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Similar to bls and acls_124320.pptx It will help in better understanding of the topic
bls and acls_124320.pptx It will help in better understanding of the topic
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- 3. What is BLS?? Basic life support refers to the type of care that first responders, healthcare providers and public safety professionals provide to anyone who is experiencing cardiac arrest , respiratory arrest and obstructed airway. -American Red Cross
- 4. Approach safely Check response Callfor help Check breathing and pulse 30 chest compressions 2 rescue breaths Rapid defibrillation ALS
- 5. APPROACH SAFELY! Scene Rescuer Victim Bystande rs Approach safely Checkresponse Call for help Check breathing and pulse 30 chest compressions 2 rescue breaths Rapid defibrillation ALS
- 6. CHECK RESPONSE Approach safely Checkresponse Call for help Check breathing and pulse 30 Chest compressions 2 rescue breaths Rapid defibrillation ALS
- 7. Shake shoulders gently Ask“Are you all right?” If he responds • Find out what is wrong. • Reassess regularly. CHECK RESPONSE
- 8. CALL FOR HELP Approachsafely Check response Call for help Check breathing and pulse 30 chest compressions 2 rescue breaths Rapid defibrillation ALS
- 9. CHECK BREATHING &PULSE • Check breathing and pulse simultaneously • Do not confuse agonal breathing with NORMAL breathing
- 10. Check breathing? • Inspectingthe chest rise of patient while palpating carotid pulse (saves time) • OR Lay rescuer can check by keeping our fingers in front of nostrils/keeping ears close to nose to check if any blow of expired air is present or not. • Agonal gasps or abnormal breathing patterns may get confused with normal respiration by lay man rescuer.
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- 12. 30 CHEST COMPRESSIONS Approachsafely Check response Call for help Check breathing and pulse 30 chest compressions 2 rescue breaths ALS Rapid defibrillation
- 13. C P R •Start CPR immediately after checking and observing there is no 1. RESPONSIVENESS 2. BREATHING 3. PULSE
- 14. Chest Compressions • Technique- oPosition yourself at patient’s side o firm, flat surface and o remove all the clothings o Put the heel of one hand on the centre of chest (sternum) at the level of nipples and put your other hand on the top of that hand.
- 16. Chest Compression • Technique- oLock all joints ; movement is allowed only at hip joint o Push hard and fast (100 - 120 times / min) o At the end of each compression, chest is allowed to recoil completely • Depth- 5 cms to 6 cms (2 inches to 2.4 inches)
- 17. RESCUE BREATHS Approach safely Checkresponse Call for help Check breathing and pulse 30 chest compressions 2 rescue breaths Rapid defibrillation ALS
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- 20. Rescue Breath • Eachrescue breath over 1 second • Visible chest rise • 30 compression: 2 breaths (no advanced aiway) • Advanced airway- o Give 1 breath every 6 to 8 seconds without attempting to synchronise breaths between compressions o 8-10 breaths per min
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- 22. Defibrillation • Important insaving patient of cardiac arrest • Mechanism- A defibrillation shock must be strong enough to stun or excite a large majority of the cardiac tissue. If a sufficient portion of the cardiac tissue were made temporarily unexcitable by a shock, the uncoordinated wavefronts of excitation that perpetuate VF would be extinguished, and would allow normal cardiac excitation and contraction to resume.
- 23. What is AED? •Automated External Defibrillator • A portable electronic device that automatically diagnose the life- threatening cardiac arrhythmias of ventricular defibrillation and pulseless VT and is able to treat them through defibrillation. • Possible for more people to respond to medical emergency where defibrillation is required • Can be used by lay-rescuer trained in CPR
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- 25. AEDs • Made partof emergency response program • Gives simple audio and visual commands,making its use easy • Should be available at public places like stations, stadiums, airports, malls etc. • Can’t be overriden manually and takes upto 10-20 sec to detect arrhythmias • Now a part of BLS program because early defibrillation is found to increase survival rate of patient
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- 27. IF VICTIM STARTSTO BREATHE NORMALLY PLACE IN RECOVERY POSITION
- 28. ADVANCED CARDIAC LIFESUPPORT
- 29. What is ACLS?? Advanced cardiac life support or advanced cardiovascular life support refers to a set of clinical guidelines for the urgent and emergent treatment of life threatening cardiovascular conditions that will cause or have caused cardiac arrest , using advanced medical procedures, medications and techniques. -AMERICAN HEART ASSOCIATION
- 31. INITIAL MANAGEMENT After recognitionof arrest C Compressions A Managing airway B Rescue breathing ANY CPR Is better than NO CPR
- 32. Advanced Airway Endotrachealintubation or supraglottic advanced airway Once advanced airway in place, give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions
- 33. Is the rhythmshockable? Continue performing excellent chest compressions while the defibrillator or AED is being attached. Reassume CPR immediately after any shock is given . Biphasic defibrillation are recommended because of their increased efficacy at lower energy level. Start with the dose recommended by the manufacturer which is typically 120-200J
- 34. MANAGEMENT OF SPECIFICARRHYTHMIAS VF and PULSELSS VT are nonperfusing rhythms, emanating from the ventricles for which early rhythm identification , defibrillation and CPR are the mainstays of treatment. Early defibrillation is the most critical action in the resuscitation effort, followed by the performance of the excellent CPR.
- 35. Every shockafter the initial shock should be of equal or greater strength If VF or pulseless VT persists after at least one attempt at defibrillation and two minutes of CPR , give epinephrine (1mg IV every 3 to 5 mins) while CPR is performed continuously Amiodarone is given in case of persistent shockable rhythm
- 36. Shock Energy forDefibrillation Biphasic: Manufacturer recommendation (eg, initial dose of 120-200 J); if unknown, use maximum available. Second and subsequent doses should be equivalent, and higher doses may be considered. • Monophasic: 360 J
- 37. ASYSTOLE AND PULSELESSELECTRICAL ACTIVITY Asystole is defined as a complete absence of demonstrable electrical and mechanical cardiac activity Pulseless electrical activity (PEA) is defined as any of a heterogenous group of organized electrocardiographic rhythm without sufficient mechanical contraction of the heart to produce a palpable pulse or measurable blood pressure.
- 38. After initiatingCPR, treat reversible cause as appropriate and administer epinephrine (1mg IV every 3 to 5minutes) Atropine is no longer recommended for the treatment of asystole or PEA.
- 39. Reversible Causes Hypovolemia Hypoxia Hydrogen ion (acidosis) Hypo-/hyperkalemia Hypothermia Tension pneumothorax Tamponade, cardiac Toxins Thrombosis, pulmonary Thrombosis, coronary
- 40. Return of SpontaneousCirculation (ROSC) Pulse and blood pressure can be observed on the monitor Spontaneous arterial pressure waves with intra-arterial monitorin
- 42. POST CARDIAC ARRESTCARE The following summarizes the AHA algorithm for adult post cardiac arrest care : Optimize ventilation and oxygenation Treat hypotension Perform a 12 lead ECG to determine whether acute ST elevation or ischemia is present For ST elevation myocardial infarction (STEMI) , perform coronary reperfusion with PCI.
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Editor's Notes
- #3 A level of medical care which is used for victims of life- threatening illnesses or injuries until they can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by qualified bystanders.