EMERGENCY LIFE SUPPORT GUIDELINES For further information contact: Karen Davey,

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1 For further information contact: Karen Davey, CHD Nurse Block A, Mamhilad House, Mamhilad Park Estate, Pontypool, Torfaen NP4 0YP Tel: Fax: ADULT EMERGENCY LIFE SUPPORT GUIDELINES

2 Introduction TES &COMMENTS This booklet is for the benefit of those undertaking adult emergency life support training courses run by Heartstart UK following the Resuscitation Council (UK) 2000 Guidelines. Emergency life support is the name given to procedures undertaken in a lifethreatening emergency. Procedures for treating cardiac arrest, dealing with an unconscious casualty, severe bleeding and choking are covered in the booklet. To live, we need a regular supply of oxygen to all parts of the body. In particular, the heart and brain will become severely damaged if they are deprived of oxygen for more than a few minutes. To keep the heart and brain supplied with oxygen, three things are essential: Airway: Breathing: Circulation: Resuscitation: an open and clear airway through which air containing oxygen can pass to the lungs a process that delivers air into the lungs where oxygen can enter the blood stream. which requires a pumping heart together with sufficient blood in the blood vessels to carry oxygen from the lungs round the body. is the term used for the emergency treatment needed to overcome the failure of one or all of those functions. It may consist simply of opening the airway and turning an unconscious person onto their side, or it may mean breathing into that persons lungs and pressing on the chest to make oxygenated blood circulate round the body. This booklet is designed to help provide you with sufficient knowledge and confidence to give emergency treatment if the need arises 1 10

3 Control of Severe Bleeding BACKGROUND Emergency Life Support (E.L.S.) includes control of severe life threatening bleeding. TREAT WOUNDS BEFORE SUMMONING HELP Wear rubber gloves if available. Leave in situ Apply pressure either side of the wound Elevate the wound if possible Sit or lay the casualty down Examine the wound site FOREIGN OBJECTS Examine the wound site. Apply pressure over the wound Elevate the wound if possible Past studies into Emergency Life Support (E.L.S.) have shown that if a Chain of Survival can be established, the survival rates from cardiac arrest can be increased considerably. Chain of Survival The first two links in the chain are provided by the person who witnesses the arrest. If effective E.L.S. is not provided by this witness, there is little that can be done once professional help arrives in terms of Defibrillation or Advanced Life Support (A.L.S.) Early Access If the Emergency Services are to be effective, it is essential that they arrive quickly. This means they need to be notified as early as possible. Early CPR Early Cardio-Pulmonary resuscitation is to buy time and maintain an artificial circulation until professional help arrives. Early Defibrillation This it the use of a Defibrillator by trained personnel to send an electric shock to the heart. SEEK HELP NEVER USE A TORNIQUET! This can increase blood loss and cause damage to limbs REMEMBER TO DIAL 999 OR 112 FOR AN AMBULANCE REMEMBER TO DIAL 999 OR 112 FOR AN AMBULANCE 9 2 Early Advanced Cardiac Life Support The administration of drugs and insertion of a tube to secure the airway is essential to maintain the resuscitated casualty during the most crucial stage. This would be undertaken by Paramedics.

4 OPENING THE AIRWAY The Recovery Position Obstructed Airway Head Tilt Chin Lift 1 Kneel beside the casualty. Place the arm nearest to you at right angles to the body, elbow bent and with palm uppermost. 2 The tongue and jaw drop back and obstruct the airway. Hand on forehead tilts the head backwards. Tongue still obstructs the airway. Maintain head tilt and at the same time lift the chin up to pull tongue clear of the airway The tongue and jaw of an unconscious patient lying on their back will drop backwards and obstruct the airway. If this is allowed to happen the patient will not be able to breathe. The diagrams above show the tongue obstructing the airway until the chin is lifted. Once the chin is lifted, the tongue, (which is attached to it) will lift clear of the airway allowing air to pass to the patient s lungs either unaided or when rescue breaths are performed. Bring the far arm across the chest, and hold the back of the hand against the persons nearest cheek. 3 Adjust the upper leg so that both the hip and knee are bent at right angles. Re-check breathing at least once every minute. 4 4 With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground. Keeping the hand pressed against the cheek, pull on the leg to roll the person towards you onto his/her side. 3 8

5 Care of the Unconscious Casualty Adult CPR CHECK FOR DANGER BREATHING Shout and shake Call for help CHECK (danger) Shout & Shake Head tilt, chin lift, check for normal breathing, take no longer than 10 seconds to do this BREATHING Turn patient into the recovery position Dial 999 or 112 for an ambulance Shout for help Head tilt Remove visible obstructions Chin lift Look, listen and feel for breathing for up to 10 seconds Leave the casualty in the position found Dial 999 or 112 for an ambulance Breathing Normal? Place in the recovery position Start chest compressions immediately. Do not check for signs of circulation 30 chest compressions 2 rescue breaths Do not stop unless you become physically exhausted or until professional help arrives If you are on your own get an Ambulance immediately On return give 30 chest compressions Do not look for signs of circulation Cont d Two rescuer CPR: If there are two rescuers one carries out CPR while the other rests and then change over after 2 minutes 7 4

6 Adult CPR continued Care of the Choking Casualty Cont d After 30 compressions open the airway again using head tilt chin lift Pinch victims nose Take a normal breath Seal your lips around victim s mouth Return your hands without delay to the correct position on the chest and give a further 30 compressions Continue with chest compressions and rescue breaths in a ratio of 30:2 Continue resuscitation until: Qualified help arrives and takes over You the rescuer becomes exhausted Remember tto Diiall 999 or 112 ffor an ambullance Compression only CPR: If you are unable or unwell, to give rescue breaths give chest compressions only Press at a rate of 100 a minute Stop only if you become physically exhausted Otherwise do not interrupt resuscitation Two rescurer CPR: If there are two rescuers one carries out CPR while the other rests and then change over after 2 minutes Can he/she talk or cough? Instruct the victim to lean forward (if possible) Give up to 5 back blows (Using the heel of one hand between the casualty s shoulder blades). SUCCESSFUL? Deliver up to 5 abdominal thrusts SUCCESSFUL? Repeat the above procedures, if necessary, and be prepared to resuscitate Encourage him/her to cough Observe and seek help Dial 999 or 112 for an ambulance DO T PERFORM BACK BLOWS OR ABDOMINAL THRUSTS AS LONG AS THE PATIENT CAN COUGH 5 6

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