BASIC LIFE SUPPORT (BLS)

BASIC LIFE SUPPORT- IT IS A TYPE OF CARE GIVEN TO PEOPLE EXPERIENCING CARDIAC ARREST, RESPIRATORY DISTRESS OR AN OBSTRUCTED AIR WAY. BLS IS PERFORMED BY HEALTHCARE PROFESSIONALS, FIRST RESPONDERS AND PUBLIC SAFETY PERSONNEL.

1. CARDIO PULMONARY RESUSCITATION BY- BANDITA PATRA ASSOCIATE PROFESSOR

2. OBJECTIVE WHO WHY WHEN WHERE WHAT HOW

3. WHAT IS CARDIAC ARREST Cessation of normal circulation of blood due to failure of heart to contract effectively. Sudden cessation of mechanical activity of heart with some or no electricalactivity. May be reversible by a rapid intervention but will lead to death in its absence.

4. R E V E R S IBLE C A U S ES O F C A R D IAC ARREST 5 Ts: Pulmonary thro mb o e m bo lism Tension pn e u m o t h or a x Cardiac Tamponade Toxins (TCAs,b- blockers,ca channel blocker,digoxin) Coronary thrombosis 5 Hs: Hypoxia Hypovolemia Hypo/hyperkalemia Hydrogen ions Hypothermia

5. M.I. Arrhythmia Low C.O.,failure,shock Cardiomyopathy Myocarditis Massive pulmonary emboli CARDIAC: OTHERS C o ronary arte r y d i sease  S e vere an a phy l a x is Suffocation Electrocution Trauma Stroke E x sangu i nation (severe loss of blood) Drowning CAUSES OF CARDIAC ARREST

6. BLS Its Cardiopulmonary Resuscitation (CPR). It Combines rescue breathing and chest compressions It requires knowledge and skill to perform CPR and how to operate AED / defibrillartor. These are Sequences of procedures performed to restore the circulation of oxygenated blood after a sudden pulmonary and/or cardiac arrest

7. ABC to CAB

8. Basics of BLS Chest compressions Airway Breathing Defibrillation

9. STEPS of BLS Assessment and scene safety Scene is safe?? Asses the patient Check breathing

10. Assesse the patient Shake shoulders gently Ask “Are you all right?” If he responds Find out what is wrong. Reassess regularly.

11. Check for pulse: no more than 10 sec Feel the pulse Feel the pulse at least for 5 seconds Slide the finger laterally Into the groove between trachea and muscle Locate the trachea Using 2 or3 fingures

12. SHOUT FOR HELP

13. Start CPR Ratio: 30:2 High quality CPR Chest compression is foundation of CPR Push hard and push fast 100-120/min 2.5-2-1.5 inch depth Allow complete chest recoil Avoid excessive ventilation Minimize interruption <10 seconds Effective rescue breaths.

14. Chest Compressions Position yourself at patient’s side Victim should be laid on firm, flat surface Remove the clothings of the patient. 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 the former hand.

15. Strengthen arms and shoulders ditrectly over hands Lock all joints ; movement is allowed only at hip joint Push hard and fast ( 100 - 120 times / min) At the end of each compression, chest is allowed to recoil completely Avoid excessive ventilation Then give next compression immediately

16. Chest Compressions

17. Mechanisms Cardiac Pump – Blood pumping is assured by compression of heartbetween sternum and spine Between compressions, thoracic cage expands and heart gets filled with blood.

18. Thoracic Pump

19. Opening the airway

20. Caution Do not press deeply into the soft tissue Don’t use thumb to lift the chin Don’t close mouth completely

21. Jaw thrust

22. RESCUE BREATHS 26 RECOMMENDATIONS : Tidal volume 500 – 600 ml Respiratory rate give each breaths over about 1s with enough volume to make the victim’s chest rise

23. T y pe s Mouth to mouth breathing Mouth to barrier device breathing Mouth to nose and mouth to stoma ventilation Ventilation with bag and mask

24. Mouth-To-Mouth breath

25. Mouth-To-Nose breath Given when mouth cant be open Good seal cant be made Severe injury present over area of mouth

26. Mouth-To-Barrier device

27. Bag and Mask ventilation  Position yourself directly above patient’s head Perform head tilt Make “C” with thumb and index finger to seal the mask And other 3 fingers,forms “E” jawthurst Chest rise is checked while squeezing the bag to give breaths to the patient.

28. BagAnd Mask Ventilation

29. Defibrillation is used for the treatment of tachydysrhythmias . Defibrillation depolarises the critical mass of myocardial cell at once. It recaptures the SA node as its role as the pacemaker . Is treatment of choice for pulseless VT/VF. Prof. Dr. RS Mehta, BPKIHS Defibrillation

30. DEFIBRILLATION

31. Ventricular tachyc a rdia 35 Prof. Dr. RS Mehta, BPKIHS

32. V entricular fibrillation 36 Prof. Dr. RS Mehta, BPKIHS

33. Defibrillators can be classified as : Monop ha s ic (d eli v e rs cur r e nt of one polarity only) Biphasic (deliver current of 2 polarity) Defibrillator 37 Prof. Dr. RS Mehta, BPKIHS

34. Position of defibrillator paddle: 1 st pa d d l e - o n t h e right side of the chest just below the clavicle 2 nd at precordial, region. Paddle should be applied with pressure equivalent to 10 kg. 38 Prof. Dr. RS Mehta, BPKIHS

35. Adult: 13cm Children:8cm Infants:4.5cm Latest Recommendation for shock protocol ; Previous recommendation of 3 successive shock (200,300,360J) Now a days only single shock is recommended .i.e. 360J by monophasic 150-200J by biphasic Pa d dle size 39

36. First turn it on. Then simply follow instructions . Using an AED 43

37. AUTOMATED EXTERNAL DEFIBRILLATOR (AED) Some AEDs will automatically switch themselves on when the lid is opened

38. ATTACH PADS TO CASUALTY’S BARE CHEST

39. ANALYSING RHYTHM DO NOT TOUCH VICTIM

40. SHOCK INDICATED Stand clear Deliver shock

41. SHOCK DELIVERED FOLLOW AED INSTRUCTIONS 30 2

42. IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN RECOVERY POSITION

43. THANK YOU FOR YOUR ATTENTION