Basic life support- a beginners tutorial
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The document outlines the principles and procedures of Basic Life Support (BLS) for various age groups, highlighting the importance of immediate response to cardiac arrest and choking scenarios. It details the steps for adult and child BLS, including CPR techniques, the use of an Automated External Defibrillator (AED), rescue breathing, and considerations for special situations such as pregnancy. Importantly, it emphasizes the chain of survival, calling for early emergency response activation and effective teamwork during resuscitation efforts.
Basic life support- a beginners tutorial
- 1. Basic Life Support Dr.Gowtham Krishna J.
- 2. OBJECTIVES • Introduction • Chains of survival • Adult BLS • Child BLS • Choking • Rescue breathing
- 3. INTRODUCTION • BLS is the foundation for saving a life after cardiac arrest. • Proper competency of BLS enables us to – Recognize cardiac arrest – Activate the emergency response system early – Respond quickly and confidently
- 6. Recognising the threat IHCA most often represents - progression of physiologic instability 100/
- 7. Adult BLS Scene safety and assessment Agitated attenders Ward environment Transport of patient to ICU
- 8. Assessment Check the response by taping at shoulder Shout for help, if no response(Code Blue/RRT) Check for the pulse and breathing simultaneously ( <5s to >10s)
- 9. Adult BLS • No pulse no breathing Code Blue Start CPR
- 10. Building blocks of CPR
- 11. Adult BLS High quality CPR( 30:2) Compressions At the rate of 100- 120 /min Allow the chest to get recoil for refilling of the heart Minimize the interruptions less than 10 secs Depth of At least 5cm or 2.5 inches Effective ventilation 1 breath over 1 secs Avoid excessive ventilation
- 12. Adult BLS • Hand placement
- 13. Adult BLS The E-C clamp
- 14. AED Turn on the AED Follow the AED Prompts Attach the Pads ,then plug can be connected (CPR to continue) Right side below the clavicle and left side nipple or mid axillary line Plug in to AED AED: Analysis of the rhythm Clear for analysis
- 15. Charging Start compression while charging Shock Advised press the shock button now (flash light) Clear the patient and deliver shock Resume CPR if needed Immediately start CPR after delivering shock
- 16. Adult BLS
- 17. Adult BLS Special consideration applying for AED Pads Hairy chest ( shave or use AED pads to stick out hair if extra pads available ) Implanted pacemaker / defibrillator (should not apply directly to that , can use just below that ) Medication Patches ( quickly remove and wipe ) Submerged with water ( pull the victim out, quick dry)
- 18. Adult BLS
- 19. Adult BLS Steps of Adult BLS Scene safety Checking for response Shout for help if no response Check pulse and breathing Activate EMS or code blue, ask for AED Start CPR if no pulse and breathing
- 20. Adult BLS Difference between single and multi rescuers In case 2 or more rescuer –follow team dynamics. Every 2 mins ( 5 cycles of CPR) the rescuers has to be switch over Others remain same for both single and multi rescuers like rate, ratio & depth
- 21. CHILD (1 yr to puberty )BLS Scene safety Checking for response Shout for help if no response Check pulse and breathing( carotid or femoral ) Activate EMS or code blue, ask for AED Start CPR if no pulse and breathing
- 22. CHILD BLS Witnessed VS Un-witnessed arrest Start CPR immediately in case of un-witnessed arrest, continue for 2 minutes, then activate EMS Activate EMS and get help then start CPR Hand placement Centre of the chest , between the nipples, you can use one hand or two hand technique for compressions.
- 23. CHILD BLS • High quality CPR( 30:2) & (15:2) Compressions At the rate of 100- 120 /min Allow the chest to get recoil for refilling of the heart Minimize the interruptions less than 10 secs Depth of about 5cm or 2.5 inches Effective ventilation 1 breath over 1 secs Avoid excessive ventilation to increases the cardiac output
- 24. CHILD BLS Difference between single and multi rescuers In case 2 or more rescuer –follow team dynamics Every 2 mins ( 5 cycles of CPR) the rescuers has to be switch over Ratio will be 30:2 if single rescuer, 15:2 if case of two or multi rescuer.
- 25. CHILD BLS AED for child All the steps remains same as like an adult If child pads available, apply as like adult (right side below the clavicle, left side below the nipple ) Adult pad for children more 10 kg If using adult pad for the children, apply one at anteriorly between the nipple another one at posteriorly between scapula. Do not use child pad for the adult but can use the adult pad for children.
- 26. RESCUE BREATHING There is a pulse but breathing, abnormal breathing or agonal gasping. Start rescue breathing Adult : 1 breath for every 6 secs – 10/min Child & infant: 1 breath for every 2-3 secs- 20- 30/min Check for pulse,every 2 minutes, if no pulse activate EMS/ code blue and start CPR.
- 27. RESCUE BREATHING Patient with Advanced Airway : 1 breath for every 6 secs, should not interrupt the compressions, compression will be 100- 120 /min. Patient on advanced airway- Clinical decision
- 28. • Follow BLS and ACLS guidelines • Modified position-do manual uterine displacement • Chest compressions should be performed slightly higher on the sternum than normal recommended to adjust for elevation of diaphragm • Intravenous access to be secured above the diaphragm level(Class 1-level C) Pregnancy and CPR
- 30. 20 wk-prob for resc /L lat-avoid cpr/ 24-25 wk- fetus can survive No ROSC -5 min-c/s(peri- mor)
- 31. Pregnancy and CPR • If no ROSC by 4 mins perform emergency caesarean section • Aim for delivery within 5 min of onset of resuscitation • Continue resuscitative efforts during and after caesarean
- 32. CHOKING Adults /children Universal choking sign is clenching the neck Responsive: Abdominal thrust (Heimlich manoeuvre ) Unresponsive : Activate EMS and Start CPR, each time before giving breath look for obstructed objects. Do not perform blind finger sweep. Pregnant woman/ obese : Perform chest thrust, instead of abdominal thrust.
- 35. MEWS score
- 37. Criteria – MEWS score • On O2- 6lit/min • SBP<100 • PR>100 • Spo2<92% on RA – <95% with O2