Basic Life Support made easy and explained in details

BASIC LIFE SUPPORT

1. BASIC LIFE SUPPORT (BLS)

2. Define BLS Explain steps and components of BLS Explain Chain of survival Explain about Defibrillator Orientation and Demonstration OBJECTIVES

3. Sudden cardiac arrest is rapidly becoming the leading cause of death across age group. Once the heart ceases to function, a healthy human brain may survive without oxygen for only up to 4 minutes without suffering any permanent damage. Unfortunately a typical EMS response may take 6, 8 or even 10 minutes. INTRODUCTION

4. Therefore during these critical minutes if CPR is initiated then the chance of survival without any neurological injury increases. And if properly instructed, almost anyone can learn and perform CPR.

5. Basic Life Support (BLS) refers to the care healthcare providers and public safety professionals provide to patients who are experiencing respiratory arrest , cardiac arrest or airway obstruction. It involves assessing and performing high quality CPR, using AED and relieving an obstructed airway. What is BLS ??

6. Anyone who knows how to do it Anywhere Immediately No Complex Device PERFORMED BY

7. If the patient is not breathing but has a definitive pulse, then the patient is in respiratory arrest. Main aim is to maintain the patency of the airway and provide ventilation. Respiratory Arrest

8. If there is no breathing, no pulse and the patient is unresponsive, then the patient is in cardiac support. The aim is to restore the circulation through mechanical or electrical stimulation and provide oxygenation. Cardiac Arrest

9. Myocardial Infarction Heart failure Airway obstruction Pneumothorax Pulmonary embolism Electrolyte imbalance Drug toxicity Common Causes for Sudden Cardiac Arrest

10. Series of life saving actions that improve the chance of survival after a cardiac arrest To achieve early and effective CPR is the key. CPR ( Cardio-Pulmonary Resuscitation )

11. Support and Restore Oxygenation, Ventilation and Circulation to prevent Neurological injury. Goal of Resuscitation

12. Strong chain made of small but strong links Chain Of Survival

13. Scene Rescuer Victim Approach Safely!

14. Step 1 Check Responsiveness/Breathing Face the victim Tap on shoulder & shout Are you all right? Scan chest for movement look for Absent or Abnormal Breathing Look or scan chest for 5-10 Sec If no Response ?

15. Shout for Help ask to Activate EMS If no help activate EMS (108) Yourself Give full details Ask for AED Don’t hang up till told to Step 2 Activate EMS & get AED

16. Pulse Check If no pulse? Start CPR Step 3 Circulation

17. Which? Carotid artery How? Maintain head tilt with one hand Use 2-3 fingers of other hand to locate trachea Slide fingers into groove b/w trachea & muscles of same side of neck How long? Not > 10 secs Pulse Check

18. Victim on firm flat surface Rescuer to kneel by side of victim Place heel of one hand on middle of victims chest (lower half of sternum) Place heel of other hand on top of 1 st hand Interlace fingers to keep them off the chest Arms straight-shoulder above victim Chest Compression

19. Push Hard (at least 2 inches or 5 cm) Push Fast (at least 100/ min) Minimize interruption Allow Chest recoil Rotate compressor 2min Avoid excess ventilation If no advanced airway 30:2 comp-vent ratio Chest Compression

20. Open Airway Head tilt and Chin lift Jaw thrust Airway

21. mouth to mouth/nose mouth to mask bag mask ventilation (2 rescuers) Breathing

22. 2 Breaths Give breath over 1second Allow 1 second for expiration See visible chest rise If no chest rise reposition and give 2 nd breath If no chest rise again go back to chest compression Compression : Ventilation ratio 30 :2 ( for single and two rescuer) No cricoid pressure Breathing

23. Get AED as soon as possible Continue CPR till AED arrives Immediately after defibrillation start CPR Do not check pulse Minimize (collapse-defibrillation) interval Chance of survival falls 7-10% per min lost if no CPR 3-4% per min if bystander CPR Step 4 Defibrillation

24. If no pulse Check for shockable rhythm with AED/Defibrillator Provide shock as indicated Follow shock with CPR for 2 min beginning with chest compression Step 4 Defibrillation

25. AED

26. Steps Power ON Follow voice prompts Attach pads to patients bare chest Analyze rhythm (stop CPR) Shock (stay clear) Continue CPR (5cycles or 2 min) Rhythm/Pulse check AED

27. ATTACH PADS TO VICTIMS BARE CHEST

28. ANALYSING RHYTHM DO NOT TOUCH VICTIM

29. SHOCK INDICATED Stand clear Deliver shock

30. SHOCK DELIVERED FOLLOW AED INSTRUCTIONS

31. Hairy Chest Press firmly Use jelly Use razor Pull and put new pads Water Implanted pacer Transdermal medication Trouble shooting AED

32. Rescue breaths 10 to 12/min (every 5-6 sec) Give breath over 1second Visible chest rise Check pulse every 2 minutes Pulse present but ineffective breathing

33. Victim Unconscious but Breathing Normally Recovery Position

34. Approach to Patient Unconscious BLS survey for initial assessment After completing BLS use ACLS survey for advanced assessment and treatment Conscious ACLS survey for initial assessment Recapitulate

35. Scene safety Step1 Check Response and Breathing Step2 Activate EMS and ask for AED Step3 Pulse Check if no pulse Start CPR Step4 Defibrillation BLS IN ADULTS Steps 1-2-3-4

36. CAB not ABC

37. SIMPLIFIED ADULT BLS Start CPR Activate emergency response Unresponsive No breathing or no normal breathing (Only gasping) Get Defibrillator / AED PUSH HARD PUSH FAST Shock

38. ADULT BLS ALGORITHM FOR HEALTH CARE PROVIDERS Resume CPR immediately For 2 minutes Check rhythm every 2 minutes; continue until ALS providers take over or victim starts to move Give 1 shock Resume CPR immediately for 2 minutes Check Pulse: DEFINITE pulse within 10 seconds? *Give 1 breath every 5-6 seconds *Recheck pulse every 2 minutes Activate emergency response system Get AED/Defibrillator or send second rescuer (if available) to do this Unresponsive No breathing or No normal breathing (i.e., only gasping) Begin cycles of 30 COMPRESSIONS and 2BREATHS AED defibrillator ARRIVES Check rhythm S hockable rhythm? Definite Pulse No Pulse Not Shockable Shockable

39. RESPONSE CHECK- calling and try painful stimulus 30: 2 compression ventilation ratio if one rescuer; 15: 2 for two rescuers for all paediatric age group. Compression depth- 1/3 rd of AP diameter of chest or less than two inches in a small child. PAEDIATRIC BLS

40. Unwitnessed cardiac arrest- perform CPR and then activate EMS. Witnessed collapse- activate EMS and then perform CPR. PULSE check site- Brachial pulse in a small child; carotid/ Femoral in a large child. Rescue Breath at every 5 seconds.

41. HEIMLICH manoeuvre- abdominal thrusts: stand behind the person and wrap your arms around the waist. place your clenched fist just above the persons navel. Grab your fist with the other hand encircling the victims and give abdominal thrusts. CHOKING -victims

42. THANK YOU