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basic life support
This document provides information on basic life support (BLS) procedures including chain of survival, high quality chest compressions, rescue breathing, use of an automated external defibrillator (AED), and differences in BLS for adults, children, and infants. It emphasizes the importance of early CPR, specifically initiating chest compressions within 10 seconds, maintaining a rate of 100 compressions per minute with appropriate depth for the victim's age, and minimizing interruptions. The sequence of BLS is described as check for response, check for breathing, activate emergency response, get AED, check pulse, provide 30 chest compressions and 2 breaths.
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basic life support
- 1.
- 2. By Dr sonal gabhiye(rahud) md paediatrics
- 3. Purpose Initiating chainof survival Performing promt, high quality chest compression for adult, child, infant victim Initiating early use of an AED Pacticing 2-rescuer team CPR Relieving choking
- 4. Chain of survivalfor ADULT
- 5. Paediatric chain ofsurvival
- 6. 2010 AHA guidelinesfor CPR Change from A-B-C to C-A-B Emphasis of high quality CPR No look listen feel Routine use of cricoid pressure is not recommended Continued de-emphasis of pulse check Use of AED in infants
- 7. HIGH QUALITY CPR Start compressions within 10 seconds of recognition of cardiac arrest Push hard, push fast ATLEAST 100/min with depth 2 inches (5 cm) for adults, 2 inches (5cm) for children, 1 ½ inches (4 cm) for infants. Allow complete chest recoil after each compression Minimize interruptions in comprssions (< 10 sec) Avoid excessive ventilation.
- 9. What to do… Scenesaftey Shout for help Activate ERS and Get AED Check pulse 30 compression Check response & breathing 2 breaths
- 10. Approach safely Safe scene Rescuer Victim Scenesaftey Shout for help Activate ERS and Get AED Check pulse 30 compression Check response & breathing 2 breaths
- 11. CHECK RESPONSE Scene saftey Shoutfor help Activate ERS and Get AED Check pulse 30 compression Check response & breathing 2 breaths
- 12. CHECK RESPONSE Tap theshoulders and shout “Are you all right ?”
- 13. CHECK BREATHING Lookbreathing non breathing Normal breathing Abnormal breathing- gasping DO NOT CONFUSE AGONAL BREATHING WITH NORMAL BREATHING
- 14. AGONAL BREATHING Presentin first minutes after sudden cardiac arrest Mouth may be open & the jaw, head or neck may move with gasps. May sound like a snort, snore or groan Recognise as a sign of cardiac arrest
- 15. Scene saftey Shout forhelp Activate ERS and Get AED Check pulse 30 compression Check response 2 breaths
- 16. Scene saftey Shout forhelp Activate ERS and Get AED Check pulse 30 compression Check response 2 breaths
- 17. If anotherrescuer responds, send him/ her to activate ERS and get AED If no one responds, activate the ERS and get AED Return to victim
- 18. Scene saftey Shout forhelp Activate ERS and Get AED Check pulse 30 compression Check response 2 breaths
- 19. Locate tracheausing 2 or 3 fingers Slides finges into groove between trachea and muscle at the side of neck Feel carotid pulses Atleast 5 seconds but not more than 10 seconds Do not feel pulse- start CPR (C-A-B)
- 20. Scene saftey Shout forhelp Activate ERS and Get AED Check pulse 30 compression Check response 2 breaths
- 21. Place theheel of one hand on the center of the chest on lower half of sternum Put other hand on top Interlock fingers Straighten arms and position your shoulders directly over hands
- 22. Chest compression Atleast 2inches (5cm) down Rate 100/ min Compression: relaxation Minimize interruptions Count loudly 5 cycles (30:2)
- 23. Precautions Surface shouldbe firm Rescuers with arthritis- put one hand on sternum to push, grasp the wrist with other hand Do not move victim while CPR unless in dangerous environment
- 24. Scene saftey Shout forhelp Activate ERS and Get AED Check pulse 30 compression Check response 2 breaths
- 25. Head tilt chinlift Jaw thurst
- 26. Place onhand on victim’s forehead and push with your palm to tilt the head back Place the fingers of the other hand under the bony part of the lower jaw near the chin. Lift the jaw to bring the chin forward
- 27. Head tilt chinlift Precautions Donot press deep to soft tissue as it may obstruct the airways Do not use thumb to lift the chin Do not close the victims mouth completely
- 28. Mouth to mouthbreaths Open airway Pinch nose Take regular breath, blow for 1 second , watch chest rise If no chest rise, repeat method If unable to ventilate after 2 attempts, return to chest compression Precaution: gastic inflation
- 29. Mouth to maskbreaths Position yourselfs Place mask Seal mask- hand closer to head- index finger and thumb along the edge Thumb of 2nd hand along the bottom edge, remaining fingers- bony, margin of jaw Head tilt chin lift to open airway Deliver air over 1 second to make the victim’s chest rise
- 30. 2 – resceuerAdult CPR sequence
- 31. Jaw thurst Head,neck injury, you suspect spine injury 2 rescue Place on hand on each side of victims head Resting elbows on the surface on which victim is lying place fingers under angle of Lower jaw, lift with both hands, displace jaw forward Use thumbs to open lips
- 33. Bag mask device Require 2 rescuers Postion at head end of victim Place mask over face Use E-C clamp technique to hold mask Perform head lilt Place mask Thumb and index finger of 1 hand to make “C” on one side Remaining fingers (form an “E”) to lift angle of jaw, open airway, press face to mask Squeeze bag to give beaths, watch chest rise
- 34. 2 resuersusing the bag – mask- 3 or > 3 rescuers
- 35. BLS/CPR for CHILDRENfrom 1 year to puberty
- 36. Difference in CPRfrom adults Compression ventilation ration is 15:2 for 2 rescuer Compression depth – atleast 1/3rd chest/ 2 inches (5 cm) Compression technique- 1 or 2 handed chest compression depending on size
- 37. Activation of ERS- If you didn’t witness arrest & alone- provide 2 min CPR & then activate ERS & get AED If arrest is sudden & witnessed- leave child to activate ERS and get AED, return to child
- 38. 1-resuer BLS sequencefor child
- 39. 1 rescue BLSfor child Check response & breathing If witnessed arrest Activate ERS and Get AED Check pulse 30 compression Shout for help 2 breaths Check response & breathing If not witnessed arrest Activate ERS and Get AED Check pulse 30 compression Shout for help 2 breaths
- 40. Check pulse Femoral artery Place 2 fingers in the inner thigh, midway between the hip bone & the pubic & just below the crease (where thigh meets abdomen) Check response & breathing If witnessed arrest Activate ERS and Get AED Check pulse 30 compression Shout for help 2 breaths
- 41. Chest compression Startcycle of chest compression and breths (30:2)if…… Within 10 seconds don’t feel pulse OR Despite adequate oxygenation and ventilation HR< 60/min With signs of poor perfusion Check response & breathing If witnessed arrest Activate ERS and Get AED Check pulse 30 compression Shout for help 2 breaths
- 42. Chest compression Check response& breathing If witnessed arrest Activate ERS and Get AED Check pulse 30 compression Shout for help 2 breaths
- 43. After 5cycles if some one has not already done so, avctivate ERS and get AED
- 44. 2- rescuer childBLS sequence
- 45. Check response &breathing Check pulse 30 compression 2nd rescuer Activate ERS and Get AED 2 breaths 2nd rescuer comes 15 compression 2 breaths Breaths are important for infants and childen in cardiac arrest !
- 46.
- 47. Key differences forinfant BLS Pulse check- brachial artery Technique of compression- 2 fingers for single rescuer, 2 thumb encircling hands technique for 2 rescuers Compression depth- 1 ½ inches (4cm) Rate & ratio of 2 rescuers- 15:2 activation of ERS same as child
- 48. What to do… Scenesaftey Shout for help Activate ERS and Get AED Check pulse 30 (15) compression/ 1 (2) rescue Check response & breathing 2 breaths
- 49. Scene saftey Shout forhelp Activate ERS and Get AED Check pulse 30 (15) compression/ 1 (2) rescuer Check response & breathing 2 breaths
- 51. Chest compression Scene saftey Shoutfor help Activate ERS and Get AED Check pulse 30 (15) compression/ 1 (2) rescuer Check response & breathing 2 breaths
- 52. Compression deptha 1½ inches (4 cm) Rate 100/min; 30 : 2 for 1 rescue, 15:2 for 2 rescue 2-finger chest compression technique- 2 fingers in center of infant’s chest just below nipple line
- 53. Rescue breaths Scene saftey Shoutfor help Activate ERS and Get AED Check pulse 30 (15) compression/ 1 (2) rescue Check response & breathing 2 breaths Neck- nutral position, External Ear canal is level with top of infant’s shoulder
- 54. Mouth to mouthand nose breath Prefered method Head tilt chin lift Place your mouth over infant’s mouth and nose and make airtight seal Blow to make chest rise, give 2 breaths Repeat procedure if no chest rise
- 55. Mouth to mouth If can’t cover the nose and mouth with your mouth Head tilt chin lift Pinch victim’s nose Make mouth to mouth seal, give 2 breaths
- 56. 2- rescuer infantCPR Place both thumb side by side in center of the chest on the lower half of sternum (thumbs may overlap in small infants) Encircle the chest and support the infant’s back with the fingers of both hands Ratio 15:2, switching roles every 2 minutes
- 57. Shout for help 2nd rescuer Activate ERS and Get AED Check brachial pulse 30 (15) compression/ 1 (2) rescue Check response & breathing 2 breaths Use AED as soon as available
- 58. WHEN CAN ISTOP CPR ? VICTIM REVIVES TRAINED HELP ARRIVES TO EXHAUSTED TO CONTINUE
- 59. CPR with Advancedairway Ventilaion technique Compression to breaths (adult) Compression to breaths (infant+child) NO advanced airway (mouth to mouth, mouth to mask, bag mask) 30:2 100/min 15:2 100/min Advanced airway (endotracheal intubation, laryngeal masl airway) Compression Rate 100/min without pause for breaths 1 breaths every 6 to 8 seconds (8 to 10 breaths per minute)
- 60. Rescue breathing foradults Rescue breathing for infants and children Give 1 breath every 5 to 6 sec (10-12 /min) Give 1 breath every 3 to 5 sec (12-20/min) Give each breath in 1 sec Each breath should result in visible chest rise Check pulse very 2 minutes
- 61. Automated external defibrillator foradult and children 8 years of Age and older
- 62. Attach AED padsto the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 63. Open topof AED Turn power on Attach AED pads to the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 64. Attach padsto bare chest Choose adult pads for victim age > 8 yrs Attach adhesive pads 1 on upper right chest (below clavicle) 2nd on side of left nipple, top edge of pad few inches below axila Attach connection cables to AED box Attach AED pads to the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 66. If AEDsays “ clear the victim” be sure no one is touching victim AED will analyze the heart rhythm and take 5 to 15 seconds AED will tells you if shock needed Attach AED pads to the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 67. Attach AED padsto the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 68. Loudly state“ CLEAR the victim” Be sure that no one is in contact with victim Press SHOCK button Attach AED pads to the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 69. Attach AED padsto the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 70. If Noshock needed resume CPR Start 5 cycles / 2 min CPR AED will prompt you to repeat last two step. If “no shock advised” restart CPR Attach AED pads to the victim’s chest “CLEAR” the victim Analyze the rhythm AED advises shock clear the victim Power ON the AED Press SHOCK button Resume CPR
- 71.
- 72. Precautions AED prompt-“check pads” or “check electrodes” Quickly pull off the pads, it remove a large amount of hairs & allow pads to stick Victim has a hairy chest-shave the area with razor Victim is immersed in water- donot use AED in water, pull out of victim out of water, quickly wipe the chest Transdermal patch- remove patch and wipe area before attaching AED pads
- 73. AED for infants& for children from 1 to 8 years of age Use smaller size If not available use standard size, making sure they do not touch/ overlap Manual defibrillator is preferred to an AED If manual D-fib not available AED with pediatric dose attenuator If neither available- use an AED without a pediatric dose Use adult dose is better than No attempt at Defibrillation
- 74.
- 75. Choking in adult& child above 1 yr SIGNS MILD OBSTRUCTION SEVERE obstruction “Are you choking” “YES” Unable to speak, May NOD Other signs Can speak, cough, breath, wheeze between coughs Can’t breath, respiratory distress, attempt to cough but NO sound, Can’t speak, Cyanosis Make choking signs unconsciousness
- 76. Relieving choking inresponsive adult / child >1 yr Heimlich maneuver (abdominal thursts with victim standing)
- 77. Large person orpregnant woman Chest thurst
- 78. Relieving choking inunresponsive Shout for help Activate ERS and Get AED Begin CPR (Donot check pulse) 30 (15) compression/ 1 (2) rescue Check response & breathing Open mouth wide & look for object 2 breaths
- 79. Relief of chokingin Infants
- 80. Choking in Infants SIGNSMILD OBSTRUCTION SEVERE obstruction Can make sound, cough, breath, wheeze between coughs Can’t breath, respiratory distress, attempt to cough but NO sound, Can’t make sound, Cyanosis unconsciousness
- 81. Relieve choking inresponsive infant Kneel/ sit with infant in your lap Deliver 5 back slaps and chest thursts
- 82. Relieve choking inunresponsive infant Shout for help Activate ERS and Get AED Begin CPR (Donot check pulse) 30 (15) compression/ 1 (2) rescue Check response & breathing Open mouth wide & look for object 2 breaths
Editor's Notes
- #5 The chain of survival is a series of actions that, when performed in sequence, will give a person having a heart attack the greatest chance of survival
- #7 CC were often delayed while the rescuer opened airway to give breaths. By changing C-A-B, rescuers can start chest compression sooer & delay in the breaths should be minimal (30 chest compression require 18 sec)