C0D5ABD2-BCLS-modified1.ppt
- 1. BASIC LIFE SUPPORT (BLS) ‘save lives following cardiac arrest’
- 4. History contd… –Prone position inadequate –Expired air did provide sufficient O2 –Head tilt, chin lift kept patent airway
- 7. Response Ask, “are u all right”? no response Tap or squeeze shoulders – gently no response activate Emergency medical services • Check for no breathing or no normal breathing (i.e., gasping) • Gasping without eye opening - failure to respond – manage as unconscious
- 8. Pulse check • The lay rescuer should not check for a pulse • The healthcare provider should take no more than 10 seconds. If no pulse or doubtful, proceed with CC - Children and adults – carotid - Infants - brachial or femoral • Use two fingers and large surface area to feel over carotid or femoral
- 10. Carotid pulse
- 11. Chest compressions • victim on flat surface • “push hard and push fast” • Rate: 100 compressions/min • Compression depth : 4-5 cm in adults, : 1/2 - 1/3 of chest in infants • Landmark: - lower 1/2 of sternum , between nipples in children & adults - just below nipple line in infants
- 14. Chest compressions • Allow complete recoil of chest after each compression • Minimize interruptions in chest compressions • Swap rescuers every 2 minutes (6-8 cycles) to avoid exhaustion • Compressions should be paused for ventilations till airway is secured
- 15. Ventilation • Head tilt and chin lift to open airway unless cervical injury is suspected • Rescue breaths
- 18. Rescue breathing • Give 2 breaths each over 1 second • Sufficient tidal volume to produce visible chest rise • Low minute ventilation can maintain effective oxygenation during CPR • Avoid rapid or forceful breath
- 19. Rescue breathing • Mouth to mouth breathing - open victim’s airway - pinch the nose , airtight mouth-mouth seal give 1 breath over 1 second - take regular (not a deep ) breath • Mouth to barrier device • Bag and mask • Ventilation with advanced airway “No pause in compressions for ventilation if advanced airway is placed”
- 20. Mask ventilation
- 23. • IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN RECOVERY POSITION
- 26. Scenarios
- 27. Rescue breathing without CC • Pulse is felt but no breath then give breath children/adults : 10-12 breaths/min infants : 12-20 breath/min. • Reassess the pulse every 2 min • No more than 10 seconds in doing so
- 28. Compressions only CPR • If you are not able or are unwilling to give rescue breaths, give chest compressions only • If patient is gasping immediately start compressions Intra-thoracic pressure won’t increase and RR also will become low • Should be continuous, at a rate of 100 /min • Stop to recheck the victim only if he starts breathing normally
- 29. Phone first or CPR first? • This confusion occurs when rescuer is single • Adult collapsing suddenly - mostly cardiac arrest----call first then start CPR • If the likely cause of unconsciousness is a breathing problem e.g., drowning, trauma, chocking, intoxication or victim is an infant then do CPR for 2 mins or 5 cycles then call for help
- 30. When to Stop CPR ??? CPR should be continued till : • Qualified help arrives and takes over • Return of spontaneous circulation (ROSC) • The patient recovers • An authorised person pronounces life extinct • Rescuer becomes exhausted
- 31. Special occasion - Pregnancy • CPR in pregnant victim: - In pregnant woman the uterus causes pressure on the major abdominal organs when she lies flat, reducing the venous return to the heart - give pelvic tilt to left using pillow/wedge as blood supply to fetus should not be jeopardized
- 32. Special occasion - chocking • Responsive Adult/Child Abdominal thrusts until object is removed or victim becomes unresponsive • Unresponsive Adult/Child Lower them to the ground and begin the steps of CPR Look in the mouth before each breath If you see the object, you can remove it
- 34. Early defibrillation • Early defibrillation implies that defibrillation carried out within 5 mins of cardiac arrest • Survival decreases by 10% for every minute that passes without defibrillation
- 35. Defib….
- 36. AED (Automated External Defibrillator) • AEDs are computerized devices that allow laypersons to attempt defibrillation safely. • AEDs are recommended for all ages >1 yr • AHA has approved low energy defibrillation with biphasic waveform AED for VT/VF • AEDs are highly accurate in rhythm detection • It delivers fixed three shock sequence of 150 or 200j
- 37. AED contd… • Power on the AED • Apply pads to the victim's bare chest • Plug the pads into the AED • "Clear" the victim and allow it to analyze • If a shock is advised, "clear" the victim again and press the shock button
- 38. ATTACH PADS TO CASUALTY’S BARE CHEST
- 39. ANALYSING RHYTHM DO NOT TOUCH VICTIM
- 40. SHOCK INDICATED • Stand clear • Deliver shock
- 41. SHOCK DELIVERED FOLLOW AED INSTRUCTIONS
- 42. Take home message – Compressions are vital – Minimal interruption of chest compressions – Push hard and fast – 8-10 breaths per minute – Delivered over one second duration – 30/2 compression ventilation ratio – Compressions immediately after defibrillation
- 43. Cough CPR/ Prone CPR • Cough cpr-Recommended only for awake monitored victim getting VF/VT • Prone cpr – when supine position cannot be given blood pressure is raised in prone CPR than supine CPR.