Basic life support & basic medical procedure

Basics for all health workers

1. BASIC LIFE SUPPORT & BASIC MEDICAL PROCEDURE. PRESENTED BY SHARAD CHAND IV PHARM D.

2. CONTENTS(BLS CONTENT) DEFINITION. COMPONENTS. Access Asses Call for help. Airway Breathing Circulation Defrilation . Environment

3. Assesment Shake shoulders gently Ask “Are you all right?” If s/he responds. Leave as you find him. Find out what is wrong. Reassess regularly.

4. Call for help if possible.

5. AIRWAY Head tilt and chin lift - lay rescuers - non-healthcare rescuers No need for finger sweep unless solid material can be seen in the airway

6. BREATHING Look, listen and feel for NORMAL breathing Do not confuse agona l breathing with NORMAL breathing Occurs shortly after the heart stops in up to 40% of cardiac arrests Described as barely, heavy, noisy or gasping breathing Recognise as a sign of cardiac arrest

7. FOREIGN BODY RX.

8. ILLUSTRATIONS.

9. CIRCULATION Place the heel of one hand in the centre of the chest Place other hand on top Interlock fingers Compress the chest Rate 100 min -1 Depth 4-5 cm Equal compression : relaxation When possible change CPR operator every 2 min

10. RESCUE BREATHING. Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat

11. DEFIBRILATION

12. Left lateral position.

13. REPEAT UNTILL THE.. Qualified help arrives and takes over The victim starts breathing normally Rescuer becomes exhausted

14. CONTENTS(BMP) INTRODUCTION DEFINITION. PROCEDURES Hand washing. Putting Gloves. NG TUBING(RYLE’s Tubing) IV Cannulae /Open IV. Ascitic tap. Pleural Tap. Catheterizing the bladder.

15. ADVANCE INVASIVE PROCEDURES INTUBATION/ENDOTRACHEAL INTUBATION. LAPARATOMY. CRICOTHYROIDOTOMY LUMBER PUNCTURE. BIOPSIES CSF ANALYSIS. etc

16. HAND WASHING

17. Surgical gloving

18. NG TUBING Nasogastric (Ryle's) tubes These tubes are passed into the stomach via either the nose or the mouth, and drain externally. Sizes: 16 = large, 12 = medium, 10 = small. Uses: To empty the stomach (pre-op, or in acute pancreatitis, or paralytic ileus ). For irreversible dysphagia ( eg motor neurone disease). For feeding ill patients (use a special fine-bore tube).

19. NG TUBE

20. PROCEDURE Wear sterile /non-sterile gloves. Explain the procedure. Take fresh new flexible tube. Get all requirements. Asses the lenth of tube by measurement. Lubricate the tube Stabilize pt. start process. When tube riches to throat ,encourage to swallow.

21. Continue… Continue until the pipe riches to stomach. Aspirate fluid, check pH. Stitch the tube to nostril. Use as requirement.

22. COMPLICATION Pain, or, rarely: Loss of electrolytes Oesophagitis Tracheal or duodenal intubation Necrosis: retro- or nasopharyngeal Perforation of the stomach

23. PLACING IV CANNULAE Set up tray. Set up drip with stand. Take help if required. Explain procedure. Search hard and best vein. Sit comfortably. Tap the vein Clean the skin and open vein.

24. Cannulae

25. After it is in Connect fluid tube and check flow. Fix cannulae with firm bandage. Immobilize if possible Calculate fluid rate and mention chart.

26. In case of fail procedure Explain to the patient that veins are difficult. Fetch a bowl of warm water. This gives you time to calm down. Immerse the patient's arm in the warm water for 2min. Use a blood pressure cuff at 80mmHg as a tourniquetâ €”and try again. Alternatively, a small amount of GTN paste over the vein may enlarge it

27. Asciting tapping Place the patient flat and tap out the ascites , marking a point where fluid has been identified, avoiding scars or vessels. Clean the skin. May need some local anaesthetic . Insert a 21G needle on a 20mL syringe into the skin and advance while aspirating until fluid is withdrawn. Remove the needle and apply a sterile dressing. Send fluid for microscopy, culture, chemistry (protein), and cytology.

28. Pleural tapping Percuss the upper border of the pleural effusion and choose a site 1 or 2 intercostal spaces below it (usually posteriorly or laterally). Mark the spot and then clean the area with an antiseptic solution. Infiltrate down to the pleura with 5–10mL of 1% lidocaine . Attach a 21G needle to a syringe and insert it just above the upper border of the rib below the mark (avoids neurovascular bundle). Aspirate whilst advancing the needle. Draw off 30mL of pleural fluid.

29. ENDOTRACHEAL INTUBATION. Advance invasive procedure. Require skilled hand and anaesthetic . Require special device called laryngoscope. It is done in life-threatening respiratory conditions. It is a life saving procedure.

30. LARYNGOSCOPE

31. PROCESS

32. Procedure for intubation Asses the patient and confirm need for intubation. Prepare the requirement. Obtain the laryngoscope and check it. Check the endo -tracheal tube. Maintain position in chin lift position. Start procedure Connect to ventilater .

33. REFERENCE Oxford handbook of clinical medicine,6 th edition, langmore & murray et.al the oxford university press. Harrison’s manual of medicine ,17 th edition ,Mc- Graw hill publication. The journal on European medicine program on basic life support. Mayo-clinic medicine review,7 th edition,the mayo-clinic publication. IMAGE SOURCE-EMR & GOOLE.

34. HOPE CLASS IS SOME BENIFICIAL AND MEANINGFUL.

35. THANK YOU FOR YOUR ATTENTION