2. Introduction
• is a process by which an individual’s basic cardiac and
respiratory functions can be restored and
maintained through a combination of expired air
resuscitation (EAR) and external cardiac
compressions (ECC).
• Cardiopulmonary arrest is the indication for BLS
which mean the state of pulseless apnoea , Most
common cause is hypoxia .
• Bradycardia is a sign of deterioration if you catch it
DON’T WAIT THE ARREST !!!
5. Danger
• Check for Danger
• To you
• To others
• To the Casualty
• Make the area safer or remove yourself and
casualty to an area of safety.
• If an area is too dangerous stand back and call
emergency services.
6.
7. Response
• Check the Child for a response
• Response may vary due to the age of the child.
• Most basic method of assessment is the ‘Talk &
Touch’ approach.
• Can also use the COWS Method.
C an you hear me?
O pen your eyes.
W hat is your name?
Squeeze my hand
• Rubbing on the palms of the hands or soles of an
infant’s feet may elicit a response.
8.
9. Help
• Help can be anyone nearby, but you should aim to contact a healthcare
professional or service as quickly as possible.
10.
11. Airway assessment
• In an unconscious casualty, the maintaining/gaining
a patent airway is the top priority.
• Check the airway is open and clear of obstructions.
• In an unconscious patient, the tongue is the most
common cause of obstruction.
• Also check the airway for blood, vomit & any other
foreign materials.
• If the airway is blocked, the casualty can’t breathe.
12. Airway clearance
• Clearing the airway
1. Turn child on one side.
2. Clearing visible foreign material from
mouth and nostrils.
3. If suction is available use suction to clear
material.
• Back Blows
• Chest Thrust
• Placing the child in the recovery position,
if they are breathing, and post airway
clearance can be useful.
13. Airway maneuver
• Airway manoeuvres and appropriate positioning in children can differ from
adults, dependant upon size.
• Infants (<1yr) should have their head in the horizontal or neutral position.
Head tilt/Chin lift
• Tilt head backwards (not neck)
• Support jaw at the point of the chin
Jaw Thrust
• Good if neck injury is suspected
• Difficulty with obtaining adequate
airway with Head tilt/chin lift.
14.
15. Breathing
Look, Listen & Feel
• Up to 10 secs
• Look for rise and fall of the chest
• Listen for breath sounds or air arising from the
nose or mouth
• Feel for chest wall movement
• If not breathing, and the casualty has a patent
airway, rescue breathing should be commenced.
• In clinical situations use a face mask to deliver
breaths.
16.
17. CPR
• CPR = Compression + Ventilation
• COMPRESSION RATE: 100 compressions/min
• Useful tunes to keep the rate are ‘Staying Alive’ – Bee Gees, Another one bites
the Dust and many more.
• RATIO: 30 Compressions to 2 ventilations (breaths)
• CYCLES: 5 cycles of [30:2] in approximately 2 minutes. Recheck for signs of life
at the end of cycle.
• Pause compressions to allow for ventilation.
18. CPR : Assessment
• Most important step is recognising need for CPR.
• CPR should be commenced immediately in children if;
1. Unresponsive
2. Not breathing normally
3. Not moving, signs of life.
• Lay rescuers should begin CPR, based upon the above
information. Checking for a pulse is not required or
recommended.
• For HCPs, the Brachial or Femoral pulse are typically the
easiest to assess. If pulse not identified within <10
seconds CPR should commence.
19. CPR : Where you should do it ?
• You do Chest Compressions in
approximately the same place right
through from infants to adults.
• Compressions are done in the midline on
the lower half of the sternum or the
‘centre of the chest’.
• The nipples can be used as landmarks to
guide you to where you should be doing
your compressions.
Sternum
Compressions should not be done
over the lower end of the sternum or
abdomen
20. CPR : How to do it
• Push hard and fast, with straight arms.
• Infants (<1yo)
• Use 2 fingers over the centre of the chest.
• Compress to 1/3 depth of chest wall (~4cm).
• Child (1-8yrs)
• Use heel of 1 hand, or alternatively 2 hands,
with one positioned on top of the other.
• Compress 1/3 depth of chest wall (~5cm) in
the centre of the chest.
• Greater than 8yrs = same as adult
21. CPR : Notes
• Don’t stop CPR to check for a response or
breathing – except at the end of a cycle.
• Interruptions to CPR should be minimised.
• If possible change the person giving
compressions every 2 minutes.
• CPR should continue until the casualty becomes
responsive, or a healthcare professional arrives.
22.
23. Defibrillator
• If a Defbrillator (e.g. Automated External
Defibrillator – AED) is available, apply and follow
voice prompts.
• CPR continues until the AED is present, all the pads
are in place and the AED is on.
• AEDs accurately identify heart rhythms as either
‘shockable’ or ‘non-shockable’.
• Remember when shocking the casualty to get
everyone to stand well back. Do not touch them!
24. Defibrillator
• AEDs can be used on children of any age.
• However, for small children & infants, paediatric pads and an AED
with a Paediatric functionality should be used if available.
• Large children can use the normal adults pads & AED.
• Pad Placement
• Most pads have a diagram on them illustrating where to place
them (e.g. right upper chest & left lower side).
• Pads should never be touching each other.
• In small children you can alternatively place one pad on the front
of the chest, and one on the back.