan-rakannya
yang lain. Selain itu, mereka lebih matang memandangkan mereka dapat mengaitkan 3
komponen penting dalam pendidikan jasmani iaitu, aspek kognitif, afektif dan psikomotor.
Peluh akibat bersukan pula dapat mengurangkan kandungan toksik-toksik dalam badan
seseorang. Sebagai contoh, pelajar yang selalu mengamalkan aktiviti skipping atau jump
rope dapat menyihatkan jantung. Dengan ini, pelajar tersebut dapat menjadi lebih sihat dan
belajar dengan lebih proaktif manakala pelajar yang tidak aktif akan sentiasa lesu dan tidak
mampu menjadi modal insan kelas pertama.
2. Pelajar dapat menangani tekanan
Pembelajaran di sekolah boleh jadi satu perkara yang membebankan. Pelajar-pelajar akan
merasa stres dengan kerja rumah yang banyak dan kelas yang memenatkan. Jadi, ketika
subjek Pendidikan Jasmanilah para pelajar dapat menghilangkan stres dengan bermain di
padang mahupun ketika kokurikulum sukan. Perkara ini akan menyeimbangkan pelajar itu
dengan pembelajaran akademik dan sukan. Di samping itu, hormon serotonin akan
dihasilkan memandangkan Pendidikan Jasmani dan Sukan Rekreasi merupakan subjek yang
menyeronokkan. Dengan ini, pelajar yang mempunyai emosi yang ceria dapat mengatasi
masalah tekanan dan kemurungan dalam diri mereka serta mampu membuat keputusan
yang tepat dalam kehidupan seharian mereka.
3. Meningkat kemahiran bersosial
Kemahiran bersosial merupakan kemahiran yang tidak dipelajari secara bertulis kerana
kemahiran ini memerlukan individu tersebut berinteraksi secara lansung dengan masyarakat
sekelilingnya. Pelajar yang mampu bersosial dengan baik , mempunyai self-esteem yang
tinggi kerana pelajar tersebut berani dan tidak gentar dengan orang lain. Melalui subjek
Sukan Rekreasi, pelajar perlu berhubung dan berinteraksi antara satu sama lain kerana
terdapat banyak aktiviti yang memerlukan kerjasama. Setiap individu bertanggungjawab
menjaga kepentingan kawan-kawan mereka. Hal ini secara tidak langsung dapat
meningkatkan kemahiran bersosial mereka. Kini, terdapat ramai anak mudak yang
mengamalkan sosial bebas dan sosial liar. Perkara ini amat menyedihkan kerana mereka
merosakkan diri sendiri. Maka guru di sekolah wajib mengajarkan pelajar kaedah yang
sesuai untuk bersosial dengan baik. Sebagai contoh, pelajar yang menyertai Persatuan
Bulan Sabit Merah perlu membantu rakan-rakan mereka yang cedera dan dalam kalangan
ahli persatuan itu sendiri, mereka perlu bekerjasama untuk menyelamatkan rakan mereka.
Tanpa kemahiran komunikasi dan sosial yan baik, ahli-ahli dalam persatuan itu tidak dapat
bekerjasama dan mungkin mencetuskan pergaduhan. Disebabkan itulah, kemahiran
bersosial ini penting.
4. Membina sahsiah dan menerapkan nilai-nilai murni dalam diri pelajar
Sukan Rekreasi mampu membina sahsiah diri pelajar cemerlang. Tidak dinafikan,
Pendidikan Sivik dan Kewarganegaraan juga menerapkan nila-nilai murni dalam diri seorang
pelajar. Namun, Sukan Rekreasi juga mampu melakukan perkara yang sama untuk
Seorang individu mbersosial dengan baik dengan rakan-rakan yang berkongsi minat yang sama
Contoh :
1. Melawat muzium
2. Membeli belah
ABC (medicine)
From Wikipedia, the free encyclopedia
Perform chest compressions to supportcirculation in those who are non-responsive without meaningful breaths
ABC and its variations are initialism mnemonics for essential steps used by both medical professionals and lay
persons (such as first aiders) when dealing with a patient. In its original form it stands
for Airway, Breathing and Circulation.[1] The protocol was originally developed as a memory aid for rescuers
performing cardiopulmonary resuscitation, and the most widely known use of the initialism is in the care of
the unconscious or unresponsive patient, although it is also used as a reminder of the priorities for assessment
and treatment of patients in many acute medical and trauma situations, from first-aid to hospital medical
treatment.[2] Airway, breathing, and circulation are vital for life, and each is required, in that order, for the next to
be effective. Since its development, the mnemonic has been extended and modified to fit the different areas in
which it is used, with different versions changing the meaning of letters (such as from the original 'Circulation' to
'Compressions') or adding other letters (such as an optional "D" step for Disability or Defibrillation).
In 2010, the American Heart Association and International Liaison Committee on Resuscitation changed the
recommended order of CPRinterventions for most cases of cardiac arrest to chest compressions, airway,
breathing or CAB.[3]:S642[4]
Contents
[hide]
1 History
2 Importance
4 Airway
5 Breathing
6 Circulation
7 Variations
7.1 DR ABC
7.2 DRsABC
7.3 ABCD
7.4 ABCDE
7.5 ABCDEF
7.6 ABCDEFG
7.7 AcBC
7.8 CABC
7.9 MARCH
8 See also
9 References
10 External links
History[edit]
The 'ABC' method of remembering the correct protocol for CPR is almost as old as the procedure itself, and is
an important part of thehistory of cardiopulmonary resuscitation. Throughout history, a variety of differing
methods of resuscitation had been attempted and documented, although most yielded very poor outcomes. [5] In
1957, Peter Safar[6] wrote the book ABC of Resuscitation,[1] which established the basis for mass training of
CPR.[7] This new concept was distributed in a 1962 training video called "The Pulse of Life" created by James
Jude,[8] Guy Knickerbocker and Peter Safar. Jude and Knickerbocker, along with William
Kouwenhouen[9] developed the method of external chest compressions, while Safar worked with James Elam to
prove the effectiveness of artificial respiration. [10]Their combined findings were presented at annual Maryland
Medical Society meeting on September 16, 1960 in Ocean City, and gained rapid and widespread acceptance
over the following decade, helped by the video and speaking tour the men undertook. The ABC system for CPR
training was later adopted by the American Heart Association, which promulgated standards for CPR in 1973.
As of 2010, the American Heart Association chose to focus CPR on reducing interruptions to compressions,
and has changed the order in its guidelines to Circulation, Airway,Breathing (CAB).[11]
Importance[edit]
At all levels of care, the ABC protocol exists to remind the person delivering treatment of the importance of
airway, breathing, and circulation to the maintenance of a patient's life. These three issues are paramount in
any treatment, in that the loss (or loss of control of) any one of these items will rapidly lead to the patient's
death. The three objectives are so important to successful patient care that they form the foundation of training
for not only first aid providers, but also participants in many advanced medical training programs. [12][13][14][15][16]
Hypoxia, the result of insufficient oxygen in the blood, is a potentially deadly condition and one of the leading
causes of cardiac arrest. Cardiac arrest is the ultimate cause ofclinical death for all animals[17] (although with
advanced intervention, such as cardiopulmonary bypass a cardiac arrest may not necessarily lead to death),
and it is linked to an absence of circulation in the body, for any one of a number of reasons. For this reason,
maintaining circulation is vital to moving oxygen to the tissues and carbon dioxide out of the body.
Airway, breathing, and circulation therefore work in a cascade; if the patient's airway is blocked, breathing will
not be possible, and oxygen cannot reach the lungs and be transported around the body in the blood, which will
result in hypoxia and cardiac arrest. Ensuring a clear airway is therefore the first step in treating any patient;
once it is established that a patient's airway is clear, rescuers must evaluate a patient's breathing, as many
other things besides a blockage of the airway could lead to an absence of breathing.
Airway[edit]
Unconscious patients[edit]
In the unconscious patient, the priority is airway management, to avoid a preventable cause of hypoxia.
Common problems with the airway of patient with a seriously reduced level of consciousness involve blockage
of the pharynx by the tongue, a foreign body, or vomit.
At a basic level, opening of the airway is achieved through manual movement of the head using various
techniques, with the most widely taught and used being the "head tilt chin lift", although other methods such
as the "modified jaw thrust" can be used, especially where spinal injury is suspected,[19] although in some
countries, its use is not recommended for lay rescuers for safety reasons. [18]
Higher level practitioners such as emergency medical service personnel may use more advanced techniques,
from oropharyngeal airways to intubation, as deemed necessary.[20]
Conscious patients[edit]
In the conscious patient, other signs of airway obstruction that may be considered by the rescuer include
paradoxical chest movements, use of accessory muscles for breathing, tracheal deviation, noisy air entry or
exit, and cyanosis.[21]
Breathing[edit]
Unconscious patients[edit]
In the unconscious patient, after the airway is opened the next area to assess is the patient's breathing,
[18]
primarily to find if the patient is making normal respiratory efforts. Normal breathing rates are between 12
and 30 breaths per minute,[21] and if a patient is breathing below the minimum rate, then in current ILCOR basic
life support protocols, CPR should be considered, although professional rescuers may have their own protocols
to follow, such as artificial respiration.
Rescuers are often warned against mistaking agonal breathing, which is a series of noisy gasps occurring in
around 40% of cardiac arrest victims, for normal breathing. [18]
If a patient is breathing, then the rescuer will continue with the treatment indicated for an unconscious but
breathing patient, which may include interventions such as the recovery position and summoning
an ambulance.[22]
Checking for general respiratory distress, such as use of accessory muscles to breathe, abdominal
breathing, position of the patient, sweating, or cyanosis
Checking the respiratory rate, depth and rhythm - Normal breathing is between 12 and 20 in a healthy
patient, with a regular pattern and depth. If any of these deviate from normal, this may indicate an
underlying problem (such as with Cheyne-Stokes respiration)
Chest deformity and movement - The chest should rise and fall equally on both sides, and should be
free of deformity. Clinicians may be able to get a working diagnosis from abnormal movement or shape of
the chest in cases such as pneumothorax or haemothorax
Listening to external breath sounds a short distance from the patient can reveal dysfunction such as a
rattling noise (indicative of secretions in the airway) or stridor (which indicates airway obstruction)
Checking for surgical emphysema which is air in the subcutaneous layer which is suggestive of
a pneumothorax
Auscultation and percussion of the chest by using a stethoscope to listen for normal chest sounds or
any abnormalities
Pulse oximetry may be useful in assessing the amount of oxygen present in the blood, and by
inference the effectiveness of the breathing
Circulation[edit]
Once oxygen can be delivered to the lungs by a clear airway and efficient breathing, there needs to be a
circulation to deliver it to the rest of the body.
Non-breathing patients[edit]
Circulation is the original meaning of the 'C' as laid down by Jude, Knickerbocker & Safar, and was intended to
suggest assessing the presence or absence of circulation, usually by taking a carotid pulse, before taking any
further treatment steps.
In modern protocols for lay persons, this step is omitted as it has been proven that lay rescuers may have
difficulty in accurately determining the presence or absence of a pulse, and that, in any case, there is less risk
of harm by performing chest compressions on a beating heart than failing to perform them when the heart is not
beating.[23] For this reason, lay rescuers proceed directly to cardiopulmonary resuscitation, starting with chest
compressions, which is effectively artificial circulation. In order to simplify the teaching of this to some groups,
especially at a basic first aid level, the C for Circulation is changed for meaning CPR or Compressions. [24][25][26]
It should be remembered, however, that health care professionals will often still include a pulse check in their
ABC check, and may involve additional steps such as an immediateECG when cardiac arrest is suspected, in
order to assess heart rhythm.
Breathing patients[edit]
In patients who are breathing, there is the opportunity to undertake further diagnosis and, depending on the
skill level of the attending rescuer, a number of assessment options are available, including:
Observation of colour and temperature of hands and fingers where cold, blue, pink, pale, or mottled
extremities can be indicative of poor circulation
Capillary refill is an assessment of the effective working of the capillaries, and involves applying
cutaneous pressure to an area of skin to force blood from the area, and counting the time until return of
blood. This can be performed peripherally, usually on a fingernail bed, or centrally, usually on the sternum
or forehead
Pulse checks, both centrally and peripherally, assessing rate (normally 60-80 beats per minute in a
resting adult), regularity, strength, and equality between different pulses
Observation for secondary signs of circulatory failure such as oedema or frothing from the mouth
(indicative of congestive heart failure)
ECG monitoring will allow the healthcare professional to help diagnose underlying heart conditions,
including myocardial infarctions