CPR and basic life support
It is vital that anyone overdosing or having an adverse reaction to drugs receives professional help quickly. If Cardiopulmonary Resuscitation (CPR) is required and you know how to perform it then do so. CPR means giving rescue breaths followed by a number of chest compressions, and repeating this cycle continuously until the ambulance arrives. If you’re not sure, the following guide will help you to perform CPR.
First aid techniques
- Head-tilt, chin-lift: Place one hand on the forehead and the fingers of the other hand on the bony part of the chin. Tilt the head back using the hand on the forehead, and at the same time lift the jaw upwards with the fingers of the other hand.
- Jaw thrust: Place one hand on either side of the head. Place your fingers in the angles of the jaw and lift the jaw forward without tilting the head back.
- Finger sweep: Used with abdominal thrusts to clear a foreign body airway obstruction in an unconscious casualty. Open the mouth by grasping the lower jaw and tongue between thumb and fingers and lifting the jaw. Insert the index finger of the other hand along the inside of the cheek, and deeply into the throat. Use a hooking action to dislodge any foreign object.
Before starting CPR
- Ensure your own safety first, then that of the victim (for example, if the victim is lying on a road, take steps to alert oncoming traffic).
- Gently tap the victim and shout “are you all right?” If the victim can respond and there is no further danger from their location, leave the victim in the position they are in. If there is no response, shout for help. Send for help if there is more than one rescuer present.
- Ask that person to dial 111 for an ambulance and return to confirm that the ambulance is on the way. Tell the ambulance dispatcher the location and telephone number closest to the scene and be prepared to provide other information before hanging up.
- Do not hang up until instructed to do so.
- If alone, the rescuer should assess the victim for unresponsiveness and absence of signs of life before going for help.
- The victim must be on his/her back on a firm surface.
If the victim is unconscious, breathing and has other signs of life, turn the victim onto his/her side in the recovery position and ensure the airway is kept open. For more information, view the website of the New Zealand Resuscitation Council at www.nzrc.org.nz
It is recommended that CPR be learned and practised under trained supervision.
- Position the casualty lying on their back. Ensure they are on a firm surface.
- Kneel to one side of the casualty.
- Locate the notch where the ribs meet the breastbone.
- Place the middle finger of one hand in the notch and the index finger next to the middle finger.
- Place the heel of the other hand next to the two fingers.
- Place the other hand on top so the heels of both hands are over the same point on the breastbone.
- Interlock the fingers to keep them off the chest.
- With your elbows straight and locked, and your shoulders over the casualtyís chest, press straight down using the weight of your body to compress the breastbone 4-5cm (the depth of an adult’s thumb). Use a smooth uninterrupted rhythm allowing equal time for compression and relaxation.
- Give 30 compressions at a rate of 80-100 compressions a minute.
- Give two slow, full breaths.
- Reposition hands and administer a further 30 compressions/two breaths.
- Continue the ratio of 30 compressions/two breaths. After completing four cycles of chest compressions and breaths, administer two further breaths and then check the pulse in the neck.
The recovery position is designed for unconscious casualties (but do not use if you suspect the casualty has neck or spinal injuries). It helps to maintain an open airway and allows vomit and other fluid to drain freely from the mouth. To move a casualty lying on their back into the recovery position, follow these steps:
- Kneel beside the casualty.
- With the casualty lying on their back, extend the arm nearest to you above the casualty’s head.
- Bring their other arm across the chest to place the palm on the opposite shoulder.
- Take the farthest away from you and cross it over the other leg at the ankle.
- Roll the casualty towards you by placing your hand on their hip and your other hand on their shoulder.
- The casualty will now be lying on their side, resting on your thighs.
- Tilt the head to ensure the airway is open.
- Bend the top leg at a right angle.
The casualty will now lie in a stable unsupported position.
Basic life support
A New Zealand Red Cross booklet, ‘Essential First Aid’, provides valuable advice on basic life support. It says different methods of basic life support should be used for infants (under 1 year of age) and children (1-8 years), and people aged over 8 (including adults). Among other helpful tips, the booklet suggests the following First Aid procedures and techniques.
Basic life support - over 8s and adults:
- Ensure a safe environment.
- Assess response. If no response, get help.
- Send someone to call an ambulance.
- If you are alone and telephone is immediately available, use it to call an ambulance (111).
- Open the airway using head-tilt, chin-lift method.
- Use jaw thrust technique if spinal injuries are suspected. (Place one hand on either side of the head. Place your fingers in the angles of the jaw and lift the jaw forward without tilting the head back.)
- Remove foreign material or vomit if it is visible in the mouth.
- Look, listen and feel for breathing. This check should take three to five seconds.
- If breathing is present and adequate, place the person in the recovery position and monitor airways, breathing and circulation.
- If breathing is absent or inadequate, continue with basic life support
- Pinch the nostrils to prevent air escaping.
- Give two slow, full breaths into the mouth, watching the chest fall after each breath as the casualty exhales.
- If the chest does not rise, reposition the casualty’s head and try again.
- If the chest still does not rise, the airway may be obstructed.
- Check the airway. If you see a foreign body, gently ‘hook’ it out.
- Check the carotid pulse in the casualty’s neck.
- Place three fingers on the adam’s apple and slide them towards you into the groove at the side of the neck between the windpipe and the muscles.
- Press gently to feel for a pulse. This check should take up to 10 seconds.
- If the pulse is present, continue rescue breathing at a rate of one breath every five seconds.
- Every time you take a breath, the casualty will need a breath also.
- If the casualty has no pulse, continue rescue breathing and begin chest compressions. This combined technique is known as cardiopulmonary resuscitation (CPR).
First aid for parents
Your ability to help in an emergency could determine your children’s survival. If you know basic first aid, you can make a big difference. Children and teenagers can also make a difference if they have the skills to help.
Such first aid training can help them to help others, and to keep them focused in an emergency. For information on training in basic first aid in your area, contact Red Cross or St Johns Ambulance. Ask also for their useful first aid guides.
The first rule in an emergency with your child is to stay calm. This will help keep the child calm and will help you assess whether emergency services are needed. If you are unsure, ring 111 anyway. Remember that if you are calling from a payphone or cell phone, the call is free. Make a quick assessment of the child, so you can advise the ambulance service. For example:
- Is the child awake?
- Can the child talk to you?
- Is the child breathing?
- Is the child bleeding severely?
Obstructed airway cycle - adult and children above 1 year
The complete actions for dealing with choking in an unconscious adult are as follows:
- Commence 30 chest compressions (see above for how to perform CPR).
- Look for obstruction in mouth, remove if object is visible.
- Attempt 2 rescue breaths
- If unsuccessful repeat cycle until breathing or medical help arrives.
Obstructed airway cycle - infant
The actions for dealing with choking in an unconscious infant are as follows:
- Place infant on a firm surface
- Open airway to neutral position, check for normal breathing. Look for and remove foreign objects.
- 30 compressions and 2 small, gentle rescue breaths. Continue with breaths and compressions until object is dislodged or medical help arrives.
How to get help
Help is usually just a phone call away. Many services are listed in the Personal Help section at the front of your telephone book. Others are listed under Community Services or Welfare Organisations in the Yellow Pages. Several agencies have national freephone telephone numbers so parents can receive free advice. In emergencies, for police, fire or ambulance - dial 111.
Natural Disaster Preparation
Disasters such as earthquakes, tsunamis, volcanic eruptions, floods and storms can strike at any time, sometimes without warning. All disasters have the potential to cause disruption, damage property and take lives. Get ready now to protect yourself, your family, home, business and community.
Household emergency plan
Plan to look after yourself and your loved ones for at least three days or more. Many disasters will affect essential services and possibly disrupt your ability to travel or communicate with each other. You may be confined to your home, or forced to evacuate your neighbourhood.
In the immediate aftermath of a disaster, emergency services will not be able to get help to everyone as quickly as needed. This is when you are likely to be most vulnerable. So it is important to plan to look after yourself and your loved ones for at least three days or more in the event of a disaster.
Get your family or household together and agree on a plan. An emergency plan helps take away some of the fears about potential disasters, and can help you respond safely and quickly when a disaster happens. Make a start on your plan today. Get a copy of a household emergency plan and checklist from your local council, or download a copy from www.getthru.govt.nz. The plan and check-lists are available in English, Samoan, Tongan, Chinese, Korean, Arabic and Hindi.
A household emergency plan will help you work out:
- What each of you will do in the event of disasters such as an earthquake, tsunami, volcanic eruption, flood or storm.
- How and where you will meet up during and after a disaster.
- Where to store emergency survival items and who will be responsible for maintaining supplies.
- What you will each need to have in your getaway kits and where to keep them.
- What you need to do for members of the household, family or community with a disability or special requirement.
- What you will need to do for your pets, domestic animals or livestock.
- How and when to turn off the water, electricity and gas at the main switches in your home or business. Turn off gas only if you suspect a leak, or if you are instructed to do so by authorities. If you turn the gas off, you will need a professional to turn it back on and it may take several weeks to respond after an event.
- What local radio stations to tune in to for civil defence information during an event
- How to contact your local council’s civil defence emergency management office for assistance during an emergency.
- If life or property is threatened, always phone 111.
Ask civil defence emergency management staff at your local council about your community’s civil defence warning system, and the location of civil defence or public shelters. It is also useful to learn first aid and how to deal with small fires.
For parents, their first concern is often the children. Planning for an emergency gives children a sense of security that they will be looked after, and that they can do something to look after themselves. Encourage your children to join school civil defence teams. Many schools compete for civil defence awards, and learn valuable skills in the process. In New Zealand, we are at risk from many kinds of natural disasters, including earthquakes, flooding, volcanic eruptions, tsunami (tidal waves) and storms. Man-made disasters can also occur; a particular danger being hazardous material spills from trucks, trains, planes and at storage facilities.
Contact your local Civil Defence office to find out what types of disasters are most likely to happen in your area. Civil Defence will give you information on preparing for a disaster. Find out if your neighbourhood has a warning signal, what it sounds like and what you should do when you hear it.
Your workplace, children’s school or preschool centre will have a disaster plan. Schools and teachers are prepared for disasters and school staff will do everything they can to keep your child safe. It’s important to create a disaster plan with your family. Talk with your family about why you need to prepare for disaster.
Explain the different dangers of fire, storms, floods and earthquakes to children. Plan to share responsibilities and work together as a team. As a family, discuss the disasters that are most likely to happen and talk about what to do in each case. Make sure everyone knows where to get help if it is needed and how to make contact with other members of the family during a disaster. Arrange a place for your family to meet.
First aid is a good skill to learn - for more information, see our section on First Aid under Emergency Preparation. Also, contact your local Order of St John or Red Cross.
Barnardos recommends a hazard hunt with the whole family participating. Anything that can move and/or break when your house starts to shake is a hazard:
- Think about what will happen to heavy furniture, fixtures and appliances.
- Anchor bookcases and other top-heavy furniture to studs using metal angle braces, ‘L’ brackets and lag screws.
- Fasten shelves to the bookcase. Stop refrigerators, washing machines and other heavy appliances from moving by blocking the rollers.
- Check for any possible flying glass.
- Check your chimney is secure and tie down your hot water cylinder.
- Anchor heavy mirrors and pictures over beds, chairs and couches with wire through eye screws into studs.
- Keep beds away from windows.
- Know where the safe spots in your home are for each type of disaster, for example under a doorway during an earthquake or in the attic in a flood.
- Keep emergency telephone numbers by the phone such as those for fire, police, ambulance and doctor.
- Teach your children how to turn off the water, gas and electricity at the main switches.
- Only turn gas and water off if you suspect the lines are damaged or if you are instructed to do so by emergency authorities.
- Keep a battery-operated radio handy and follow instructions from local emergency officials.
- Be ready to evacuate immediately if you need to do so.
- If you have to evacuate, wear protective clothing and sturdy shoes.
- Take your disaster survival kit (see separate section).
- Lock your home.
- Listen for and use travel routes specified by local authorities.
- If there is time, shut off water, gas and electricity before leaving.
- Always leave a note telling others when you left and where you are going.
- Meet with your neighbours to plan how you can all work together after a disaster until help arrives.
- If you are a member of a neighbourhood organisation such as Neighbourhood Watch, introduce disaster preparedness as a new activity.
- Get to know your neighbours’ skills and needs.
- Think ahead and plan childcare for children of parents who can’t get home.
- Stock supplies in your home to meet your needs for at least three days.
- Replace stored water every three months and stored food every six months.
- Keep a bucket and supply of rubbish bins handy for a makeshift toilet.
- Don't put chemical cleaners in the toilet cistern as chemicals will poison a potential source of drinking water.
- Assemble a disaster survival kit with items you will need in an evacuation.
- Store these supplies in sturdy, easy to carry containers such as backpacks, duffle bags or covered rubbish containers.
If disaster does strike:
- Remain calm and put your disaster plan into action.
- Check for injuries.
- Give first aid and get help for seriously injured people.
- Listen to your battery-powered radio for news and instructions and be prepared to evacuate if advised to do so.
- Always wear protective clothing and sturdy shoes.
- Check for damage in your home.
- Use flashlights.
- Check for fires, fire hazards and other household hazards.
- Sniff for gas leaks.
- If you smell gas or suspect a leak, turn off the main gas valve, open windows and get everyone outside quickly. Do not light a match or open flame.
- Clean up spills, medicines, bleaches, petrol and other flammable liquids immediately.
- Be prepared to deal with the emotional needs of your children.
- Stay close enough to talk with and comfort each other.
- Talk about what happened and encourage your children to talk about their feelings.
Emergency survival items and getaway kits
In most emergencies you should be able to stay in your home. Plan to be able to look after yourself and your household for at least three days or more. Assemble and maintain your emergency survival items for your home as well as a portable getaway kit in case you have to leave in a hurry. You should also have essential emergency items in your workplace and in your car.
Emergency survival items:
- Torch with spare batteries or a self charging torch
- Radio with spare batteries
- Wind and waterproof clothing, sun hats, and strong outdoor shoes
- First aid kit and essential medicines
- Blankets or sleeping bags
- Pet supplies
- Toilet paper and large rubbish bags for your emergency toilet
- Face and dust masks.
Check all batteries every three months. Battery powered lighting is the safest and easiest. Do not use candles as they can tip over in earthquake aftershocks or in a gust of wind. Do not use kerosene lamps, which require a great deal of ventilation and are not designed for indoor use.
Food and water:
- Food and water for at least three days.
- Non-perishable food (canned or dried food), formula and drinks for babies and small children.
- Water – at least three litres per person per day for drinking.
- Water for washing and cooking.
- A primus or gas barbecue to cook on.
- A can opener.
Check and replace food & water every twelve months. Consider stocking a two-week supply of food & water for prolonged emergencies such as a pandemic.
In some emergencies, you may need to evacuate in a hurry. Everyone should have a packed getaway kit in an easily accessible place at home and at work which includes:
- Torch and radio with spare batteries.
- Any special needs such as hearing aids (and spare batteries), glasses or mobility aids.
- Emergency water and easy-to-carry food rations such as energy bars and dried foods in case there are delays in reaching a welfare centre or a place where you might find support. If you have any special dietary requirements, ensure you have extra supplies first aid kit and essential medicines.
- Essential items for infants or young children such as formula and food, nappies and a favourite toy.
- Change of clothes (wind/waterproof clothing and strong outdoor shoes).
- Toiletries – towel, soap, toothbrush, sanitary items, toilet paper.
- Blankets or sleeping bags.
- Face and dust masks.
- Pet supplies.
- Include important documents your kit: identification (birth and marriage certificates, driver’s licences and passports), financial documents (e.g. insurance policies and mortgage information) and precious family photos.
Stay quake safe
New Zealand could be hit by a natural disaster at any time, taking lives and causing huge physical and economic damage. We need to be prepared. The threat of earthquakes anywhere in the country is very real, but storms, floods, volcanic eruption, tsunamis, landslides and other events can also seriously disrupt our lives.
Living with the risk of disaster means we have to be prepared – firstly to survive the initial effects; then to be resilient enough to be on our own for a period of time (at least three days) without the assistance of emergency services, and without water, electricity and sewerage systems; and finally to recover as quickly as possible. The following information is provided with the assistance of the Ministry of Civil Defence and Emergency Management, and includes the latest safety strategies.
- Earthquakes offer no warning, so you could be at home, school or work when one strikes. Think now about where you can get to quickly to be safe. For example:
- A strong table (perhaps your desk at work) provides good protection. Grab the table legs to stop the table from moving.
- Next to an interior wall, away from windows that can shatter and cause injury and tall furniture that can fall on you.
- Protect your head and neck with your arms. (Note that modern homes don’t generally have doorways that are any stronger than the wall, and the doors can swing and injure you.)
Practise the Drop, Cover and Hold routine. It’s internationally recognised as the best strategy for earthquake survival (beware of bogus advice such as the “triangle of life” that has been widely discredited). In an earthquake, the routine means moving no more than a few steps (away from buildings, trees, street lights and power lines if outside) and then:
Drop to the floor or ground. This will help to prevent injury not only from flying glass and other objects, but also from being knocked to the ground by the quake.
Take cover under a nearby table or desk. If nothing is nearby or you’re outside, cover your face and head with your arms.
Hold on to something sturdy, such as the table legs, until the shaking stops.
- If you’re in an elevator, drop, cover and hold. When the shaking stops, try and get out at the nearest floor if you can safely do so.
- If you’re at the beach or near the coast, drop, cover and hold then move to higher ground immediately in case a tsunami follows the quake.
- If you’re driving, pull over to a clear location, stop and stay there with your seatbelt fastened. When the shaking stops, drive on if you think it’s safe and avoid bridges or ramps that might have been damaged.
After a quake
- Listen to a local radio station – emergency management officials will broadcast advice that’s appropriate for your community and situation.
- Expect to feel aftershocks.
- Check yourself for injuries and get first aid if necessary. Help others if you can.
- Electricity could be cut, and fire alarms and sprinkler systems can go off in buildings during an earthquake even if there’s no fire. Check for small fire and put them out if you can.
- If you’re in a damaged building, try to get outside and find a safe, open place. Use the stairs, not the elevators.
- Watch out for fallen power lines or broken gas lines, and stay out of damaged areas.
- Use the phone for short essential calls to keep the lines clear for emergency calls.
- If you smell gas or hear a blowing or hissing noise, open a window and get everyone out quickly and turn off the gas if you can. If you see sparks, broken wires or electrical system damage, turn off the electricity at the main fuse box if it’s safe to do so.
- Control your animals because they can become disorientated. They might need to be protected from hazards, and they could annoy or attack other people.
- When it’s safe to do so, take notes and photographs for insurance purposes if your property is damaged. If you rent your property, contact your landlord/property manager and your contents insurance company as soon as possible.
If someone you care for is injured in a disaster, your knowledge of first aid will be invaluable. Many organisations provide first aid training courses. Consider taking a first aid course, followed by regular refresher sessions. You can buy ready-made first aid kits or make up your own. For further information go to www.getthru.govt.nz
Household emergency plan
Images of people queuing for water and digging toilets in their backyard after the February 2011 Canterbury earthquake show that life will not necessarily return quickly to normal. In a serious earthquake, you might not be able to leave your home or communicate with other people, or you might have to leave your damaged home.
Emergency services are unlikely to reach you immediately. That’s why you need a plan that ensures you and your family can survive for at least three days on your own. So get your family or household together and work on the plan. To help, the website www.getthru.govt.nz has a template for a household emergency plan you can use. Your local council will also be able to help.
It pays to ask your council about the community’s civil defence warning system, and where civil defence or public shelters are. It’s also useful to learn first aid and how to deal with small fires.
Other important stuff:
- Check your insurance policy for cover (home, business and contents) and ensure your cover is adequate and up to date. Know where your important documents and keep them within easy reach if you have to evacuate.
- Parents and caregivers should consider talking to children about the disasters that could happen in your community and what to do to keep safe. This can help to reduce fear and anxiety and helps everyone know how to respond.
- Seek qualified advice to make sure your house is secured to its foundations and ensure any renovations comply with the New Zealand Building Code.