DAN Medical Frequently Asked Questions

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Travelers, especially those who engage in outdoor pursuits in remote areas, may need to stabilize and deliver care to an injured companion before medical assistance arrives. Travelers, especially those who engage in outdoor pursuits in remote areas, may need to stabilize and deliver care to an injured companion before medical assistance arrives. Doing so is the topic of major medical tomes, but the essential points are distilled here.If individuals have been injured but are still responsive — conscious and aware — these are the key steps:
* Maintain and/or assist with airway control.
* Control severe bleeding.
* Prevent or administer treatment for shock.
If individuals are breathing but unresponsive, they should be assumed to be in respiratory failure (also known as respiratory insufficiency) — that is, an inadequate exchange of oxygen for carbon dioxide; such individuals need the following immediate attention:
* Protection of their airway.
* Careful monitoring to determine whether they require artificial respiration (such as CPR).
If individuals are unresponsive and show no signs of life — no breathing, no movement, no response to an attempt to rouse them — chest compressions should be started immediately. See below for a brief description of this process, which can be done safely by anyone, whether or not they have received training.If individuals are unresponsive and not breathing, the crucial priority is to reestablish their circulation. Anyone who took a CPR course before 2010 may recall the mnemonic "ABC" as a reminder of the order in which it was then believed the steps of CPR should be administered: airway, breathing and compressions. But that advice was revised in 2010. Now the mnemonic is "CAB," as it has been determined that the most effective order of the steps is as follows:
* *Circulation:* Push hard and fast on the center of the victim's chest. Press down about two inches with the heel of your hand, at a rate of at least 100 compressions per minute (more than one a second), letting the chest rise fully after each compression; after every 30 compressions, stop to see if the person has started breathing again.
* *Airway:* Tilt the victim's head back and lift their chin to open their airway.
* *Breathing:* Give mouth-to-mouth rescue breaths. Pinch the victim's nose shut, cover their mouth with your mouth, and blow until you see their chest rise. Give two breaths, with each breath taking about one second. Then administer another 30 chest compressions.
It is of particular note that chest compressions can be done safely by anyone, whether or not they have received training. In fact, chest compressions are now often referred to as "hands-only CPR." Remember, as the American Heart Association (AHA) puts it, that "any attempt at CPR is better than no attempt." Learn more from the AHA's Hands Only CPR FAQs document.

Although administering chest compressions and/or rescue breathing in a remote location can be difficult, if a victim is in cardiac arrest, chest compressions should be continued with minimal interruption until:
* The victim's circulation has been restored and he or she is moving, breathing and speaking normally.
* Emergency medical care is available.
* Those present are unable to continue due to exhaustion or to conditions that place them at risk.
* Reliable criteria indicating irreversible death are present, including:
**The victim has not been restored to spontaneous circulation after three full rounds of CPR and automated external defibrillator (AED) analysis. An AED is a device that analyzes the heart's rhythm and, if appropriate, delivers a shock to restore its normal rhythm.
**Three consecutive AED analyses have resulted in no shocks.
**Advanced life support has been administered, if it's available.
Learn more in the Highlights of the 2010 AHA Guidelines for CPR and ECC.

Learning the full CPR procedures is not difficult, but it does require training and practice with qualified instructors. This guide cannot substitute for such instruction. But even if you have had CPR training, it's advisable to review the basic steps in your course manual before a trip — especially if you'll be heading into a remote area. Furthermore, if your last CPR course was some time ago, it wouldn't hurt to take a refresher.


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