Prinsip Dan Prosedur T [PDF]

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Prinsip dan Prosedur T.O.T.A.P.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.



Assessing Injuries with TOTAPS! Injury management involves identifying an injury, treating it and then returning to the sport. It’s extremely important that sports players are adequately rehabilitated before returning to their sport. If they are not, the injury can become lead to other complications. For serious injuries, like spinal injuries, get help first. If you are unsure get help. To assess all other injuries, remember TOTAPS! TOTAPS Ask the player what happened. Where does it hurt? Talk What kind of pain is it? What day is it etc for head injuries. Look at the affected area for redness or Observe swelling. Is the injured side different from the other side? Touch will indicate warmth for Touch inflammation – touch also assesses pain. Ask the injured player to move the Active movement injured part without any help. If the player can move the injured part, Passive movement carefully try to move it yourself through its full range of motion. Did the active and passive movement produce pain? If no, can the player stand and demonstrate some of the Skill test skills from the game carefully? If an injury is identified, remove the player from the activity immediately.



RICE (medicine) From Wikipedia, the free encyclopedia



For other uses, see Rice (disambiguation). RICE is a mnemonic for a treatment method for soft tissue injuries which is an acronym for Rest, Ice, Compression and Elevation.[1][2][3] When used appropriately, recovery duration is usually shortened and discomfort minimised.[citation needed] RICE is considered a first-aid treatment, rather than a cure for soft tissue injuries. The aim is to manage discomfort and internal bleeding.[4] Contents [hide]



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1 Primary four terms



o



1.1 Rest



o



1.2 Ice



o



1.3 Compression



o



1.4 Elevation



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2 Variations



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3 Alternatives



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4 See also



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5 References



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6 External links



Primary four terms[edit] Rest[edit]



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 15–20 minutes each, for a 24–48 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: 



"HI-RICE" - Hydration, Ibuprofen, Rest, Ice, Compression, and Elevation







"PRICE" - Protection, Rest, Ice, Compression, and Elevation [7][8][9]



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"PRICE" - Pulse (Typically Radial or Distal), Rest, Ice, Compression, and Elevation







"PRICES" - Protection, Rest, Ice, Compression, Elevation, and Support



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"PRINCE" - Protection, Rest, Ice, NSAIDs, Compression, and Elevation[10]



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"RICER" - Rest, Ice, Compression, Elevation, and Referral [11]



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"DRICE" - Diagnosis, Rest, Ice, Compression, and Elevation



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"POLICE" - Protection, Optimal Loading, 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.



Cardiopulmonary resuscitation (CPR): First aid



Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends that everyone — untrained bystanders and medical personnel alike — begin CPR with chest compressions. It's far better to do something than to do nothing at all if you're fearful that your knowledge or abilities aren't 100 percent complete. Remember, the difference between your doing something and doing nothing could be someone's life. Here's advice from the American Heart Association: 



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:







Is the person conscious or unconscious?



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.







Remember to spell C-A-B The American Heart Association uses the acronym of CAB — circulation, airway, breathing — to help people remember the order to perform the steps of CPR. Circulation: Restore blood circulation with chest compressions 1.



Put the person on his or her back on a firm surface.



2.



Kneel next to the person's neck and shoulders.



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.



Airway: Clear the airway 1.



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.



Breathing: Breathe for the person Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. 1.



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.



Resume chest compressions to restore circulation. If the person has not begun moving after five cycles (about two minutes) and an automatic external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. Use pediatric pads, if available, for children ages 1 through 8. Do not use an AED for babies younger than age 1. If an AED isn't available, go to step 5 below. Continue CPR until there are signs of movement or emergency medical personnel take over.



To perform CPR on a child The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows: If you're alone, perform five cycles of compressions and breaths on the child — this should take







about two minutes — before calling 911 or your local emergency number or using an AED. 



Use only one hand to perform heart compressions.







Breathe more gently.







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.



To perform CPR on a baby Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or choking. If you know the baby has an airway obstruction, perform first aid for choking. If you don't know why the baby isn't breathing, perform CPR. To begin, examine the situation. Stroke the baby and watch for a response, such as movement, but don't shake the baby. If there's no response, follow the CAB procedures below and time the call for help as follows: If you're the only rescuer and CPR is needed, do CPR for two minutes — about five cycles —







before calling 911 or your local emergency number. If another person is available, have that person call for help immediately while you attend to the



 baby.



Circulation: Restore blood circulation 1.



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.



Gently compress the chest about 1.5 inches (about 4 cm). Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of 100 compressions a minute.



Airway: Clear the airway 1.



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.



Breathing: Breathe for the infant 1. 2.



Cover the baby's mouth and nose with your mouth. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue



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. ^_^ -



Pengenalan kepada Sukan Dan Rekreasi. Konsep Sukan dan Rekreasi Kepentingan rekresasi dalam kurikulum sekolah Jenis-jenis rekreasi



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



membangunkan peribadi mulia seorang pelajar. Kelab-kelab permainan di sekolah acapkali menganjurkan pertandingan seperti pertandingan bola sepak, bola jarring dan sebagainya. Sudah menjadi adat permainan, ada menang dan ada kalah. Kumpulan yang kalah perlu belajar menerima kekalahan dan belajar daripada kumpulan yang menang. Perkara ini mampu mematangkan pelajar agar mereka tidak terlalu kecewa jika jatuh,namun mereka harus berdiri dan membaiki kesilapan diri. Selain itu, nilai-nilai murni seperti semangat kekitaan dapat diperolehi. Sesuatu kumpulan perlu bersatu-padu untuk menewaskan pihak lawan. Pelajar akan menjadi lebih bertanggungjawab demi kumpulan mereka , bekerjasama dan tidak mementingkan diri. Hal ini secara tidak lansung dapat memastikan pelajar tersebut memperoleh nila-nilai murni. Justeru itu, sukan rekreasi sememangnya memberi banyak faedah kepada para murid yang mengikuti matapelajaran ini di sekolah mereka. Oleh itu, sukan rekreasi haruslah dijadi sebagai matapelajaran wajib bukan sahaja di sekolah rendah tetapi juga di sekolah menengah dan juga di Institut Pendidikan Tinggi Awam (IPTA). 4. Jenis-jenis Rekreasi Terdapat dua jenis rekreasi iaitu rekreasi aktif dan rekreasi pasif. Rekreasi Aktif Rekreasi aktif merupakan satu senaman. Oleh itu,kebaikan dan sumbangannya terhadap gaya hidup sihat adalah amat besar. Rekreasi aktif memerlukan pergerakan yang cergas untuk memastikan tahap daya kardiovaskular mencapai tahap ideal. Dengan melakukan senama, aktiviti sukan dan perkara-perkara yang mengeluarkan peluh, seseorang itu akan berasa lebih segar dan mampu menjadi cergas dalam urusan kerja mereka juga. Hal ini menjadi kepada modal insane kelas pertama kepada Negara. Rekreasi pasif Seringkali rekreasi pasif menjadi pilihan orang ramai memandangkan aktiviti rekreasi pasif merupakan aktiviti yang santai dan tidak memerlukan tenaga yang banyak. Walaupun rekreasi ini hanya menghilang tekanan mahupun rasa bosan, namun rekreasi ini tetap relevan juga kerana tidak dapat dipertikaikan bahawa, kita juga memerlukan waktu santai untuk ‘window shopping’ , membaca buku sambil mendengar muzik , untuk menenagkan diri di tempat kerja mahupun di rumah. Perbezaan Aktiviti Aktif dan Pasif •Aktif •Aktiviti aktif melibatkan tenaga •Seorang individu boleh menghiburkan diri dalam bentuk menggembirakan emosi dan psikologi Contoh : •1. Berenang •2. Mendaki bukit •Pasif •Aktiviti pasif kurang menggunakan fizikal dan bersifat relaksasi



•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



Opening the airway with a head tilt-chin lift maneuver



Looking, listening and feeling forbreathing



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]



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1 History



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2 Importance



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3 Simple application for CPR



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4 Airway



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4.1 Unconscious patients



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4.2 Conscious patients



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5 Breathing



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5.1 Unconscious patients



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5.2 Conscious or breathing patients



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6 Circulation



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6.1 Non-breathing patients



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6.2 Breathing patients



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7 Variations



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7.1 DR ABC



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7.2 DRsABC



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7.3 ABCD



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7.4 ABCDE



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7.5 ABCDEF



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7.6 ABCDEFG



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7.7 AcBC



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7.8 CABC



7.9 MARCH



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8 See also



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9 References



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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.



Simple application for CPR[edit] The basic application of the ABC principle is in first aid, and is used in cases of unconscious patients to start treatment and assess the need for, and then potentially deliver,cardiopulmonary resuscitation. In this simple usage, the rescuer is required to open the airway (using a technique such as "head tilt - chin lift"), then check for normal breathing.[18] These two steps should provide the initial assessment of whether the patient will require CPR or not. In the event that the patient is not breathing normally, the current international guidelines (set by the International Liaison Committee on Resuscitation or ILCOR) indicate that chest compressions should be started. Previously, the guidelines indicated that a pulse check should be performed after the breathing was assessed, and this made up the 'circulation' part of the initialism, but this pulse check is no longer recommended for lay rescuers. Some trainers continue to use 'circulation' as the label for the third step in the process, since performing chest compressions is effectively artificial circulation, and when assessing patients who are breathing, assessing 'circulation' is still important. However, some trainers now use the C to mean 'Compressions' in their basic first aid training.



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]



Conscious or breathing patients[edit] In a conscious patient, or where a pulse and breathing are clearly present, the care provider will initially be looking to diagnose immediately life-threatening conditions such as severe asthma, pulmonary oedema or haemothorax.[21] Depending on skill level of the rescuer, this may involve steps such as: [21] 



Checking for general respiratory distress, such as use of accessory muscles to breathe, abdominal breathing, position of the patient, sweating, or cyanosis



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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)



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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



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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)



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Checking for surgical emphysema which is air in the subcutaneous layer which is suggestive of a pneumothorax



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Auscultation and percussion of the chest by using a stethoscope to listen for normal chest sounds or any abnormalities



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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



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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



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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



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Blood pressure measurements can be taken to assess for signs of shock



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Auscultation of the heart can be undertaken by medical professionals



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Observation for secondary signs of circulatory failure such as oedema or frothing from the mouth (indicative of congestive heart failure)



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ECG monitoring will allow the healthcare professional to help diagnose underlying heart conditions, including myocardial infarctions