Basic Life Support NCORT KK Gemencheh 2024.pptx

BLS

1. UPDATE ON BASIC LIFE SUPPORT BLS FOR HEALTHCARE PROVIDERS DR THULASI DEVI RAJU Basic Life Support Training Manual ,2nd Edition 2023

2. TOP MESSAGES EARLY RECOGNITION OF CARDIAC ARREST ALERT EMS/ 999 EARLY HIGH QUALITY CPR EARLY AED USAGE

3. Chain of survival The key observations are unresponsiveness and not breathing normally Defibrillation within 3–5 mins of collapse produce survival rates 50–70%.

4. CPR Principles 999

5. DANGER Ensure area is safe for yourself, patient, others and environment

6. Tap victim on the shoulder Hello….are you ok? Can you hear me? RESPONSE

7. Call 999 Bring AED / Emergency trolley SHOUT

8. Open Airway Head tilt-chin lift Head tilt : place one hand on the forehead and not the eyes, to tilt the head back Chin lift : place fingers of the other hand on the bony part and not the soft tissue of the jaw, to lift the chin AIRWAY

9. Jaw Thrust

10. BREATHING LOOK, LISTEN, FEEL FOR BREATHING , AND PULSE PRESENCE <10 sec

11. Breathing Absent or abnormal breathing < 10s - treat as sign of cardiac arrest start chest compression If in doubt --> treat as abnormal breathing start CPR PULSE +, ABNORMAL BREATHING -> RESCUE BREATH (1 BREATH EVERY 6 SEC)

12. CIRCULATION

13. High quality CPR - Site: middle chest, lower half of sternum - Rate: 100 to 120 compressions per minute - Depth: at least 5 cm and not greater than 6 cm - Complete recoil of the chest - Minimize interruption on chest compression - Compression to ventilation ratio 30:2 - Ventilate adequately, each breath delivered over 1 second with visible chest rise

14. Figure 6 : Two hands technique (E-C clamp technique) Figure 5 : One hand technique (E-C clamp technique) Each breath should be given over 1 second inspiratory No BVM, CPR only BVM VENTILATION

15. DEFIBRILLATION Once AED or Defib machine available : Attach machine and check rhythm , shockable/ non shockable

16. AED, Defibrillator ARRIVES SHOCKABLE RHYTHM? YES NO Give 1 shock Resume CPR For 5 cycles Resume CPR For 5 cycles and CHECK RHYTHM ; Cont. till ALS Provider take over, victims start to move

17. Reassessment during CPR After 5 cycles / 2 minutes Normal breathing check Pulse check Analyze rhythm

18. When to stop CPR Victim recovers with normal breathing HCW is exhausted Assistance arrives to take over CPR Safety of provider can no longer be sufficiently assured Obvious mortal injury or irreversible death Asystole for more than 20 minutes despite ongoing BLS in absence of reversible cause SIGNS OF RECOVERY : - WAKING UP/ MOVING/OPENING EYES/ NORMAL BREATHING

19. Recovery position

20. Airway Adjuncts ET

21. If you are uncomfortable with intubation techniques required and ventilation is adequate If patient’s condition improves during intubation attempts If respiratory arrest is reversible with drugs If patient has a deformity of the airway or neck but stable If patient has a DNR order Guidelines on when NOT to intubate

22. TAKE AWAY MESSAGE Recognise and start early high quality CPR Minimise interuptions during CPR Early AED usage Intubate if skillful and decide if really in need Suction <10sec Epinephrine during the third CPR cycle, and every 3-5 min afterwards

23. NO RESPONSE / MOVEMENT CALL FOR HELP Get AED / Defibrillator Open AIRWAY, Check BREATHING If NO Breathing/ Gasping Give cycles of 30 compressions and 2 breath Until AED, Defib , ALS Provider take over, victims start to move Push HARD and FAST (100-120 /min) and release completely Minimise compression interruptions AED, Defibrillator ARRIVES SHOCKABLE RHYTHM? Give 1 shock Resume CPR For 5 cycles Resume CPR For 5 cycles and CHECK RHYTHM ; Continue till ALS Provider take over, victims start to move YES NO

24. Adult Foreign Body Airway Obstruction Definition: severe difficulty in breathing because of a constricted or obstructed throat or a lack of air

25. Recognize FBAO Witness episode Coughing or choking, gagging, stridor Sudden onset respiratory distress Recent history of playing with or eating small objects Universal sign

26. Adult with FBAO Algorithm

27. Effective Vs Ineffective cough Effective cough Crying or verbal response to questions Loud cough Able to take a breath before coughing Fully responsive Ineffective cough Unable to vocalize Quiet or silent cough Unable to breathe Cyanosis Decreasing level of consciousness

28. If cough is ineffective, i n conscious patient, give 5 back blows following with 5 abdomen thrust/chest thrust

29. DURING PANDEMIC

30. THANK YOU