BASIC LIFE SUPPORT / orthodontic courses by Indian dental academy

SEMINAR ON
BASIC LIFE SUPPORT
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

As they rightly say that
“A STITCH IN TIME SAVES NINE”
But presence of mind coupled with
quick timely action saves many a
lives.

INTRODUCTION :-
 The air we breathe in travels to our lungs where
oxygen is picked up by our blood and then pumped by
the heart to our tissue and organs. When a person
experiences cardiac arrest - whether due to heart
failure in adults and the elderly or an injury such as
near drowning, electrocution or severe trauma in a
child - the heart goes from a normal beat to an
arrhythmic pattern called ventricular fibrillation, and
eventually ceases to beat altogether.

 Prevents oxygen from circulating throughout the body,
rapidly killing cells and tissue. In essence, Cardio (heart)
Pulmonary (lung) Resuscitation (revive, revitalize) serves
as an artificial heartbeat and an artificial respirator.
 CPR may not save the victim even when performed
properly, but if started within 4 minutes of cardiac arrest
and defibrillation is provided within 10 minutes, a
person has a 40% chance of survival.
 Invented in 1960, CPR is a simple but effective procedure
that allows almost anyone to sustain life in the first
critical minutes of cardiac arrest. Provides oxygenated
blood to the brain and the heart enough to keep vital
organs alive until emergency equipment arrives.

 BLS = Maintaining an airway, supporting breathing
and circulation
 It comprises of : initial assessment, airway maintenance,
expired air maintenance[ mouth to mouth ventilation ]
and chest compression } cardiopulmonary
resuscitation

 In basic life support no instruments are use and when a
simple airway or face mask for mouth to mask
resuscitation is use it is called as basic life support with
airway adjunct.
 Also called as HOLDING OPERATION as adequate
ventilation and circulation are maintained until a means
can be obtained to reversed the underlying cause of
arrest.
 The guidelines for BSL are given by American Heart
Association in case of cardiac arrest, respiratory failure,
choking, drowning,.

 Bystander resuscitation improves outcome significantly.
There is good evidence from experimental models that
doing either chest compression or expired air ventilation
alone may result in a better outcome than doing nothing.
 It follows that outcomes could be improved if bystanders
who would otherwise do nothing, were encouraged to
begin resuscitation, even if they do not follow an
algorithm targeted specifically at adult & children.
 There are, however, distinct differences between the
predominantly adult arrest of cardiac origin and the
asphyxial arrest which occurs commonly in children

•Drowning is easily identified. It can be difficult, on the
other hand, for a layperson to determine whether
cardiorespiratory arrest has been caused by trauma or
intoxication.
•These victims should, therefore, be managed according
to the standard protocol.

 Sequence of Action
1. Ensure safety of rescuer and victim.
2. Check the victim for a response: Gently shake
the victim's shoulders and ask loudly, "Are you all
right?"
3. a. If there is a response (the victim answers or
moves):
Do not move the victim (unless he or she is in
further danger), check the victim's condition, and
get help if needed.
Reassess the victim's condition regularly.
b.If the victim does not respond:- BSL

CALL FOR HELP

REMEMBER
 DO NOT leave the victim alone.
 DO NOT try make the victim drink water.
 DO NOT throw water on the victim's face.
 DO NOT prompt the victim into a sitting position.
 DO NOT try to revive the victim by slapping his face.
 approach the victim after determining that the scene is
safe: always check for any potential hazards before
attempting to perform CPR

POSITION THE PATIENT

OPEN THE AIRWAY

JAW THRUST MANEUVER
{in case of spine injury,
But if this fails then chin lift maneuver
as airway is priority}

Perpendicular line to surface

Mouth to mouth breathing

Mouth to nose breathing

Locate the carotid pulse

Locate the rib margin Locate the notch where the
Rib meets sternum
EXTERNAL CHEST COMPRESSION

Locating the correct hand
Position on lower half of the
Sternum.

Proper position of rescuer: shoulders directly
over victim's sternum; elbows lockedwww.indiandentalacademy.com

External chest compressions: sternum compressed
to a depth of 1 1/2 - 2 inches. Compression-relaxation
duration must be 50:50 for better flow to occur.

One-rescuer adult CPR. Fifteen compressions
are alternated with two ventilations

Two-rescuer CPR: Pause after the 5th external
chest compression as ventilator gives
a rescue breath

Universal distress signal for foreign body airway obstruction

Subdiaphragmatic abdominal thrust (the Heimlich maneuver)
administered to a conscious (standing) victim
of foreign body airway obstruction.

Subdiaphragmatic abdominal thrust (the Heimlich maneuver)
administered to an unconscious (lying) victim
of foreign body airway obstruction - astride position.

Finger sweep maneuver
administered
to an unconscious victim of
foreign
body airway obstruction
Crossed-finger
technique for
opening the airway

Chest thrust
administered to a
conscious victim
(standing) of foreign
body
airway obstruction
Chest thrust administered
to an unconscious victim
(lying) of foreign body
airway obstructionwww.indiandentalacademy.com

Locating and palpating
the brachial pulse
Rescue breathing with an airtight
seal around the mouth and nose.
Tilt the head back into what is
called the "sniffer's position"

Locating finger position
for chest compressions
in an infant
Locating hand position
for chest compressions
in a child.

Heimlich
maneuver
conscious child
standing
Heimlich
maneuver
unconscious
child, lying

Back blow
in an infant
Chest thrust in
an infant.

Hand position for chest encirclement
technique for external chest compressions
in neonates

 According to recent statistics sudden cardiac arrest is
rapidly becoming the leading cause of death in India.
Once the heart ceases to function, a healthy human brain
may survive without oxygen for up to 4 minutes without
suffering any permanent damage. Unfortunately, a
typical EMS [emergency medical service] response may
take 6, 8 or even 10 minutes.
 It is during those critical minutes that CPR can provide
oxygenated blood to the victim's brain and the heart,
dramatically increasing his chance of survival.

 The first thing to remember about Child CPR is this: in
children cardiac arrest is rarely caused by heart failure
but rather by an injury such as poisoning, smoke
inhalation, or head trauma, which causes the breathing
to stop first. And since children are more resilient than
adults statistics have shown that they tend to respond to
CPR much better if administered as soon as possible.

• The following minor modifications to the adult sequence
will, however, make it even more suitable for use in children:
•Give five initial rescue breaths before starting chest
compressions
• perform CPR for approximately 1 min before going for help.
• Compress the chest by approximately one-third of its depth.
Use two fingers for an infant under 1 year; use one or two
hands for a child over 1 year as needed to achieve an adequate
depth of compression.
The same modifications of five initial breaths, and 1 min of
CPR by the lone rescuer before getting help, may improve
outcome for victims of drowning.

•Following successful treatment for choking, foreign material
may nevertheless remain in the upper or lower respiratory tract
and cause complications later.
•Victims with a persistent cough, difficulty swallowing, or with
the sensation of an object being still stuck in the throat should
therefore be referred for a medical opinion.
•Abdominal thrusts can cause serious internal injuries and all
victims receiving abdominal thrusts should be examined for
injury by a doctor.

•Both ventilation and compression are important for victims of
cardiac arrest when the oxygen stores become depleted – about
4-6 min after collapse from ventricular fibrillation (VF), and
immediately after collapse for victims of asphyxial arrest.
Previous guidelines tried to take into account the difference in
causation, and recommended that victims of identifiable
asphyxia (drowning; trauma; intoxication)
• The majority of cases of sudden cardiac arrest out of hospital,
however, occur in adults and are of cardiac origin due to VF.

ADULT
(over 8 years of age)
CHILD
(12 months to 8 years)
INFANT
(up to 12 months)
Check For
Responsiveness
By shaking and shouting By shaking and shouting By patting feet and chest
Dial 9-1-1 If unresponsive After 1 to 2 minutes of CPR After 1 to 2 minutes of CPR
Pulse Location Carotid artery (neck) Carotid artery (neck) Brachial artery (arm)
Airway
Lift the neck and tilt the
head back
Lift the neck and tilt the
head back
Slightly tilt the head into
"sniffer's position"
Breathing
Pinch the nose; give 2
breaths
Pinch the nose; give 2
breaths
Mouth over mouth & nose; give
2 gentle puffs
Circulation
2 hands, 2 inches;
30 compressions
1 hand, 1 inch;
30 compressions
2 fingers, ½ chest depth;
30 compressions
CHECK FOR PULSE EVERY MINUTE. REPEAT A-B-C CYCLE AS NECESSARY UNTIL AMBULANCE ARRIVES.

REFERENCES :-
 Peter Booth, Stephen Schendel: primary care of
maxillofacial injuries ; maxillofacial surgery ;vol 1 2nd
edition ; 12-16, churchill livingstone publication.
 Raymond Fonseca, Robert Walker: emergency and
intensive care of trauma patient ; oral and maxillofacial
trauma; vol 1 2nd
edition ; w.b saunders company
publication.

 2005 American Heart Association guidelines for
cardiopulmonary resusitation and emergency
cardiovascular care: part 4; Adult Basic Life Support.
( circulation 2005;112;1V-19-1V-34 ).
 Currents in emergency in cardiovasular care; highlights
of the2005 American Heart Association guidelines for
cardiovascular care.
( volume 16 number 4 winter 2005-2006 ).

 R.M. Edwards, D.A Simpson; emergency management ;
cranio-maxillofacial trauma 219-220; 1995; churchill
livingstone publication
 2005 American Heart Association guidelines for
cardiovascular care: part 11; pediatrics Basic Life
Support.

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