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American Heart
Association
Basic Life Support
COMPILED BY :
MR. ASHISH H.
ROY
(NURSING TUTOR )
The Chain of Survival
Early access to the Emergency
Response System.
Early CPR
Early defibrillation
Early advanced care
Cardiac Arrest
No response
No adequate breathing
No signs of circulation
Recognition
Heart attack.
Chest discomfort, pressure, or pain
Lightheadedness or "feeling dizzy"
during the pain
Fainting
Sweating
Nausea
Shortness of
breath
Stroke
Facial droop
Arm weakness
Speech difficulties
FBAO
Universal sign of choking (hands
clutching the throat)
When asked if they are choking or if
they can speak, the victim cannot
speak, the airway obstruction is
severe or complete
Weak, ineffective or silent coughs
FBAO
• High-pitched sounds or
no sound when inhaling
• Increased difficulty
breathing
• Blue lips or skin (cyanosis)
CPR
Check responsiveness by gently
shaking the victim and shouting
"Are you OK?”
If the victim is unresponsive
activate EMS by
Sending a second rescuer if one is
present to phone1111 and get the
AED
CPR
• If the victim is unresponsive
activate EMS (cont’d)
– If you are alone, leave the victim to
phone 1111 and get the AED
– Once EMS has been activated kneel
at the patient’s side near the head
and turn the victim onto the back if
needed. Try to turn the victim’s
head, neck, and back as a unit
CPR
• Airway – Open the patients airway
– Head tilt-chin lift - Place the palm of
one hand on the victim’s forehead and
tilt the head back by applying firm
backward pressure. Gently lift the chin
with two fingers of the other hand
– Jaw thrust - Lift the angles of the jaw
forward without bending the neck
Head tilt-chin lift
Jaw thrust
CPR
• Breathing – hold the
airway open and look,
listen, and feel to see if
the patient is breathing.
If the patient is not
breathing give two slow
rescue breaths
CPR
• Breathing (cont’d)
– Mouth-to-mouth technique
• Breathing (cont’d)
– Barrier devices
• Face shields
• Face masks
–Cephalic technique
–Lateral technique
CPR
• Breathing (cont’d)
– Bag-mask respiration
CPR
CPR
Circulation
Check for a carotid pulse by sliding
the middle and index fingers down
into the groove created by windpipe
(trachea) and muscle at the side of
the neck (sternocleoidmastoid)
CPR
• Circulation (cont’d)
– Check for a pulse no longer than 10
seconds
– If no pulse, then start chest
compressions and prepare to use the
AED
If the victim has a pulse but is not
breathing, then perform rescue
breathing by giving one breath every 5
seconds
CPR
• Chest compressions
– Locate the correct position by sliding
fingers up the rib cage to the notch
where the ribs meet
the lower sternum
– Place the heel of one hand on the
lower half of the
sternum and the other hand on
top of the first making sure to avoid
the very bottom of the breastbone
CPR
• Chest compressions (cont’d)
– Lean forward so your shoulders are
over the compression
point and your arms are straight and
you are looking down at the patient
– Extend or interlace your fingers but
do not rest them on the patient.
Only the heel of the hand should be
in contact with the patient
CPR
• Chest compressions (cont’d)
– Compress the chest 1.5 to 2 inches
with each compression
– Provide 30 compressions and 2
rescue breaths for 2 minute (about 5
cycles) and check for signs of
circulation. If no circulation, continue
CPR and reassess every few minutes
2-Rescuer CPR
1 rescuer is positioned at the head
and performs
respiration and assesses
compressions
The other is positioned at the
patient’s side and performs chest
compressions
 Compression ratio remains 30:2 until an endotracheal tube in
placed and then it changes to 5:1
FBAO
• Conscious patient
– Stand behind the victim
– Make a fist with one hand
– Place your fist on the victim’s abdomen
slightly above the navel and below the
breastbone
– Grasp your fist with the other hand and
deliver quick upward thrusts until the
object is expelled or the victim
becomes unresponsive
FBAO
• Unresponsive patient
– Activate EMS
– Perform tongue-jaw lift by
grasping the tongue and
lower jaw with the thumb
and fingers,
lifting the mandible.
– Sweep the victims mouth with
an index finger to remove the
object
FBAO
• Unresponsive patient (cont’d)
– Open the airway and look,
listen, and feel. If breathless,
then give 1 or 2 rescue
breaths. If the chest does not
rise, then reposition the head
and reattempt to ventilate
the patient.
FBAO
• Unresponsive patient (cont’d)
– If the victims chest does not rise,
then straddle the patient and give up
to 5 abdominal thrusts
• Kneel astride the victims thighs
and place the heel of one hand
against the victims abdomen.
FBAO
• Unresponsive patient (cont’d)
• Place your other hand on top of the
first and press the hands into the
abdomen with quick upward thrusts
– Repeat the process of finger sweep,
attempt to ventilate, and abdominal
thrusts until the airway is cleared
Automatic External
Defibrillators (AEDs)
Early defibrillation is critical for
victims of sudden cardiac arrest
Sudden arrest is most often the result
of Ventricular Fibrillation (VF)
The most effective treatment of VF is
defibrillation
Defibrillation is most successful when
administered within minutes of arrest
Often ineffective if delayed
AEDs
Public access defibrillation (PAD) is
an initiative the places AEDs
throughout the community for use
AEDs
• Operation of the AED
– Power on the AED
– Attach the electrode pads to the
victim’s chest
• Place the first electrode in the upper
right quadrant of the chest between
the nipple and the collar-bone
AEDs
• Operation of the AED (cont’d)
• Place the second electrode outside
the victims left nipple with the top
of the pad several inches below
the left armpit
– Clear the victim and analyze the
heart rhythm
– Clear the victim and deliver a shock,
if necessary
AEDs
• Special considerations
– Children – The AED should not be
used for patients under 8 years old
– Water – Water may conduct the
electricity away from the victim and
may cause burns or shocks to the
victim or the rescuers. Remove the
victim from water and dry the victim
before using an AED.
AEDs
• Special considerations (cont’d)
– Implanted pacemakers or
defibrillators – If the victim has an
implanted pacemaker or defibrillator,
then do not place the electrode pad
over the implanted device but place
it instead at least 1 inch from the
device
AEDs
• Special considerations (cont’d)
– Transdermal medications (patches) –
Do not place the electrode over a
medication patch but instead remove
the patch and wipe the area clean
before application
AEDs
• The CPR-AED Protocol
– Airway - Open the airway
– Breathing - Look, listen, and feel for
breath. Give two breaths, if needed.
– Circulation - Check for circulation and
begin chest compressions, if necessary
– Defibrillation – Use the AED to provide
defibrillation
Pediatric CPR
Recognition
Respiratory arrest - Patient is not
breathing or breathing is clearly
inadequate
Cardiac arrest – Patient is
unresponsive, will not have adequate
breathing, and will have no signs of
circulation
FBAO – a sudden onset of weak or
silent coughing or an inability to
speak or stridor
Pediatric CPR
• Chain of survival
– Prevention
– Early CPR
– Early Access
– Early Advanced care
Child/Infant CPR
Check responsiveness by shouting to
the child and gently tap the child’s
foot or arm. Shout for help if the
child does not respond and begin
CPR
Open the Airway by performing the
head tilt-chin lift or jaw thrust
methods
Child/Infant CPR
• Check for Breathing by looking,
listening, and feeling for breath. If
the patient is not breathing or
breathing inadequately, then give
the patient 2 rescue breaths
Head tilt-chin lift
Jaw thrust
Child/Infant CPR
• Assess the patient’s circulation
– Feel for a carotid pulse on a child by
sliding two fingers into the groove
between the trachea and the
sternocleoidmastoid muscle
Child/Infant CPR
• Assess the patient’s
circulation (cont’d)
– Feel for a brachial pulse for an
infant on the inner part of the
upper arm between the elbow
and the shoulder
– Do not take more than 10
seconds to check for signs of
circulation
Child/Infant CPR
• Assess the patient’s circulation
(cont’d)
– If the patient has a pulse of greater
than 60 bpm but is not breathing
adequately, the patient is in
respiratory arrest. Continue rescue
breathing (1 breath every 3 seconds).
• If the patient has no pulse, then
begin chest compressions
Child/Infant CPR
• Chest compressions (one rescuer)
– Infant
• Imagine a line drawn between
the infant’s nipples
• Place 2 or 3 fingers on the infants
breastbone about 1 finger’s width
below the line
• Compress the chest one third to
one half of the depth of the chest
and release completely
Child/Infant CPR
• Chest compressions (one rescuer)
– Infant (cont’d)
• Provide compressions at a rate of at
least 100 compressions per minute
• Give one breath after every five
compressions
Child/Infant CPR
– Child
• Place the heel of the hand on the
lower half of the breastbone but
above the very bottom of the
sternum
• Continue to tilt the head with the
other hand
Child/Infant CPR
– Child (cont’d)
• Compress the chest one
third to one half of the depth
of the chest and release
completely
• Provide compressions at a
rate of about 100
compressions per minute
• Give one breath after every
five compressions
Child/Infant CPR
– Provide cycles of 5 chest compressions
and 1 rescue breath
– After providing CPR for 1 minute (about
20 cycles)
• Check for signs for circulation
• If no sign of circulation and EMS has
not been activated, leave the victim
and activate the EMS system
– After providing CPR for 1 minute
(cont’d)
• Continue to provide cycles of chest
compressions and rescue breaths
Child/Infant CPR
– Pediatric 2 rescuer CPR is essentially the
same as one rescuer CPR with one
rescuer providing rescue breaths and the
other chest compressions. The two
thumb-encircling hands technique is used
for infants with two healthcare providers
performing CPR
Child/Infant CPR
FBAO
Responsive infant
Hold the infant face down supporting
the body with the forearm and the
infants head by supporting the jaw with
the hand
Deliver up to 5 back blows with the
heel of the hand
FBAO
• Responsive infant (cont’d)
– If the object is not expelled, sandwich
the infant between both arms and turn
the body as a unit while supporting the
head and keeping the head lower than
the body
– Deliver up to 5 chest compressions in
the same way that you
would perform CPR but deliver the
thrusts toward the head. Stop if the
object is expelled
FBAO
• Responsive infant (cont’d)
– Alternate 5 back blows and 5 chest
thrusts until the object is expelled or
the infant becomes unresponsive
FBAO
• Responsive child
– For children use
abdominal thrusts to
relieve the obstruction
until the object is
expelled or the child
becomes unresponsive
FBAO
• Unresponsive child or infant
– Shout for help. If a second rescuer is
available, send them to activate the
EMS system
– Perform a tongue-jaw lift and look
for the object in the back of the
throat. Perform a finger sweep only
if you see the object
FBAO
• Unresponsive child or infant (cont’d)
– Open the airway and give a rescue
breath
– If the chest does not rise, reposition the
head and reattempt to ventilate the
patient
– If you still cannot ventilate the patient,
then perform abdominal thrusts for a
child or back blows and chest thrusts
for an infant
SUMMARY
Chain of Survival
Recognition
Adult CPR / FBAO
Automatic External
Defibrillators
Pediatric CPR / FBAO
THANKYOU FOR YOUR
ACTIVE LISTENING AND
ATTENTION..
IF ANY ANY
QUESTIONS ?
REGARDING THE TOPIC
KINDLY ASK….
The End.
?

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BASIC LIFE SUPPORT- BLS (CPR) -American Heart Association

  • 1. American Heart Association Basic Life Support COMPILED BY : MR. ASHISH H. ROY (NURSING TUTOR )
  • 2. The Chain of Survival Early access to the Emergency Response System. Early CPR Early defibrillation Early advanced care
  • 3. Cardiac Arrest No response No adequate breathing No signs of circulation
  • 4. Recognition Heart attack. Chest discomfort, pressure, or pain Lightheadedness or "feeling dizzy" during the pain Fainting Sweating Nausea Shortness of breath
  • 6. FBAO Universal sign of choking (hands clutching the throat) When asked if they are choking or if they can speak, the victim cannot speak, the airway obstruction is severe or complete Weak, ineffective or silent coughs
  • 7. FBAO • High-pitched sounds or no sound when inhaling • Increased difficulty breathing • Blue lips or skin (cyanosis)
  • 8. CPR Check responsiveness by gently shaking the victim and shouting "Are you OK?” If the victim is unresponsive activate EMS by Sending a second rescuer if one is present to phone1111 and get the AED
  • 9. CPR • If the victim is unresponsive activate EMS (cont’d) – If you are alone, leave the victim to phone 1111 and get the AED – Once EMS has been activated kneel at the patient’s side near the head and turn the victim onto the back if needed. Try to turn the victim’s head, neck, and back as a unit
  • 10. CPR • Airway – Open the patients airway – Head tilt-chin lift - Place the palm of one hand on the victim’s forehead and tilt the head back by applying firm backward pressure. Gently lift the chin with two fingers of the other hand – Jaw thrust - Lift the angles of the jaw forward without bending the neck
  • 12. CPR • Breathing – hold the airway open and look, listen, and feel to see if the patient is breathing. If the patient is not breathing give two slow rescue breaths
  • 13. CPR • Breathing (cont’d) – Mouth-to-mouth technique
  • 14. • Breathing (cont’d) – Barrier devices • Face shields • Face masks –Cephalic technique –Lateral technique CPR
  • 15. • Breathing (cont’d) – Bag-mask respiration CPR
  • 16. CPR Circulation Check for a carotid pulse by sliding the middle and index fingers down into the groove created by windpipe (trachea) and muscle at the side of the neck (sternocleoidmastoid)
  • 17. CPR • Circulation (cont’d) – Check for a pulse no longer than 10 seconds – If no pulse, then start chest compressions and prepare to use the AED If the victim has a pulse but is not breathing, then perform rescue breathing by giving one breath every 5 seconds
  • 18. CPR • Chest compressions – Locate the correct position by sliding fingers up the rib cage to the notch where the ribs meet the lower sternum – Place the heel of one hand on the lower half of the sternum and the other hand on top of the first making sure to avoid the very bottom of the breastbone
  • 19.
  • 20. CPR • Chest compressions (cont’d) – Lean forward so your shoulders are over the compression point and your arms are straight and you are looking down at the patient – Extend or interlace your fingers but do not rest them on the patient. Only the heel of the hand should be in contact with the patient
  • 21.
  • 22. CPR • Chest compressions (cont’d) – Compress the chest 1.5 to 2 inches with each compression – Provide 30 compressions and 2 rescue breaths for 2 minute (about 5 cycles) and check for signs of circulation. If no circulation, continue CPR and reassess every few minutes
  • 23. 2-Rescuer CPR 1 rescuer is positioned at the head and performs respiration and assesses compressions The other is positioned at the patient’s side and performs chest compressions  Compression ratio remains 30:2 until an endotracheal tube in placed and then it changes to 5:1
  • 24. FBAO • Conscious patient – Stand behind the victim – Make a fist with one hand – Place your fist on the victim’s abdomen slightly above the navel and below the breastbone – Grasp your fist with the other hand and deliver quick upward thrusts until the object is expelled or the victim becomes unresponsive
  • 25.
  • 26. FBAO • Unresponsive patient – Activate EMS – Perform tongue-jaw lift by grasping the tongue and lower jaw with the thumb and fingers, lifting the mandible. – Sweep the victims mouth with an index finger to remove the object
  • 27. FBAO • Unresponsive patient (cont’d) – Open the airway and look, listen, and feel. If breathless, then give 1 or 2 rescue breaths. If the chest does not rise, then reposition the head and reattempt to ventilate the patient.
  • 28. FBAO • Unresponsive patient (cont’d) – If the victims chest does not rise, then straddle the patient and give up to 5 abdominal thrusts • Kneel astride the victims thighs and place the heel of one hand against the victims abdomen.
  • 29. FBAO • Unresponsive patient (cont’d) • Place your other hand on top of the first and press the hands into the abdomen with quick upward thrusts – Repeat the process of finger sweep, attempt to ventilate, and abdominal thrusts until the airway is cleared
  • 30.
  • 31. Automatic External Defibrillators (AEDs) Early defibrillation is critical for victims of sudden cardiac arrest Sudden arrest is most often the result of Ventricular Fibrillation (VF) The most effective treatment of VF is defibrillation Defibrillation is most successful when administered within minutes of arrest Often ineffective if delayed
  • 32. AEDs Public access defibrillation (PAD) is an initiative the places AEDs throughout the community for use
  • 33. AEDs • Operation of the AED – Power on the AED – Attach the electrode pads to the victim’s chest • Place the first electrode in the upper right quadrant of the chest between the nipple and the collar-bone
  • 34. AEDs • Operation of the AED (cont’d) • Place the second electrode outside the victims left nipple with the top of the pad several inches below the left armpit – Clear the victim and analyze the heart rhythm – Clear the victim and deliver a shock, if necessary
  • 35.
  • 36.
  • 37. AEDs • Special considerations – Children – The AED should not be used for patients under 8 years old – Water – Water may conduct the electricity away from the victim and may cause burns or shocks to the victim or the rescuers. Remove the victim from water and dry the victim before using an AED.
  • 38. AEDs • Special considerations (cont’d) – Implanted pacemakers or defibrillators – If the victim has an implanted pacemaker or defibrillator, then do not place the electrode pad over the implanted device but place it instead at least 1 inch from the device
  • 39. AEDs • Special considerations (cont’d) – Transdermal medications (patches) – Do not place the electrode over a medication patch but instead remove the patch and wipe the area clean before application
  • 40. AEDs • The CPR-AED Protocol – Airway - Open the airway – Breathing - Look, listen, and feel for breath. Give two breaths, if needed. – Circulation - Check for circulation and begin chest compressions, if necessary – Defibrillation – Use the AED to provide defibrillation
  • 41. Pediatric CPR Recognition Respiratory arrest - Patient is not breathing or breathing is clearly inadequate Cardiac arrest – Patient is unresponsive, will not have adequate breathing, and will have no signs of circulation FBAO – a sudden onset of weak or silent coughing or an inability to speak or stridor
  • 42. Pediatric CPR • Chain of survival – Prevention – Early CPR – Early Access – Early Advanced care
  • 43. Child/Infant CPR Check responsiveness by shouting to the child and gently tap the child’s foot or arm. Shout for help if the child does not respond and begin CPR Open the Airway by performing the head tilt-chin lift or jaw thrust methods
  • 44. Child/Infant CPR • Check for Breathing by looking, listening, and feeling for breath. If the patient is not breathing or breathing inadequately, then give the patient 2 rescue breaths
  • 46. Child/Infant CPR • Assess the patient’s circulation – Feel for a carotid pulse on a child by sliding two fingers into the groove between the trachea and the sternocleoidmastoid muscle
  • 47. Child/Infant CPR • Assess the patient’s circulation (cont’d) – Feel for a brachial pulse for an infant on the inner part of the upper arm between the elbow and the shoulder – Do not take more than 10 seconds to check for signs of circulation
  • 48. Child/Infant CPR • Assess the patient’s circulation (cont’d) – If the patient has a pulse of greater than 60 bpm but is not breathing adequately, the patient is in respiratory arrest. Continue rescue breathing (1 breath every 3 seconds). • If the patient has no pulse, then begin chest compressions
  • 49. Child/Infant CPR • Chest compressions (one rescuer) – Infant • Imagine a line drawn between the infant’s nipples • Place 2 or 3 fingers on the infants breastbone about 1 finger’s width below the line • Compress the chest one third to one half of the depth of the chest and release completely
  • 50. Child/Infant CPR • Chest compressions (one rescuer) – Infant (cont’d) • Provide compressions at a rate of at least 100 compressions per minute • Give one breath after every five compressions
  • 51. Child/Infant CPR – Child • Place the heel of the hand on the lower half of the breastbone but above the very bottom of the sternum • Continue to tilt the head with the other hand
  • 52. Child/Infant CPR – Child (cont’d) • Compress the chest one third to one half of the depth of the chest and release completely • Provide compressions at a rate of about 100 compressions per minute • Give one breath after every five compressions
  • 53. Child/Infant CPR – Provide cycles of 5 chest compressions and 1 rescue breath – After providing CPR for 1 minute (about 20 cycles) • Check for signs for circulation • If no sign of circulation and EMS has not been activated, leave the victim and activate the EMS system
  • 54. – After providing CPR for 1 minute (cont’d) • Continue to provide cycles of chest compressions and rescue breaths Child/Infant CPR
  • 55. – Pediatric 2 rescuer CPR is essentially the same as one rescuer CPR with one rescuer providing rescue breaths and the other chest compressions. The two thumb-encircling hands technique is used for infants with two healthcare providers performing CPR Child/Infant CPR
  • 56. FBAO Responsive infant Hold the infant face down supporting the body with the forearm and the infants head by supporting the jaw with the hand Deliver up to 5 back blows with the heel of the hand
  • 57. FBAO • Responsive infant (cont’d) – If the object is not expelled, sandwich the infant between both arms and turn the body as a unit while supporting the head and keeping the head lower than the body – Deliver up to 5 chest compressions in the same way that you would perform CPR but deliver the thrusts toward the head. Stop if the object is expelled
  • 58. FBAO • Responsive infant (cont’d) – Alternate 5 back blows and 5 chest thrusts until the object is expelled or the infant becomes unresponsive
  • 59. FBAO • Responsive child – For children use abdominal thrusts to relieve the obstruction until the object is expelled or the child becomes unresponsive
  • 60. FBAO • Unresponsive child or infant – Shout for help. If a second rescuer is available, send them to activate the EMS system – Perform a tongue-jaw lift and look for the object in the back of the throat. Perform a finger sweep only if you see the object
  • 61. FBAO • Unresponsive child or infant (cont’d) – Open the airway and give a rescue breath – If the chest does not rise, reposition the head and reattempt to ventilate the patient – If you still cannot ventilate the patient, then perform abdominal thrusts for a child or back blows and chest thrusts for an infant
  • 62. SUMMARY Chain of Survival Recognition Adult CPR / FBAO Automatic External Defibrillators Pediatric CPR / FBAO
  • 63. THANKYOU FOR YOUR ACTIVE LISTENING AND ATTENTION.. IF ANY ANY QUESTIONS ? REGARDING THE TOPIC KINDLY ASK…. The End. ?