BCLS Conducted in Singapure

Transcription

1 BCLS Conducted in Singapure 1. ADULT ONE - MAN CPR D : Danger R : Response CPR Cycle Re-assesment Look out for unsafe environtment, e.g. Electrical current, Fire, Possible Explosion, Construction works, or Poisonous gas Ensure that the scene is safe for you to help Establish unresponsiveness Call, tap or gently shake the casualty Call out loudly: Hello! Hello! Are you OK? If no response, Call for help Feel for the flow of air from the casualty s nose moving past your cheek If no breathing, Give 2 short breaths (1 sec/breath; Volume of air : ml/breath) Allow lung deflation between each breath Check for pulse / *signs of circulation (6 to 10 seconds) If no pulse or *signs of circulation, start CPR Locate the landmark for chest compression Proper body and hand position Compress vertically 4-5 cm downwards with complete relaxation of pressure after each compression at rate of 100 per minute Say mnemonic 1&2&3&4&5&1&2&3&4&10&1&2&3&4&15&1&2&3&4&20&1&2&3&4&25 &1&2&3&4&30 Perform 30 chest compressions followed by 2 short breaths Assess the casualty for pulse or signs of circulation after every 5 cycles of CPR 30 : 2 If pulse or *signs of circulation is absent, resume CPR 30 : 2 If pulse or *signs of circulation is present, stop CPR and assess for breathing 2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand after each breath Give 12 rescue breaths in 1 minute Casualty is unconscious

2 2. ADULT TWO - MAN CPR Re-assesment Start one-man CPR 30 chest compressions followed by 2 short breaths Appear and say : I know 2-man CPR, can I help? Acknowledge by nodding head and complete the cycle of 30 chest compressions followed by 2 short breaths and then reassess pulse or *signs of circulation (6 to 10 seconds) Locate the landmark for chest compressions while is assessing circulation If pulse or *signs of circulation are absent, says : No pulse, start CPR. Start chest compression by counting : 1&2&3&4&5&1&2&3&4&10&1&2&3&4&15&1&2&3&4&20&1&2&3&4&25&1&2& 3&4&30 Gives 2 short breaths after rescuer 2 has completed every 30 chest compression Repeat the cycles : : deliver 2 short breaths : perform 30 chest compressions Will initiate the switch of roles on the 5 th cycle of 30 compressions, by counting: 1&2&3&4&5&1&2&3&4&10&1&2&3&4&15&1&2&3&4&20&1&2&3&4&25& Switch&2&3&4&30 Will complete the 2 short breaths before moving to the chest to take up compression position Moves to the head and assess for pulse (6 to 10 seconds) and say : No pulse, continue CPR. Assess the casualty for pulse or signs of circulation after every 5 cycles of CPR 30 : 2 or after every switching of roles If pulse or *signs of circulation is absent, resume CPR 30 : 2 If pulse or *signs of circulation is present, stop CPR and assess for breathing 2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand after each breath Give 12 rescue breaths in 1 minute

3 Casualty is unconscious 3. ADULT FOREIGN-BODY AIRWAY OBSTRUCTION (Conscious Unconscious) Conscious casualty Assessment Heimlich Manoeuver Technique (Normal Size) Chest Thrust Technique (Pregnant & Obese) Unconscious casualty Ask : Are you choking? Casualty acknowledges by nodding. Rescuer replies : I can help Stand behind the casualty. Position one foot between the casualty s legs Locate the landmark : Put your arms around the casualty s abdomen and locate for the navel Place 2 fingers breath above the navel and well below the tip of the breastbone (xiphoid process) Make a fist with one hand Place thumb-side of the fist against the abdomen above the 2 fingers spacing Release the 2 fingers spacing but maintain the fist on the abdomen Lean the casualty forward and grasp the fist with the other hand Give successive inward upward thrusts Check if foreign body is expelled after every set of 5 abdominal thrusts Repeat thrusts until the foreign body is dislodged or the casualty becomes unconscious Stand behind the casualty. Position one foot between the casualty s legs Locate the landmark : Place arms under the casualty s armpits to encircle the chest Make a fist with one hand Place thumb-side of fist on the middle of casualty s breastbone Grasp the fist with the other hand and give successive quick backward thrusts Check if foreign body is expelled after every set of 5 chest thrusts Repeat thrusts until the foreign body is dislodged or the casualty becomes unconscious When casualty becomes unconscious. Proceed with the following steps : Position casualty on a firm, flat surface. Call for help Feel for the flow of air If breathing is absent, attempt to ventilate (1 st attempt) If airway is blocked, re-position the casualty s head and re-attempt to ventilate (2 nd attempt) If airway is still blocked, relieve obstruction by : Perform 30 chest compressions (hand position for chest compression is the same as for CPR)

4 Repeat steps A & B until able to give 2 successful ventilations Check pulse or *signs of circulation and if it is absent, resume CPR 30 : 2 If pulse or *signs of circulation is present, assess for breathing 2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand after each breath Give 12 rescue breaths in 1 minute Casualty is unconscious 4. INFANT CPR D : Danger R : Response Look out for unsafe environtment, e.g. Electrical current, Fire, Possible Explosion, Construction works, or Poisonous gas Ensure that the scene is safe for you to help Establish unresponsiveness : Call, tap or gently shake the infant s shoulder to elicit response Activate Emergency Medical Service if second rescuer is available Feel for the flow of air from the casualty s nose moving past your cheek If no breathing, Give 2 short breaths (1 sec/breath; Volume of air : 30 ml/breath) Allow lung deflation between each breath Check for brachial pulse / *signs of circulation (6 to 10 seconds) If no pulse, start CPR Locate the landmark for chest compression : Draw an imaginary line between nipples Place index finger on the imaginary line Place your middle and ring fingers next to the index finger Move the 3 fingers to the centre of the sternum (breastbone) Position the fingers upright Lift up the index finger but maintain the middle and ring fingers on the sternum (breastbone) Lean forward and place your cheek near the infant s mouth and nose Use your middle and ring fingers to compress the sternum (breastbone) by about 2 cm Demonstrate correct technique of compression Keep fingers on the sternum during upstroke Say mnemonic 1&2&3&4&5&1&2&3&4&10&1&2&3&4&15&1&2&3&4&20&1&2&3&4&25&1&2 &3&4&30 Compression rate is at 100 per minute

5 CPR Cycle Perform 5 cycles of 30 chest compressions followed by 2 short breaths for approximately 2 minutes Activate EMS if it is not done earlier Assess for pulse or signs of circulation after every 5 cycles of CPR 30 : 2 If pulse absent, continue CPR 2-a-thousand, 3-a-thousand after each breath Give 20 rescue breaths in 1 minute Infant is unconscious 5. INFANT FOREIGN-BODY AIRWAY OBSTRUCTION (Conscious Unconscious) Conscious casualty Assessment Back Blows & Chest Thrust Re - assessment Unconscious casualty Assess for signs of complete airway obstruction (choking) If infant is choking, attempt to relieve the airway obstruction immediately Support the infant s head and body between your hands and forearms using the Sandwich Manoeuvre Hold the infant s face down and rest your forearm on your thigh Keep the head lower than the trunk Deliver 5 back blows forcefully between the shoulder blades with the heel of your other hand Support the infant s head and body between your hands and forearms after delivering the 5 back blows Turn the infant over on his/her back, resting on your thigh Keep the head lower than the trunk Deliver 5 chest thrusts over the lower half of the sternum (breastbone) by counting aloud 1,2,3,4,5. (landmark for chest thrust is the same as for infant CPR) Check if foreign body is expelled after every set of 5 back blows and 5 chest thrusts and remove if it is visible If the foreign body is expelled successfully, assess the infant for pulse and breathing If the airway remains obstructed and the infant is conscious, repeat the sequence of 5 back blows and 5 chest thrust When infant becomes unconscious. Proceed with the following steps : Position infant on a firm, flat surface. Call for help Feel for the flow of air If breathing is absent, attempt to ventilate (1 st attempt) If airway is blocked, re-position the infant s head and re-attempt to ventilate (2 nd attempt)

6 If airway is still blocked, relieve obstruction by : Perform 30 chest compressions (The landmark and technique for chest compression is the same as for CPR) Repeat steps A & B until able to give 2 successful ventilations Check pulse or *signs of circulation and if it is absent, resume CPR 30 : 2 If pulse or *signs of circulation is present, assess for breathing 2-a-thousand, 3-a-thousand after each breath Give 20 rescue breaths in 1 minute Infant is unconscious